What to do when antihistamines don't help a rash

DebE13 · Post by **DebE13** » Mon Sep 15, 2014 5:18 am

I was out in my garden doing some fall work and as usual something out there doesn't like me. A day later the rash/welt developed across my cheek (just one side this time) and I can't get it to go down. It is red hot, usually take a couple weeks to go away, and ends almost like a sunburn by peeling a bit. It's a bit puffy in the cheek area and a lot puffy around my eye. My eyeball feels fuzzy and gross but that's due to the inflammation. I took two Allegra the morning I woke up with it and used the topical Allegra cream. Didn't help much. That evening I took two Benadryl and it really hasn't changed much either which is odd because it normally helps.

Does any one else have this type of reaction? I usually just ride it out until it goes away but it is bothersome having my eye feel so squishy because of the inflammation. It isn't anything I want to see a doctor about because it will be an expensive visit to have her tell me to take some antihistamines. Is there a better brand to try?

Staying indoors and out of the garden is not an option.

It seems the things I love most give me problems.

Post by **tex** » Mon Sep 15, 2014 7:20 am

Hi Deb,

That sounds like a pretty potent welt. The thing about antihistamines is that they are designed to block histamine receptors by attaching to them (and thereby preventing them from attaching to anything else). This has to occur before histamine attaches to the receptors, because once histamine has attached to a receptor, then that receptor is activated, and it will go on to promote additional proinflammatory events.

So if a welt is already in place (as an indicator of an on-going reaction), the best that an antihistamine can do is to prevent further exacerbation of the reaction, and/or prevent the reaction from being continued. That said, most IgE-type reations fade away relatively quickly, when antihistamines are used to prevent the reaction from being "refreshed". Frankly, I would have expected the Benadryl to have a significant effect, even if the Allegra didn't do much.

So now I'm wondering if using antihistamines on a medium to long-term basis might reduce their effectiveness for acute events. Have you been using one or more antihistamines somewhat regularly for a while?

Have you ever tried to figure out exactly what in your garden is causing those reactions? Look for a fuzzy-leafed plant, with a height to match the location of the welt (of course, you might have been on your knees, or even hands and knees when the contact occurred). Okra, for example, is a prime suspect IMO, because they're tall enough. Okra eat me alive, if the leaves or pods contact my skin. But squash leaves and other cucurbits give me welts, also.

Tex

Polly · Post by **Polly** » Mon Sep 15, 2014 9:26 am

Deb,

Have you tried topical cortisone cream?

Polly

UkuleleLady · Post by **UkuleleLady** » Mon Sep 15, 2014 9:50 am

I agree with Polly on the cortisone cream. I get weird rashes sometimes and I need to use it for a night or two or three, it normally knocks things down to baseline so I stop reacting and the rash stops spreading. If I don't use it sometimes these rashes get out of control and I'm at the allergist seeking prednisone. Haven't had to do that for a while, thankfully.

I always keep 1% cortisone cream on hand if I travel.

Nancy

DebE13 · Post by **DebE13** » Mon Sep 15, 2014 11:02 am

I don't use antihistamines daily but do use them regularly. I haven't been able to pinpoint what it is as my whole yard is a hodge-podge of anything and everything. I'm the local dumping ground for unwanted or scavenged plants. I've wondered if mint may be a culprit but it would be impossible to eradicate plus I like the smell of it. Would be kind of funny though if that was is it (in a non ha-ha kind of way)

I am up and down and all over the place when I'm in the yard so the height would be a difficult indicator. I am barefoot and exposed most the time. Maybe I should try long sleeves and gloves to see if it helps but I think it's more airborne. I do itch on my torso and arms but the rash always manifests on my cheeks even though there is no contact.

I have used Allegra cream and that hasn't done a whole- lot either. Or maybe it has and I should be happy it's helping.

The puffiness has gone down but the welt has spread as is red-hot. Quite annoying. This time it happened a good twelve hours after I was outside so I'm at a loss. Some plants will immediately make my face feel tingly but I didn't have any of that. I will keep with the cream and Benadryl at night. Maybe with a little more awareness I can figure out what's causing it.

