Latex allergies have been a hot topic in the medical field for quite some time. Much of my routine exposure has been evaluating medical personnel who are concerned they may have developed a latex allergy to the gloves they are wearing. Interestingly enough, they often do not have such conditions, but rather trouble tolerating harsh antibacterial skin scrubs and continuous water contact in the hospital environment.

Latex can cause a skin reaction similar to a contact dermatitis. A contact dermatitis is the result of the body becoming allergic to an "allergen" that comes into contact with the surface of the skin. In this case, a rash develops as a result of the inflammation set off by the allergy. Usually, the skin becomes red and rough, possibly scaling, cracking, weeping, and there may even be the presence of tiny blisters that contain the serum from the deeper layers of the skin. Itching almost always accompanies this condition. There are a variety of allergens that can cause a contact dermatitis.

The most frequent causes of latex allergy in my patients, has been intolerance to the latex contained in the elastic of their bras and underwear. This has been so common of late, that I will usually perform a confirmatory latex test if I see the appearance of a contact dermatitis in these areas.

A simple blood test that checks the blood level of Latex Specific IgE, can tell whether or not a true latex allergy is occurring. The test results come with numerical ranges, called titers. The higher the titer, the stronger the reaction.

In addition, patch testing is also helpful when working up a patient with suspected latex allergy. For instance, a patient who appears to have a latex allergy may in fact be allergic to Thiuram Mix or to Carba Mix, both of which are used in many products that contain latex. However, they are NOT latex, and the associated concerns don't apply to these patients.

People experiencing latex allergy may also have cross- reactions to foods, particularly Banana, Kiwi, Avocado and Chestnuts, as their molecular make-up mimics that of latex. It is not unheard of for patients with a more serious systemic form of latex allergy to develop serious reactions after eating these fruits.

Of more concern for patients with latex allergy is that they will progress from nuisance skin reactions to overwhelming and potentially life-threatening systemic reactions. Asthmatic type wheezing, generalized swelling and anaphylactic shock fall into this category. There has been a push primarily in the medical community to develop ways to prevent exposing patients routinely to latex. I have also noticed since having a baby, that products I took for granted 5 years ago, such as pacifiers and baby bottle nipples are now available in silicon which do not contain latex. The theory is that the less exposure to latex, the better off you are later in life. This takes into account the fact that latex allergies become worse with continued exposure to latex-containing products.

There are now several wonderful websites devoted to latex-free products for those with serious allergies. strong>Alert,Inc or American Latex Allergy Association (www.latexallergyresources.org), gives you access to a number of different websites related to latex allergy education. Probably the most difficult issue has been where my patients can find undergarments that are free of elastic, no small thing. Spandex is latex free, and I often recommend this as an alternative. As with all contact and systemic allergies, avoidance is the best method of treatment. I do have my patients with latex allergy carry an Epi Pen wherever they go, (available only by prescription) just as patients with serious reactions to bee stings or peanut products do. Wearing an ID Bracelet denoting your allergy is another important aspect of protecting yourself in case you are unable to communicate your history. Many emergency medical devices from intravenous tubing to ventilator tubes contain latex. Hospitals are now stocking latex-free medical equipment for these instances. But they won't use them if they don't know about your condition in advance.

I was contacted by a client who shared with me how she was inaccurately diagnosed with a nickel contact dermatitis allergy (rash on her earlobes, thought to be due to the metal of the earring) and it was later determined that the allergy was to latex in the earring pad. This is something to keep in mind, and certainly was something that I'd never previously thought about.

There is undoubtedly going to be further information about latex allergies and how we as a society can change our lifestyles to avoid exposure to a product originally thought to be a miracle of the modern age.

As always, thank you for taking your time to read my newsletter on Latex Allergy. I hope that you have found it informative.

Audrey Kunin, M.D.

(Any topic discussed in this article is not intended as medical advice. If you have a medical concern, please check with your doctor.)

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