My Experience with Allergic Contact Dermatitis + Skin Allergy Testing
I put up a poll on Instagram last week asking if you were interested in my experience with Allergic Contact Dermatitis and the series of skin allergy testing which I went through last Summer and it was a resounding YES. So...here it is. In the form of a blog because there is 0 way this was going to fit in the word count of any other platform.
I also want to put out a DISCLAIMER... this is my PERSONAL EXPERIENCE. Everyone is different. Every body is different. Everyone's skin is different. Everyone's allergies are different. My allergies and reactions are completely independent of anyone else's and just because I had these experiences and reacted a certain way does not mean you are going to react the same. Just throwing that out there...!
My Allergic Reactions
I have suffered from skin issues most of my life. None have ever been acne related but skin conditions such as psoriasis, rosacea and eczema have been predominant for most of my life. But a skin allergic reactions were something I didn't start experiencing until my mid 20's.
The first time I had an allergic reaction was in 2015 while I was living in Vancouver. I don't know what happened, but I ended up with raised red bumps around my eyes, across my jaw and had blotchy red patches all over my cheeks, neck and chest. I had zero clue what was going on, and figured I must have eaten something strange. I ran across the road to the local Shopper's Drug Mart and straight to the pharmacist on duty and he told me I was suffering from an allergic reaction to something I had touched and not consumed. He gave me some hydrocortisone and antihistamines and my face cleared up within a few days. I honestly didn't think too much of it again until years later.
When I moved to Ontario in January 2019, I noticed a couple of months in that I was developing similar reactions to the one I had experienced years before. I was getting itchy, large rashes, severe dry skin around my nose and mouth as well as swollen patches on my cheeks and again around my eyes. I was honestly a hot mess. Shit was not cute.
During the Summer of 2019 and I vividly remember waking up that morning to go and meet with a friend and my face was on FIRE. I went into the bathroom, looked in the mirror and I am pretty sure I let out a light yelp. My face was so swollen, raw red, covered in a rash and was burning. So, I marched my ass over to the walk in clinic and as soon as the doctor saw me she let me know that I was having an allergic reaction to something I had most likely come into contact with a few days before. I was convinced that it had something to do with my food allergies but she reassured me that it was not linked at all and that it was something I had physically come into contact with. Same thing, she gave me a hydrocortisone cream and a repeat prescription for some stronger antihistamine tablets and told me to apply the cream 4 times a day for 5-7 days and take the tablets until it cleared up. It was at this point that she strongly suggested I get allergy testing done.
I'm going to be perfectly honest here. I put it off. I went through various skin reactions on my face every few months for most of 2019 and into early 2020. I couldn't put it off any longer. I knew it wasn't food allergies. I knew it was something different and I couldn't keep slathering on hydrocortisone cream every time I had a flare up. I needed to fix it. But then just as I made the call to finally get the testing done, the world shut down. I wasn't able to get into any clinics. I started to take pictures everytime I had a reaction so that I could show my doctor and managed to do a virtual appointment with my family doctor who referred me to a skin allergy specialist.
So, we were off to the races. I did a phone consultation with the allergist and she confirmed that what I was experiencing was without a shadow of a doubt contact allergy dermatitis and we needed to perform some testing to see what exactly it was that was triggering the reactions.
I had to wait 5 months before I was able to go in for the testing but she had briefed me well in advance of going in so I knew exactly what to expect. We were going to carry out a patch allergy test and the process was going to be done over five days.
Skin Prick Test
The first appointment was on a Monday. I had a skin exam done and the doctor recommended that we first start with a Skin Prick Test to test for common household and environmental allergens such as animal hair, dust, pollen, grasses, flowers, trees etc.
The test consists of the skin on your forearm being "pricked" with a series of common allergens in the form of liquids. You are then numbered and left for about 15 minutes to see if a reaction appears in the form of a red, bumpy rash. As you can see from the picture below, I had some allergens detected. The picture on the left is before and the one on the right was taken after 15 mins were up.
I tested positive for allergens to dust and dust mites and a mix of grasses which consisted of timothy, rye, sweet vernal, orchard, red top, fescue and kentucky.
My doctor pointed out that the most important result from this test was the positive test result for timothy grass. She explained that timothy grass is one of the most common grass variants in Ontario and is used mainly for the production of hay. I was living in Burlington and surrounded by farm land so she explained to me that this was most likely why I was noticing so many reactions since moving to the province. As for the dust allergy, the only way to combat that is with frequent cleaning, reducing the amount of rugs and soft furnishings in the house such as throw pillows, curtains etc. She also recommended that I made sure to wash all my sheets, cushion covers etc at least once a week. None of this was a big concern for me but was really good to know.
