Information about allergies

Click on one of the headings below to find out more about particular allergies or information about food.

These are only brief descriptions and we recommend that you refer to one of the many excellent Societies or Associations which support people with these conditions.

Animal allergy
Asthma
Dust-mite
Eczema
Hayfever
Mould
Psoriasis
Sensitive skin
Herbal medicine

Animal allergy

It is estimated that 26% of the population in approximately 6 million households in the UK are allergic to pets. People who are allergic to pets are only too familiar with the awful symptoms:

• Breathing difficulties, wheezing & coughing
• Streaming, puffy eyes
• Hives and skin irritations
• Asthma & Eczema

Most people are not allergic to the animal's fur or feathers. The allergy is more usually an immune reaction to a protein (an allergen) found in the saliva, dander (dead skin flakes) or the urine of an animal. The allergen is carried in the air or in dust on very small, invisible particles. It then lands on the lining of the eyes (conjunctiva) and nose. It may also be inhaled directly into the lungs, causing allergic symptoms. Allergen contact with an allergic person's skin may also cause itching and hives.

Cat allergy

One of the most common pet allergies. Cats are very common pets which is why cat-derived allergens are a widespread component of house dust, and one can become sensitized without even living with a cat. Cat allergens are one of the most common causes of respiratory allergy across the world. The symptoms are asthma and rhinitis. Sensitization to cats might predispose to the development of asthma. Removal of the cat will always be the most effective preventative measure when it comes to avoiding the allergic symptoms. Even after the cat has gone, its allergens can persist in the environment for up to five months.

Dog allergy

The allergenic determinants are mainly found in the saliva, urine, sweat and shed skin from dogs. All these tend to end up in the animal's fur which is therefore indirectly allergenic. The key allergens can also be airborne and so can be inhaled all day long, especially by children who are often at the perfect height for maximum exposure.

Dog-derived allergens can induce diverse symptoms, including rhinitis, conjunctivitis, asthma, urticaria and edema. Removal of the dog will always be the most effective preventative measure when it comes to avoiding the allergic symptoms. If the presence of the dog in the home cannot be avoided, a few simple measures can improve the situation:

• forbid the dog entry inside the house, or at least the bedroom
• once a week, wipe the dog down with warm water as this alone will cut the animal's allergen load in half
• carefully clean the house at regular intervals, using a vacuum cleaner fitted with special filters
• remove any carpets, rugs, cushions, stuffed toys, etc.

Note: an allergist, a medical doctor specially trained to treat allergies, should be consulted for proper diagnosis and treatment of allergies.

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Asthma

What is asthma?

Asthma is an allergic condition. If you have asthma, your airways (the tubes that transport air to and from the lungs) become narrow and inflamed, leading to the following symptoms:

• coughing
• wheezing
• breathlessness
• a tight feeling in the chest
• tachypnea (fast breathing/panting)

During an asthma attack, the airways of the lung undergo a number of changes, including inflammation, bronchospasm, and increased mucus production. Inflammation and spasms keep air from circulating freely in the lungs. Increased mucus production clogs and narrows the airways in the lungs, making breathing even more difficult.

Asthma attacks can be mild, moderate, or severe, and can last for a few minutes, a few hours, or several days. Attacks can occur anywhere and at any time, often at night. Sometimes, though not always, there are warning signs that an attack is about to happen.

What causes it?

This varies from one person to the next, but some of the most common triggers are:

• An allergy to house dust mites, pets, food or pollen
• Getting a virus or cold
• Sudden exertion
• Weather (wind, cold air, heat, temperature changes)
• Strong fumes (such as paint or pollution)
• Smoke (including cigarette smoke)

If you suffer from asthma, try to work out what your triggers are, so that you can avoid them.

Who gets it?

In the UK, roughly 5.1 million people have asthma. It affects one in 13 adults and one in seven children. For the majority of sufferers, symptoms develop during childhood, though asthma can develop at any age. The number of people diagnosed with asthma rises every year. Asthma frequently runs in families and is closely associated with hayfever and eczema. You're more at risk if a family member has asthma, hayfever, or eczema, or combinations of these, or, as research suggests, if your mother smoked during pregnancy.

Treatment

There is no cure for asthma, but medication can help control the symptoms. There are two main types of medication - relievers and preventers.

