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Hives, Insect Bites

Hives
In hives (urticaria) the superficial blood vessels are the seat of response and the substances reaching them and causing the reaction are, in most cases, distributed by the bloodstream. Small blood vessels dilate due to the release of histamine by nearby cells. The skin reaction appears as pale lumps or wheals, sometimes surrounded by reddish skin. They may appear anywhere on the body, and are extremely itchy. They are frequently caused by an allergic reaction to particular foods, such as fish, cheese, nuts, chocolate, strawberries, or to a particular medication. A frequent sufferer may benefit by noting which foods or medications precede an eruption.

The duration of wheals is extremely variable, lasting from minutes or hours to many years. Spontaneous remission may occur. Acute forms may be self-limiting, while cases recurring over time may be kept  relatively free from discomfort by proper treatment. Occasionally there is associated respiratory difficulty. Any severe condition needs medical attention. Other causes of wheals are a reaction to extreme heat and cold or an abnormal reaction to a new type of insect bite.

Insect Bites

Insect bites are caused by a variety of mites, fleas, ticks or other insects, and are often on children. They may occur as recurrent bouts of groups of large, red spots often with a vesicle on top. These occur mostly under the clothing or may be on the exposed surfaces from flying insects. They are intensely itchy. Insect bites resulting from mosquitoes, fleas or other insects cause erythema and oedema at the site of the bite. The damaged skin is susceptible to infection especially if the itch is not controlled and scratching continues. Secondary infection is common and, if present, should be treated.

Hives Treatment
Treatment firstly involves avoiding the substance which causes the hives. It is important to try to make the patient comfortable to avoid scratching. Topical anti-inflammatory and anti-pruritic treatments are used for this. Treatment of the wheals is usually with oral anti-histamines.

Insect Bites Treatment
It is important to quickly relieve itching to help prevent the patient from scratching.

“In general, pruritus is relieved by: substituting some other sensation, such as heat or cold, for the itching, anaesthesia of the sensory nerves; protecting the skin from external influences such as scratching, other trauma, change of temperature, pressure etc.” Sulzberger et al. (1961)

Advice for the Patient
1. Try to discover the offending substance and avoid it.
2. The patient should be advised not to scratch as this may lead to secondary infections.
3. The patients finger nails should be kept short and clean to help avoid infections.

Products to Help (Topical Anti-inflammatories - Nonsteroidal)

EGODERM OINTMENT
Egoderm Ointment provides effective relief for irritated skin by reducing inflammation and relieving itching. It is soothing and suitable for use on areas of skin which require protection. Egoderm Ointment is corticosteroid-free and lanolin-free. Apply to affected area 3 times daily.

Products to Help (Topical Anti-inflammatories - Hydrocortisone)

DERMAID™ 0.5% CREAM*
DermAid™ 0.5% Cream is a topical corticosteroid with anti-inflammatory and vaso-constrictive properties that’s suitable for the majority of skin types. It contains dissolved hydrocortisone in an occlusive base which provides increased skin penetration and enhanced effectiveness for treatment of red, itchy skin. DermAid™ also contains a moisturising element which helps prevent dry skin, and it’s lanolin and paraben-free to help avoid secondary allergic reactions. DermAid™ 0.5 Cream contains 0.5% hydrocortisone.

DERMAID™ 1.0% CREAM*
DermAid™ 1.0% Cream is a topical corticosteroid with anti-inflammatory and vaso-constrictive properties that’s suitable for the majority of skin types. It contains dissolved hydrocortisone in an occlusive base which provides
increased skin penetration and enhanced effectiveness for treatment of red, itchy skin. DermAid™ also contains a moisturising element which helpsprevent dry skin, and it’s lanolin and paraben-free to help avoid secondary
allergic reactions. DermAid™ 1.0% Cream contains 1.0% hydrocortisone.

DERMAID SOFT™ 0.5% CREAM*
DermAid Soft™ 0.5% Cream has been formulated especially for people with sensitive skin. The essential difference with DermAid Soft™ is that the hydrocortisone is dispersed throughout it so that it gently penetrates
the irritated skin. DermAid Soft™ is smooth and non-greasy. It’s easy to apply which also helps prevent further trauma, especially if skin is already tender and inflamed. The emollients in DermAid Soft™ moisturise and soften dry, inflamed skin, helping to restore its hydration and suppleness, as well as reducing skin roughness and encouraging the healing process. DermAid Soft™ 0.5% Cream contains 0.5% hydrocortisone.

DERMAID SOFT™ 1.0% CREAM*
DermAid Soft™ 1.0% Cream has been formulated especially for people with sensitive skin. The essential difference with DermAid Soft™ is that the hydrocortisone is dispersed throughout it so that it gently penetrates
the irritated skin. DermAid Soft™ is smooth and non-greasy. It’s easy to apply which also helps prevent further trauma, especially if skin is already tender and inflamed. The emollients in DermAid Soft™ moisturise and soften dry, inflamed skin, helping to restore its hydration and suppleness, as well as reducing skin roughness and encouraging the healing process. DermAid Soft™ 1.0% Cream contains 1.0% hydrocortisone.

*DermAid Cream 1.0%, DermAid Soft Cream 1.0% and EgoCort 1.0%

Contraindications:
- Known sensitivity to any of the ingredients.
- Chickenpox, herpes, other viral infections and other skin infections, otherwise concurrent antimicrobial therapy is required. Acne.

Dosage:
(DermAid Cream 1.0%) Apply a small amount to affected skin 1-2 times daily as required.
(DermAid Soft Cream 1.0%) Apply a small amount to affected skin 2-4 times daily as required
(EgoCort 1.0%) Apply a thin layer 1-2 times daily to the affected skin.

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