The results to the skin prick test were not too much of a shocker as I suspected that grass, hay and dust allergies may have been an issue as I do suffer from hay fever during the summer months. She explained to me that there was little to be done with regard to these as I couldn't change my environment but recommended that during times where I was over exposed to take an antihistamine as I would when suffering from hay fever during the spring and summer months. There was also the option to get some shots done periodically but I opted for the antihistamines instead. She also prescribed me a nasal spray which she said I could use when times where my hay fever was really bad. Luckily, I have only had to use this a few times.
The biggest relief from this test was that I wasn't allergic to my dog or any other animals such as horses or cats. THANK GOD. And I already had way more answers just from this one test alone. We were off to a great start!
Patch Allergy Test
The next step was to conduct a patch allergy test. This test takes a few days to complete and is used to detect delayed allergic reactions. The test is conducted by allergens which are applied to patches and then placed on to your skin on your back. The patches are left for a few days to see if there is a reaction to any of the substances applied. I had patches which tested for 80 substance extracts placed on my back but the number really can vary. It is also worth noting that if you have any cosmetics, skincare products, make up products, cleaning products etc. which you think you may have an allergy to, you can bring these to your appointment and the doctor can add these to a patch to check which is pretty awesome!
The patches were applied after the skin prick test was complete and I was strapped up. I was told in preparation to this first appointment that this test was going to be conducted and that I needed to be prepared to not shower or interfere with the patches for two full days. The patches were applied and I was instructed to go home and come back in again on Wednesday for the patches to be removed and an initial reading to be conducted.
So off I went home. Keep in mind it was the middle of summer in Ontario and in the mid-high 30's (°c) so I was pretty uncomfortable for the following 48 hours. I was instructed not to shower, not to exercise and to try and sleep on my front so that the patches didn't become loose.
And then there was the itching. I knew I was definitely reacting to something because my skin was burning beneath the patches. Like...B.U.R.N.I.N.G. It was so uncomfortable but I actually was excited at the same time because I knew this wasn't going to be in vain as I was clearly reacting to multiple patches. I knew I would have more answers soon.
I went back in on the following Wednesday morning to have the patches removed. OH SWEET RELIEF. The nurse was so lovely and removed all the tape gently as those patches were really stuck on there. The allergist came in and she said I had 6 areas which were showing signs of a reaction. She drew squares around the areas and re-numbered them and then told me to go home, try not to scratch and make sure I still didn't exercise or shower. She didn't tell me at this stage what the reactions were and I didn't ask, I knew that when i went in for my final reading on Friday morning that I would be given the full lowdown.
48 hours later and I was back in the office. The allergist came in and did a final reading and measurement of the reactions on my back. The reactions looked basically like large circles of severe psoriasis. Large raw red blobs. Cute right? She got to work, documenting everything and told me that she was going to get some print outs and would give me my full list of reactions.
Contact Allergy Dermatitis: My Allergen Results
So what am I allergic to? You may be shocked to discover that all of my most severe reactions from my patch test came from predominantly NATURAL ingredients but there were some chemical compounds which came back positive too.
- Amyl Cinnamal is a synthetic compound which is found in cosmetics. It is a fragrance which smells like a tropical scent but also jasmine and floral scents.
- Cinnamyl alcohol is a cinnamon fragrance which can trigger a skin reaction and is found in a lot of skincare and make up products.
- Cinnamal is a common additive in the cosmetic industry and is also found naturally in chamomile essential oils. It is used as a fragrance ingredient and comes naturally from the bark of cinnamon trees.
- Eugeno is a liquid which is extracted from clove oil, nutmeg, cinnamon, basil and bay leaves. Very common in dental treatments and products.
- Geraiol is a monoterpenoid and an alcohol and is a fragrance material that has been known to be a frequent cause of contact allergy dermatitis. It is the primary component of rose oil, lemongrass, lavender and citronella oil and other aromatic plants.
- Hydroxycitronellal is a common scent ingredient which is synthetically produced from the naturally occurring scent chemical citronellal (lemon aroma). It has a role as an anti-fungal agent and a metabolite in cosmetics, aromatherapy and skincare products.
- Isoeugenol occurs in the essential oils of plants such as ylang-ylang and is used as a flavouring agent in cosmetics as well as a fragrance.
- Oakmoss Absolute is solvent extracted and is used in natural perfuming. It is a long lasting perfume on the skin.
- Acetic acid is the main organic compound found in vinegar.