• Reliever inhalers can be taken immediately for the relief of symptoms on their onset. They relax the muscles in the airways, making it easier to breathe again.
• Preventer inhalers are used daily to reduce the risk of an attack, even if you are feeling well. They limit inflammation in the airways, making your body less sensitive to triggers. Sometimes, preventer tablets are prescribed.

If possible avoid known triggers of asthma:

• Cover all beds with a protective covering that does not allow the house dust mites to
• come through. It is also more hygienic because it can be easily wiped clean.
• Vacuum regularly (or ask a person who does not suffer from asthma to do this) with a vacuum cleaner with an efficient micro filter.
• Stop smoking and avoid smoky areas. The effects of one cigarette can linger for 7 days.

Note: an allergist, a medical doctor specially trained to treat allergies, should be consulted for proper diagnosis and treatment of allergies.

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Dust-mite

Dermatophagoides pteronyssinus, Dermatophagoides farinae

Dust mites are members of the spider family. They primarily feed on dead skin cells regularly shed from humans and their animal pets. These skin cells and scales, commonly called dander, are often concentrated in mattresses, pillows and frequently used furniture and associated carpeted areas. There may be large numbers of these microscopic mites.

The cast skins and excrement of dust mites are a major constituent of house dust that induces allergic reactions in some individuals.

Asthma sufferers

Cases of asthma have doubled in the last ten years and 50% of all child hospital admissions are asthma related. The pathogens in dust mite excrement, bacteria, mould and fungi are medically proven triggers and causes of asthma.

Allergy sufferers

Itchy eyes? Runny nose? Skin rash? Sneezing? You are not alone. Every night, you share your bed with about 2 million dust mites. The pathogens in dust mite excrement, bacteria, mould or fungi are known triggers.

Allergic rhinitis (hay fever)

Year round hay fever can be triggered by the pathogens in dust mite excrement and mould. Symptoms include sneezing, blocked nose, itchy eyes, nose and throat, snoring and headaches.

Eczema sufferers

The pathogens in dust mites excrement, mould and bacteria are known triggers of atopic eczema, contact dermatitis and other skin complaints.

Respiratory disorders and other ailments

Dust mites, mould, bacteria and fungi are known to contribute to emphysema and bronchitis.

Pregnant women and unborn babies

A recent study has highlighted that dust mite excrement inhaled by pregnant women can reach the womb and amniotic fluid, and could be a cause asthma and allergies in up to 20% of new born babies. (Source: The Lancet 12/2/2000)

Babies

Although there is no single established cause, bacteria such as staphylococcus aureus found in an infants' mattress have been linked to cot death, as well as life threatening throat infections. (Source: De Montfort University, Leicester, UK)

Everyone

All these conditions can actually be caused as well as triggered by the pathogens in dust mite excrement, bacteria, mould and fungi and may be diagnosed at any time in life, to anyone, whether a child or adult.

Note: an allergist, a medical doctor specially trained to treat allergies, should be consulted for proper diagnosis and treatment of allergies.

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Eczema

Eczema, or dermatitis as it is sometimes called, is a group of skin conditions which can affect all age groups. In the United Kingdom, up to one fifth of all children of school age have eczema, along with about one in twelve of the adult population.

The severity of the disease can vary. In mild forms the skin is dry, hot and itchy, whilst in more severe forms the skin can become broken, raw and bleeding. Sometimes, itchy blisters form. When these burst, or when scratching damages the skin, the surface may be left moist and crusty. Although it can sometimes look unpleasant, eczema is not contagious. With treatment the inflammation of eczema can be reduced, though the skin will always be sensitive to flare-ups and need extra care.

The causes of eczema are many and varied, and depend on the particular type of eczema that a person has. Atopic eczema is thought to be a hereditary condition, being genetically linked. It is proposed that people with atopic eczema are sensitive to allergens in the environment which are harmless to others. In atopy there is an excessive reaction by the immune system producing inflamed, irritated and sore skin. Associated atopic conditions include asthma and hayfever. Other types of eczema are caused by irritants such as chemicals and detergents, allergens such as nickel, and yeast growths. In later years eczema can be caused by a blood circulatory problems in the legs. The causes of certain types of eczema remain to be explained, though links with environmental factors and stress are being explored.

