What to do in case of a food allergy on the skin?

If a food allergy only affects the skin and does not appear to pose a risk of anaphylactic shock, it is not necessary to alert emergency services. However, it is advised to consult a doctor promptly to ensure this and receive appropriate treatment. Most often, antihistamines are prescribed to reduce allergic symptoms. As their name suggests, these medications work by blocking the specific receptors of histamine, thus preventing the attachment of this mediator and the cascade of inflammatory reactions it triggers.

In cases where antihistamines are ineffective and the allergic skin reaction persists, a doctor may prescribe dermocorticoids, such as hydrocortisone or betamethasone. These creams reduce local inflammation by inhibiting the release of pro-inflammatory cytokines and reducing the activity of the transcription factor NF-κB through the activation of the IkB gene transcription, thereby helping to alleviate inflammatory symptoms. However, corticoids should not be used over an extended period as they can lead to thinning and weakening of the skin.

Once the reaction is managed, it is crucial to ensure that it does not recur in the future by proceeding with the elimination of the responsible food allergen. To do this, it must first be identified, which can be done during an allergy assessment conducted by an allergist. Most often, a prick test is performed. This test involves placing a drop of several allergens on the skin, then lightly pricking it to allow the substances to penetrate the epidermis. In case of an allergy, swelling, redness, or itching appear within a few minutes at the injection point of the allergen.

If the prick test does not yield results, the allergist may perform a specific IgE assay, which involves a blood test. To be considered normal, the total IgE levels in the blood should be less than 150 IU/ml (International Units per milliliter). If this value is exceeded, an allergy is suspected.

The identification of the responsible food allergen must absolutely be done with an allergist and not independently at home, in order to avoid a new allergic reaction, potentially serious.

Once the allergen is identified, it is essential to adapt one's diet to prevent recurrences. This involves completely eliminating the offending food and carefully reading the labels of food products to spot potentially hidden allergenic ingredients. Terms such as "traces of" or "produced in a facility that handles allergens" should not be overlooked and can alert to the allergenic potential of a food.

Informing your loved ones is also a good practice to adopt when suffering from food allergies, especially if they often invite you to lunch or dinner. In addition, it's beneficial for them to know how to recognize the signs of a severe allergic reaction, such as anaphylaxis. Explaining to those around you how to use an adrenaline auto-injector pen can also make a difference in an emergency situation.

Note : Just because your child suffers from a food allergy doesn't mean they can't have lunch at the cafeteria. If you wish to enroll them, you simply need to establish an Individualized Welcome Plan (IWP) with their school.