- Glycerol Thioglycolate, Glycerol monomercaptoacetate, Glycerol Monothioglycolate and Mercaptoacetic Acid are acids used in permanent hair waving solutions and hair dressing practices and can remain in hair for months after exposure.
- Balsam of Peru is a natural liquid which comes from the bark of Balsam trees and is used as a fragrance, flavouring and antibacterial agent in cleaning supplies, shampoos and conditioners, essential oils, aromatherapy products and more.
- Imidazolidinyl Urea is an antimicrobial preservative that works by forming formaldehyde in cosmetic products.
- Ylang-ylang Oil is an essential oil which comes from flowers of the Ylang Ylang tree and is used extensively in making perfume, make up, skincare, hair care and aromatherapy products.
But what is Contact Allergy Dermatitis?
Contact Allergy Dermatitis is a red, itchy rash which is caused by direct contact with a substance or having an allergic reaction to it. It is not a contagious rash but it is damn uncomfortable. The substances that can cause these reactions include ingredients and chemicals found in jewelry, plants, cosmetics, make up, cleaning products and more.
When a person has a sensitivity to certain substances even just one time, the skin reaction which appears in the forms of itchy, pinkness, small bumps and even blisters can appear as quickly as 4 hours but usually takes 1-3 days to appear after initial contact. The reaction itself can last from 2-8 weeks even if you don't come into contact with the substance again. I KNOW. Crazy.
If your body has many exposures over time, it can take 3-6 months for your skin to get better AFTER you start avoiding the substances. There will be brief flare ups if you are avoiding these products all together but if you do come into contact with the ingredients again it can cause a huge set back in your recovery. I definitely still experience flare ups and sometimes I will use something and notice a reaction within a matter of hours. It is frustrating, but it is just part of the process and every mistake I make is a learning.
The craziest thing is learning that allergies develop from repeat exposures and it is because of this that we become allergic to them. Once you develop these allergies, they will always trigger a reaction so they should be avoided forever.
What happened afterwards?
Armed with my new list of allergens, the allergy doctor then emailed me a pdf the same day which is basically now my BIBLE for all products in cleaning, skincare, beauty, medications and make up which are safe for me to use and do not contain any of the ingredients, chemicals and fragrances which I am allergic to. The main use for this is for purchasing make up. I am able to go down to "Skincare - Foundations" for example and choose from an approved list. The document is vital and so beneficial as it contains common brands that you can find at the drug store, Sephora etc. and makes shopping for make up products in particular so much easier.
In addition to my new bible, I went home and pulled literally every single cleaning product, hair product, make up item, skincare item etc out and went to work on websites such as Skin Safe Products and was able to dispose of all the products which contained harmful allergens. The results were pretty shocking. Nothing I was using bar maybe 5-6 items were OK for me to continue to use. It was a deep blow but explained why I was reacting as some of the products I was using everyday like toothpaste, my moisturizer and my shampoo and conditioner which were just some of the many products that contained harmful ingredients for my skin type.
If you made it to this section, fair play. There is a LOT of information above. Would I recommend it? ABSOLUTELY. If you are someone who suffers from dry skin, reactive skin, rashes, blisters etc then you need to have answers. Don't do what I did and just put it off and suffer for months or even years. Although it is a pain in the ass being allergic to so many common ingredients at least I know and at least when I do have small flare ups I know exactly what the reason is and what it was that I did differently. Before doing these test I was convinced that the reactions on my skin were linked to my food sensitivities and allergies and they are not linked AT ALL.
As the testing was a referral from my family doctor I did not have to pay for the testing with the Allergy Doctor. I do not know what it is like in other countries or even other provinces so please ensure you check beforehand!
- Contact Dermatitis Institute
- Skin Safe Products Database
- Pubchem National Library of Medicine
- An unexpected positive hypersensitive reaction to eugenol
- Cinnamal Cosmetics Info
- Amyl Cinnamal Cosmetics Info
- Allergy Skin Tests - Mayo Clinic
- Timothy Grass Canada
- Amyl Cinnamal | Lush Fresh Handmade Cosmetics
- EWG Skin Deep® | What is ISOEUGENOL
- EWG Skin Deep® | What is HYDROXYCITRONELLAL
- Oakmoss Absolute | The Apothecary in Inglewood
- Allergy to glyceryl monothioglycolate
- Thioglycolic Acid | Cosmetics Info
- Glyceryl monothioglycolate | Allergic Contact Dermatitis Institute
- Balsam of Peru | Allergic Contact Dermatitis Database
- EWG Skin Deep® | What is IMIDAZOLIDINYL UREA ..
- Ylang Ylang Oil | dōTERRA Essential Oils
- Contact dermatitis - Symptoms and causes - Mayo Clinic