There are several different types of eczema, many of which look similar but have very different causes and treatments. The first step in effective treatment of eczema is a correct diagnosis. It is very important to see a general practitioner in the first instance, who may make a referral to a specialist dermatologist for further diagnosis and treatment.

Types of eczema

a) Atopic eczema

Atopic eczema is the commonest form of eczema and is closely linked with asthma and hayfever. Often the problem is worst in the folds of skin where the limbs bend. It can affect both children and adults, usually running in families. One of the most common symptoms of atopic eczema is its itchiness (or pruritis), which can be almost unbearable. Other symptoms include overall dryness of the skin, redness and inflammation. Constant scratching can also cause the skin to split, leaving it prone to infection. In infected eczema the skin may crack and weep ('wet' eczema). Treatments include emollients to maintain skin hydration and steroids to reduce inflammation.

b) Allergic contact dermatitis

Develops when the body's immune system reacts against a substance in contact with the skin. The allergic reaction often develops over a period of time through repeated contact with the substance. For example, an allergic reaction may occur to nickel, which is often found in earrings, belt buckles and jeans buttons. Reactions can also occur after contact with other substances such as perfumes and rubber. In order to prevent repeated reactions it is best to prevent contact with anything that you know causes a rash.

c) Irritant contact dermatitis

This is a type of eczema caused by frequent contact with everyday substances, such as detergents and chemicals, which are irritating to the skin. It most commonly occurs on the hands of adults and can be prevented by avoiding the irritants and keeping the skin moisturised.

d) Infantile seborrhoeic eczema

A common condition affecting babies under one year old, the exact cause of which is unknown. Also referred to as cradle cap, it usually starts on the scalp or the nappy area and quickly spreads. Although this type of eczema looks unpleasant, it is not sore or itchy and does not cause the baby to feel uncomfortable or unwell. Normally this type of eczema will clear in just a few months, though the use of moisturising creams and bath oils can help to speed this along.

e) Adult seborrhoeic eczema

Characteristically affects adults between the ages of 20 and 40. It is usually seen on the scalp as mild dandruff, but can spread to the face, ears and chest. The skin becomes red, inflamed and starts to flake. The condition is believed to be caused by a yeast growth. If the condition becomes infected, treatment with an anti-fungal cream may be necessary.

f) Varicose eczema

Varicose eczema affects the lower legs of those in their middle to late years, being caused by poor circulation. Commonly the skin around the ankles is affected, becoming speckled, itchy and inflamed. Treatment is with emollients and steroid creams. If left untreated, the skin can break down, resulting in an ulcer.

g) Discoid eczema

Discoid eczema is usually found in adults and appears suddenly as a few coin shaped areas of red skin, normally on the trunk or lower legs. They become itchy and can weep fluid. Usually discoid eczema is treated with emollients (and steroid creams if necessary).

Having access to accurate information is important as this allows the person with eczema, or their carer, to make informed choices when managing the condition. The following are the more commonly used treatments. Further information on any of these can be obtained through the National Eczema Society.

Treatments

There is essentially no cure for eczema. There are, however, a number of approaches which help to minimise symptoms, all of which begin with an effective skin care routine. It should be stressed, however, that what works for one person, will not always work for another. Eczema is a highly individual condition, which is why it is so difficult to find a "cure-all". The following are the more commonly used treatments:

a) Emollients

Emollients are necessary to reduce water loss from the skin, preventing the dryness normally associated with eczema. By providing a seal or barrier, the skin is less dry, itchy and more comfortable. Emollients are safe to use as often as is necessary and are available in various forms: ointments for very dry skin, creams and lotions for mild to moderate or 'wet' eczema. Some are applied directly to the skin, whilst others are used as soap substitutes or can be added to the bath. Some of the creams and oils contain an antiseptic, as it has been found that eczema often flares up as a result of a germ infecting the skin. The range of emollients available is enormous and it may be necessary to try several before the most suitable one is found. Testing a small amount on the skin first is advisable, as emollients contain substances to which some people are sensitive.

