Archive for Hives


Itching without a rash may not be an allergy

Itching is a common symptom seen often in the allergist/immunologist’s office. However, if the patient is itching without a preceding rash, there are a list of numerous possible causes and include non-allergic conditions. We first need to determine whether the cause of itching is derived from the skin or another organ system. Itching that is not caused by a skin condition usually does not have a rash, although some patients can develop a secondary rash.

Several circumstances can cause itching without a rash and can be due to systemic, neurologic, or psychiatric conditions. A few examples of systemic conditions include kidney disease, liver disease, hyperthyroidism, lymphoma, polycythemia vera, and HIV infection. Narcotic medications can have itching as a side effect, as well as nerve injury from shingles or spine disease, as they can cause localized itching at the affected area. Lastly, psychiatric conditions such as substance abuse or obsessive-compulsive disorder can also lead to itching.

The management of itching without rash should start with evaluating for and treating the underlying cause. There are a variety of remedies available for symptomatic relief; moisturizing the skin, keeping nails short, wearing loose clothing and taking antihistamines. While antihistamines are often used for itching, studies suggest that first generation antihistamines only help itching by causing sedation.

There are more successful, prescribed oral medications available which can be slowly increased to minimize side effects.

If you have questions regarding an allergic condition, I invite you to come in for a consultation.

For more on allergy triggers, visit my website NYC Allergy Doctor.

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Shut Inside this Winter?

We shut out winter’s cold by sealing windows, cutting drafts and weatherproofing our living areas.  And as we insulated ourselves from the outdoors, we are also sealing in several allergens that can trigger allergy symptoms despite January’s bitter temperatures.

Pet dander.

Your pets are your babies. They are spending less time outdoors and more time in the same dry air environment drying out their skin and yours. Pet allergy symptoms may increase during winter months. Give yourself a safe haven – don’t let Fifi sleep on your bed or groom herself on the couch. Vacuum more often and have someone less susceptible brush your pets between groomings.


As the heat inside goes up – moisture trapped in walls, basements and bathrooms can trigger mold growth. While most molds are benign, those susceptible to mold spores can find allergy symptoms disarming; troubled breathing, sneezing, runny or stuffy nose, itchy eyes, throat and/or inside of ears, hives, swollen eyelids, coughing, and wheezing.  A simple blood test can confirm if your symptoms are attributed to a mold allergy. If mold is to blame, it is important to remove the source of the mold to successfully eliminate it; repair leaks, ventilate the bathroom, discard old periodicals and newspapers and use a dehumidifier in damp basements.


Although there is no “Allergy to People” diagnosis, as we are forced indoors we may find ourselves a little shorter with our coworkers, mates and children. Stress lowers immune responses and can lead to increases in cold and flu and even hives. Winter Blues (more casual connotation) or Seasonal Affects Disorder can be attributed to lack of quality time outdoors and decreased exposure to sunlight. For example, many of us are leaving for work at dawn and home after dark, missing out on sunlight and fresh air.  Maximize your exposure to sunlight, if possible sit near a window at work or lunch. Plan activities and outings to break up your winter routine. Vacation in the summer? Why not take a few days off in the winter to relax and unwind? For more serious depression, see a specialist.

If you have any questions regarding winter allergy symptoms, feel free to give my office a call. I’d be happy to set up a consultation to help improve your quality of life; enjoy winter while waiting on spring.

Having sinus problems? Visit this post for several tips to ease sinus pain









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An Allergy Can Turn You Into A Reluctant Vegeterian

I have a friend, a retired doctor, who is a vegetarian. He is strict and won’t eat any red meat, chicken or fish. I know that eating vegetarian is healthy, but once and a while I like a pastrami sandwich, you know what I mean.

But for some people, being vegetarian is not a matter of choice.

Doctors across the country are seeing a phenomenon in which people are suddenly allergic to meat because they were bitten by a certain type of tick.

Most people associate tick bites with other diseases, such as Lyme disease. But this tick is different. Called the Lone Star tick, named for the state of Texas–it has caused severe allergic reactions in people who have eaten a burger or a steak and has landed them in the hospital. The allergy has spread from the Southwest and the East and is spreading to other parts of the US.

An interesting article in Science Daily quotes Vanderbilt University Medical Center’s Dr. Robert Valet who says, “it is not completely understood exactly how the allergy starts. The thought is that the tick has an alpha-gal sugar in its gut and introduces it as part of the allergic bite and that causes the production of the allergy antibody threat then cross-reacts to the meat.”

Vanderbilt reports seeing one or more new cases each week.

In the Wall Street Journal, Dr. Erin McGintee, an allergist on Long Island has reported to have seen as many as 200 Lone Star tick cases in the last three years. She says “the symptoms can occur as long as eight hours afte eating meat rather than immediately.

Allergic symptoms, said Dr. Valet, can range from the hives and swelling, to broader ones such as vomiting, diarrhea, trouble breathing, and a drop in lood pressure. Other symptoms such as itching can be treated with antihistamines, but severe or broader ones can only be treated with epinephrine.

People who have suffered an allergic attack are encouraged to carry an EpiPen in case of a reoccurance of symptoms from cross-contimination of any food associated with red meat.


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Hives And Itching–The Psychogenic Factor

Not long ago, a young woman walked into my office with hives. She looked stressed. So I asked her about the hives and she said she didn’t know how they started. I then asked her to tell me about herself, and her job. She asked me why I was inquiring about these aspects of her life. I said to her “I need to know what I need to know. I need to know to better treat you.” She was reluctant, but then told me a lot about herself.

The patient lived on the Upper West Side and worked in a high-stressed business. She hated her job because of the pressure but said she took this job because she wanted the best private schools for her children and that she needed a lot of money. But it appeared she didn’t spend too much time with her children because she was working so hard. And that she didn’t have much personal time. I told her “look, your hives are being caused by the stress of this job and if you don’t deal with this stress they would become worse.” She cried but I think she got it.

A lot of allergies, particularly hives, can have a psychogenic factor. Hives, also known as pruritus often have a psychopathology associated with symptoms. According to the website,, “types of psychopathology that may be associated with this type of pruritus include individuals with compulsive or impulsive disorders, or delusional disorders…In some cases, it may be difficult to establish whether it is the sensation of itching that provokes the desire to scratch or whether pruritus is a consequence of compulsive scratching.”

In another interesting article on the subject by the American Academy of Allergy, Asthma & Immunology it states “psychogenic itch is induced in response to the chemicals serotonin and norepinephrine. These chemicals influence stress, depression and delusional parasitosis (a false belief of parasite infestation). It can be treated with anti-depressants and antipsychotic medications.”

An allergist/immunologist that has experience in identifying psychosomatic symptoms of hives and itching can successfully treat the disease and its symptoms.

To learn more, visit

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