JoAnn · Post by **JoAnn** » Mon Sep 15, 2014 2:43 pm

Hi Deb, I don't know if this will help you, but earlier this summer I was working in my yard and pulling out a vine that has been on our property for years. I never reacted to it in the past so it didn't occur to me to take extra precautions. I did have on gloves during the work. That night, I started breaking out in a rash much like you describe. I did all the usual things antihistamines, hydrocortisone creams, etc. The rash kept spreading and itching like crazy. I went online and googled "reactions to Virginia Creeper." I couldn't believe all the posts about how wicked this plant can be to a lot of people-worse than poison ivy. Many of them were like me-they had not reacted in the past but now had severe reactions. I gave it a few days, but I could not stand the itching and my skin looked terrible. Based on the experience of others online I finally went to Insta-Care and the Dr. prescribed a low dose of Prednisone which I took for a week. It helped a lot with the itching, but it still took a month for the rash to completely disappear. I still have a red spot on my arm which I hope goes away eventually. This plant grows wild and prolific in the east and we also have it in the west. I even saw it for sale at Home Depot a couple of weeks ago in a pot for $25! After my experience, my husband and son have removed a lot of it around the house, but we do have it growing on a fence. My son has had a mild reaction to it. You can google Virginia Creeper and see if you have any of that in your yard. It caused me a month of misery and I really needed the Prednisone for the itching. I couldn't sleep because of it. I did try all the remedies mentioned online using baking soda, apple cider vinegar, hydrocortisone creams, but I needed the Prednisone to really kick it. Those other things will help with coping with it.
Good Luck, JoAnn

Post by **tex** » Mon Sep 15, 2014 3:41 pm

Deb,

Mint (Lamiaceae) is a possibility, but it's way down the list of known risks:

http://www.telemedicine.org/botanica/bot6.htm

Hmmmmm. I've always been suspicious of the Virginia Creeper, and stayed away from them, but I never knew why. Now I know why — sometimes instinct is right on target.

Thanks JoAnn.

Tex

DebE13 · Post by **DebE13** » Mon Sep 15, 2014 5:59 pm

Thanks JoAnn! I looked in my yard and low and behold there was a Virginia Creeper vine that must have been a tag along with a shrub I purchased years ago because I never planted it. It is in the corner of my yard where I usually find my rash originates. It was only one vine but I remember getting up close and personal in that specific area this weekend. I can't say for sure that was it but is is no longer there now. I will have to wait and see.

I had a bad case of poison ivy once and have been sensitive to it ever since. I know the Virginia Creeper is not the same but I see it is in the sumac family so it's possible that was the culprit. It will take a good 2-3 weeks for it to totally go away so I will put up with it and see if it comes back again at a later date.

Tex, you have the coolest references! Very interesting read. I always wished I would have went into horticulture. It's a shame you have to decide what you want to be when you grow up at such a novice age. I've always given a suspicious glance to that Virginia Creeper since it does look so similar to poison ivy but never gave it much thought. It was much easier to remove that than the mint. It's everywhere.

JoAnn · Post by **JoAnn** » Mon Sep 15, 2014 7:57 pm

I wish I had your instincts Tex! It would have saved me a lot of grief. Deb, we actually planted this vine on purpose years ago. It turns a beautiful red in the fall. It volunteers all over our property now-I guess from wind and birds. I see it growing around our little town in yards, on ditch banks, and up telephone poles. The birds love the berries it produces. You're right about it's similarities to poison ivy, but after my experience and reading others online, I think Virginia Creeper is way worse than poison ivy. The weird thing about the Virginia Creeper rash is that it lives up to its name and keeps creeping away on your skin long after the exposure creating new red welts and bumps. I hope your rash is short lived and is gone sooner than mine was. It was the worst itching I've ever experienced. Try baths with baking soda and apple cider vinegar. I almost forgot, but one thing that helped me as much as hydrocortisone cream was applying coconut oil to my skin.
Good luck, JoAnn