b) Topical steroids

When eczema is under control only emollients need to be used. However in flare-ups, when the skin becomes inflamed, a steroid cream may be needed. Steroids act by reducing inflammation and are used in most types of eczema. Topical steroids come in four different strengths, mild, moderately potent, potent and very potent. The strength of steroid cream that a doctor prescribes depends on the age of the patient, the severity of the condition and, the size of the area and part of the body to be treated. Topical steroids are applied thinly to the affected area, as directed by the prescribing doctor. Your eczema should be reviewed regularly if topical steroids are being applied. It is important to use only the steroid cream prescribed for yourself and not to lend or borrow (what may be) an unsuitable cream from someone else. Many people have concerns regarding the use of topical steroids and their side-effects. As long as steroids are used appropriately and as directed by your doctor, the likelihood of side effects is very rare. Reported side-effects have been largely due to the use of very potent steroid preparations over long periods of time.

c) Oral steroids

Oral steroids are sometimes prescribed in very severe cases and usually under the direction of a consultant dermatologist, when topical steroids have been found to be ineffective. These can have possible side-effects and the doctor should ensure close monitoring when prescribed.

d) Other treatments:

• anti-histamines to reduce inflammation
• wet wrap bandaging to soothe dry itchy skin
• ultra-violet light treatment (UVB and PUVA) may be considered for very severe atopic eczema

Reducing the itch

For children in particular, the itchiness of eczema can be very distressing. There are many methods of reducing the itchiness of the skin and minimising the damage from scratching. Cotton clothing and bedding keep the skin cool and allow it to breathe, whereas synthetic fabrics and wool can irritate. The use of a non-biological washing powder and avoidance of fabric softeners, can also help to reduce the itchiness of the skin. Children's nails should be kept short. During the day, distraction is often the best way of reducing the amount of scratching. At night-time, cotton mittens over children's hands can be helpful in reducing damage to the skin occurring during sleep.

Reducing the effect of the house dust mite

It is thought that people who have atopic eczema may be affected by allergens in the droppings of the house dust mite. This mite thrives in warm and moist environments and unfortunately likes to live in bedding, mattresses, curtains and carpets. It is believed that reducing the amount of house dust mites in the home may improve the condition of the skin. This can be achieved in a number of ways, from effective and regular vacuuming, to damp dusting and airing of bedding.

Diet

The role of diet in the management of eczema has not been ascertained. Generally changes in diet are only considered in severe cases, when conventional treatments are failing. Dietary changes can be quite helpful in babies and young children, though the effects on older children and adults are less conclusive. When considering altering the diet of a baby or child it is important to seek advice from a dietitian, or a nutritional therapist, in order to ensure that the child continues to receive adequate nutrients. Sometimes it can be useful to keep an accurate diary of foods eaten and the condition of the eczema and, when weaning babies, to do so very slowly observing for skin reactions. This is a large and complex topic. Further information can be obtained from the National Eczema Society.

Note: an allergist, a medical doctor specially trained to treat allergies, should be consulted for proper diagnosis and treatment of allergies.

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Hayfever

What is hayfever?

Hayfever (also called 'seasonal allergic rhinitis' or 'pollinosis') is an allergy to pollen, or sometimes mould spores, causing inflammation of the mucous membranes of the nose and eyes. During the seasons when plants are pollinating, there is a large amount of pollen in the air. People breath in the pollen and have an allergic reaction to it.

Hayfever often runs in families, and is related to asthma and eczema. It is quite common to find a family with some members with asthma, some with hayfever, and some with eczema. Any individual might have more than one of these conditions.

Symptoms

Some of the symptoms of hay fever are:

• repeated and prolonged sneezing
• a stuffy and watery nose
• redness, swelling and itching of the eyes
• itching of the nose, throat and mouth
• itching of the ears, or other ear problems

Other symptoms which may occur are:

• breathing difficulties at night
• coughing (as a result of post nasal dripping of clear mucus)
• loss of smell and taste
• nose bleeding (in severe conditions)

What causes it?

Sneezing and swelling occurs because when the pollen (or other substance) enters the nose, the body produces antibodies against them. The antibodies release histamine and histamine irritates the upper respiratory passages. When the upper respiratory passages are irritated, swelling and sneezing often occurs. If you suffer from hayfever, try to work out what your triggers are, so that you can avoid them.

When will I develop hayfever?

The "hay fever season" will occur at different times of the year for different people. This happens because trees, grasses, and weeds produce pollens during different seasons. The "hay fever season" greatly depends on where you live.

People who are sensitive to tree pollen may suffer in the early spring when trees such as elm, maple, birch and poplar are producing pollen. People who are sensitive to pollens produced by grasses may suffer in the late spring / early summer when most grasses are pollinating.

The weather and the air quality may also aggravate the situation for a hayfever sufferer.

Controlling hayfever

There is no cure for hayfever, but it can be controlled by:

• In the summer stay inside when pollen counts are high, especially between 5pm and 7pm. Keep windows and doors closed, particularly at these times and when sleeping.
• Use an air conditioner or filter when possible (at home, work, and in the car) to remove pollen and other allergens from the air.
• Damp dust and vacuum your home regularly, to minimise the presence of pollen and dust.
• Airing bedclothes in direct sunlight is helpful.
• Dry washing indoors as pollen grains may stick to it outside.
• Be aware of the pollen count (usually broadcast along with the weather) and avoid areas of high pollen concentration such as long grass, lawn mowings, and trees, if allergic to these. If you need to work in these environments consider wearing a mask and goggles.
• Avoid unnecessary extra irritants such as smoke and chemical fumes.
• Avoid pets as they can bring pollen in from outdoors on their coats.

• Antihistamine tablets or medicine reduce the effect on the body of one of the main chemicals released by the allergic response.
• There are nasal sprays which contain steroids and other substances which reduce the local inflammatory response in the nose.
• There are eye drops which have similar effects on the eye.
• People with asthmatic symptoms need treatment as for asthma.
• Occasionally the doctor may consider it necessary to prescribe either tablets containing steroids, or an possibly an injection.
• Injection treatments (given under close hospital supervision) can desensitise patients against the substance to which they are allergic.

• Eat a balanced diet with plenty of fruit and vegetables. Of particular value is vitamin C, which has long been known for its antihistamine response.
• The symptoms of hay fever may be exacerbated by food allergies. Avoiding wheat and dairy foods (which can increase the production of catarrhal secretions) may bring some relief.
• Eat locally produced honey as this could offer a degree of homoeopathic protection.

Note: an allergist, a medical doctor specially trained to treat allergies, should be consulted for proper diagnosis and treatment of allergies.

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Mould

Many people are allergic to mould. Moulds are naturally occurring clusters of microscopic fungi that reproduce and grow by sending tiny spores into the air. It is these spores which, when inhaled, cause allergy and asthma symptoms. Mould is most prevalent indoors, in damp locations and in swamp coolers, bathrooms, washrooms, fabrics, rugs, stuffed animals, books, wallpaper and other "organic" materials. Outdoors, mould lives in the soil, on compost, and on damp vegetation.

Alternaria alternata

Alternaria is one of the most common moulds inside houses, and also carried in the atmosphere. It is a fungus measuring a few micrometers in diameter and multiplies rapidly in warm, damp conditions. Alternaria spores are released in massive numbers in August and September, at which time of year they are a common cause of combined seasonal rhinitis and conjunctivitis. Symptoms affect the airways (rhinitis and asthma), and Alternaria appears to be involved in some cases of recrudescent, severe asthma.

Environmental control

• Mould sensitivity can be identified by skin testing. Once this allergy has been detected, an attempt should be made to decrease or eliminate exposure to the mould.
• Allergy and asthma symptoms may improve over time if the environmental control changes are made. Many of the changes are for the entire home. The bedroom is the most important, because the bedroom is where people usually spend a third to half of their time.

Control of mould allergens

• In the bathroom - use an exhaust fan or open a window to remove moisture after showering. Wipe down the damp surfaces after showering. Wash bathrooms with a mould-preventing or mould-killing solution at least once a month.
• In the kitchen - use an exhaust fan to remove water vapour when cooking. Discard spoiled foods immediately. Empty the garbage daily. Empty water pans below self-defrosting refrigerators frequently.
• Remove mouldy stored items.
• Vent the clothes dryer outside.
• Remove leaves, clippings and compost from around your house.

The person with a mould allergy should avoid cutting grass and raking leaves or wear a face mask for these activities.

Other suggestions

Keep the indoor moisture low. The ideal humidity level is 30-40%. Use an air conditioner or dehumidifier in warm climates to decrease the humidity. Clean the dehumidifier regularly.

Humidifiers and vaporizers are not recommended because they will increase humidity in the room and create a favourable environment for mould growth. If you must use a humidifier, clean it daily to prevent mould growth.

Note: an allergist, a medical doctor specially trained to treat allergies, should be consulted for proper diagnosis and treatment of allergies.

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Psoriasis

Psoriasis is a non-contagious, chronic recurring skin disease. The scope of the disease can vary considerably; from mild outbreaks where the person may not even be aware they have psoriasis, to severe cases which can be socially disabling and, in rare instances, life-threatening. The most common type of psoriasis appears on the elbows, knees and, occasionally, the limbs and trunk.

Psoriasis is derived from the Greek word 'psora', which means itch. It is thought that the underlying problem is that new skin cells are produced too quickly and rise to the surface before the old skin cells have had time to die off and be scrubbed away. The result of this overproduction of skin cells result is raised, scaly, red patches of dead skin (called 'plaques'), often with silvery flakes which come off easily. Plaques can be anything from a couple of millimetres to several centimetres wide. When these patches of scaly skin fall off, you can often see small areas of bleeding.

Types of psoriasis

• Plaque psoriasis: The patches most commonly seen are called plaques. They especially affect the back of the elbows and the front of the knees and the back.
• Guttate psoriasis: This is many small patches of psoriasis, all over the body, and often happens after a throat infection.
• Flexural psoriasis: This causes red, shiny areas in skin folds such as under breasts, between buttocks etc.
• Pustular psoriasis: Smaller, circular patches, filled with pus, appear on the palms of the hands and soles of the feet. This can sometimes cause a fever, and may need treatment with an antibiotic.
• Scalp psoriasis: Scaling and flakes of the scalp, often particularly affecting the hair margins.

A serious, but rare, complication of psoriasis is erythroderma, where large areas of the skin become hot, red, and dry. This is one of the few emergencies involving skin conditions. If you suffer from this your doctor will admit you to hospital.

Sometimes parts of the body other than the skin can be affected:

• Psoriatic arthropathy: The joints can be affected by a form of arthritis. This can affect any joint, but often it is only one joint, that becomes inflamed, at a time.
• Nail dystrophy: One or more of your finger or toe nails may develop little pits as on a thimble, or may become generally more opaque and thickened.
• Uveitis: The eyes may become inflamed.

What causes it?

Scientists are still investigating this, but there is evidence that it's inherited and lies dormant until something triggers it to appear. In psoriasis sufferers, their bodies' immune systems, when triggered, may cause too many white blood cells (known as T cells) to be produced in the skin. These T cells cause the skin to become inflamed by releasing chemicals that cause the body to react as if it was being attacked by an infection - this is known as the inflammatory cycle. This inflammatory cycle causes the excess production of skin cells and this produces psoriasis. Recognised triggers include:

• Infection or illness
• Skin damage (e.g. burns, cuts, sunburn)
• Extreme stress
• Hormones (e.g. periods, puberty)
• Some medications (e.g. malaria tablets)

Who gets it?

In the UK, psoriasis affects roughly one person in 50. It can happen at any age, but it is mostly seen in 16 to 22 year-olds (which could be due to exam stress) and also between the ages of 50 and 60. You're more at risk of getting psoriasis if a family member has it. Around two per cent of the population have psoriasis to a greater or lesser degree.

Diagnosis and treatment

Psoriasis is fairly straightforward to diagnose, usually from the appearance of the rash. If you have inflamed joints your doctor may want to arrange for some blood tests. In rare cases of doubt, your GP may remove some of the scaling, or a small sample of skin (a biopsy), to be sent to a laboratory. He or she may refer you to a dermatologist.

Psoriasis can't be cured, but it can be controlled. Many people have long periods when it does not trouble them and sometimes it gets better on its own.

Some common effective treatments include:

• emollient cream containing paraffin or salicylic acid.
• preparations containing tar.
• dithranol cream.
• steroid cream.
• medicines that use derivatives of vitamin D and A.
• ultra-violet light therapy.

Other methods that may help to control psoriasis include:

• exposure to sunlight
• eating a diet rich in oily fish or taking cod liver oil capsules
• complementary therapies, such as acupuncture and homeopathy
• bathing in salt water

Note: an allergist, a medical doctor specially trained to treat allergies, should be consulted for proper diagnosis and treatment of allergies.

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Sensitive skin

Sensitive skin is characterized by overreaction to external influences (sun, wind, certain cosmetics, handling and temperature extremes). It is easily irritated and exposure can result in redness, a rash, itching, stinging, or burning. Sensitive skin has a tendency to develop distended or broken capillaries as well as allergies, and it usually sunburns easily.

Note: an allergist, a medical doctor specially trained to treat allergies, should be consulted for proper diagnosis and treatment of allergies.

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Herbal medicine

It is recognised that many herbs can have a dramatic effect on a wide variety of ailments. For thousands of years herbal medicine was the only medicine and was used all over the world to treat every kind of injury and disease. A great wealth of information and expertise was built up amongst the different peoples of the world regarding which plants were most useful for treating particular conditions. Herbalists appreciate the importance of the active chemicals in plants, but believe that other less active components of the plant are essential in producing a medicine that is easily absorbed, utilised and excreted by the human body. Herbal medicines are used to restore and support the body's own defensive and restorative mechanisms, boosting vital energy and self-healing potential.

How do herbal medicines differ from normal medicines?

A major difference between orthodox and herbal medicine is in the form of medicines used. While orthodox medicine relies on drugs made of concentrated pure chemicals, herbal medicines are prepared solely from the crude plant material: the leaves, bark, roots, resin, gum and oil of plant species. Many modern chemical drugs were originally derived or based on compounds found in plants.

Are herbal medicines real medicines?

Herbal medicines can prevent or cure medical conditions (illnesses) or relieve the symptoms which is the definition of a medicine. It is an 'approved' medicine if it has been issued with a marketing authorisation (look on the packaging for a PL number) which means the authorities have agreed that the product is safe, is manufactured to an acceptable quality standard and works. Both British and European law support herbal medicines as an effective and viable contribution to healthcare. There are many herbal remedies on the market but not all have a marketing authorisation, so they may or may not be effective.

Using herbal medicines

• Take care to read the label particularly regarding dosage instructions and cautions.
• Some remedies are not suitable for pregnant women or young children.
• Often herbal medicines need time to work and the effects may only become apparent after some days. Take the full course and, with rare exceptions, do not expect results in just a day or two.
• If you are taking other medications of any kind, seek the advice of your doctor or consultant before taking any herbal products internally. Your doctor should be consulted before stopping prescribed treatment.
• Over the counter herbal medicines are generally known for being free from unwelcome side effects. If by any chance you notice a problem, stop taking the product and consult a health professional.
• Keep all medicines out of the hands of children.
• Do not use after the 'use by' date that is indicated on the product.

Licensing of medicines

Before a medicine can be marketed in this country, an application must be submitted to the MHRA (Medicines and Healthcare Products Regulatory Agency). This application must include full details about how the medicine is made and used and the research that has been carried out to assess its safety, effectiveness and quality. The MHRA examines all this information and the test results in detail. Only medicines which meet the strict standards laid down by law are granted a marketing authorisation, which is normally necessary before they can be prescribed or sold. This rigorous examination ensures that medicines on the UK market meet acceptable standards of:

• Safety: they are sufficiently safe to take.
• Efficacy: they work as they are supposed to.
• Quality: they are made to the highest possible standards.

Products that have been granted a marketing authorisation carry a number beginning with the letters PL on the manufacturer's pack.

There are three categories for the supply of medicines:

• General Sale List (GSL): medicines that are widely available for sale and use without supervision of a pharmacist or doctor.
• Pharmacy (P): medicines that can only be obtained from a pharmacy, where they are supplied under the supervision of a pharmacist who may ask questions to ensure that, if a medicine is necessary, you get the best one to suit your needs.
• Prescription Only Medicines (POM): medicines which must be prescribed by a doctor or a dentist. They can be obtained from a pharmacy.

Note: an allergist, a medical doctor specially trained to treat allergies, should be consulted for proper diagnosis and treatment of allergies.

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