Can I be allergic to topical Chinese medicine?
Can I be allergic even if I use Chinese medicine topically? Aren’t Chinese herbs safe and have no side effects? Many people have this perception. Some western medicines may have some adverse reactions in their use, and one of the more common ones is allergic reactions. A few people may have serious allergic reactions to certain drugs such as penicillin, the lighter the skin itching and rash, the heavier the whole body skin exfoliative dermatitis, laryngeal edema or even shock will be life-threatening. Therefore, these drugs should be done before use skin test. And the instructions of the drug must also be marked which allergic reactions may occur, and the frequency of the occurrence of the drug. In contrast, Chinese medicine, especially herbal tablets, comes from nature, and allergies are rare when decocted and taken orally, and serious allergies are rare when Chinese medicine is used externally. Patients who receive Chinese medicine treatment also generally believe that Chinese medicine has no side effects and is not harmful to the body, so it is safer to use it externally. Many patients also find their own “prescriptions”, “experimental prescriptions” that have worked for other patients or “secret prescriptions” from certain sources to use directly. At present, China’s research on adverse reactions to tablets is not in-depth. Doctors also lack knowledge about which patients will have allergies to Chinese medicine.
So will there be any allergic reactions to the topical use of Chinese medicine? Are the chances of such adverse events large or not? In recent years, the domestic literature on adverse reactions to the topical application of Chinese medicine has found that some allergic reactions have indeed occurred with the topical application of Chinese medicine, and there have been individual reports of more serious allergic reactions. However, the majority of these reports are individual cases, and no large sample of adverse reactions have occurred. Therefore, the probability of allergic reactions due to topical application of Chinese medicine is not high, but it should be taken seriously.
How do allergic reactions occur?
In modern life, people are exposed to a large number of chemicals. For example, drugs: sulfa for oral use, penicillin for injection, Neosporin for external use, alcohol, iodine, wound and damp pain relief cream, etc.; chemicals: dyes, paints, asphalt, pesticides; household products: cosmetics, plastic additives, etc. Some people have caused adverse reactions after being exposed to these chemicals, the reason being that these originally small molecular weight chemicals, when in contact with the skin, combine with keratin in the epidermal cells to form large molecules of antigen. T lymphocytes in the body can then be sensitized to these antigens, causing an immune response in the body. The most common form is dermatitis due to allergy. This is manifested by erythema, papules, blisters and, in severe cases, exfoliative dermatitis. This type of dermatitis is also known as contact dermatitis because it is caused by exposure to chemical substances. Topical herbal medicines contain complex ingredients and chemical substances such as solvents in the ready-to-use medicines, so there are also factors that can cause allergic skin reactions.
What are the symptoms of an allergic reaction?
Generally allergic reactions caused by drugs have the following manifestations.
1, skin damage: the most common are itching, rash, papules, blisters, edema, ulceration, pigmentation, etc.
2, gastrointestinal reactions: such as abdominal distension, abdominal pain, diarrhea, nausea and vomiting, etc..
3, circulatory system performance: chest tightness, dyspnea, cyanosis, precordial discomfort, palpitations, tachycardia, arrhythmia, increased blood pressure.
4, liver and kidney damage: certain TCM injection intravenous drip may cause weakness of limbs, dizziness and abnormal liver and kidney functions. Long-term large amounts of certain TCM have also been reported to cause liver and kidney damage.
5. Anaphylaxis: There are reports of anaphylactic shock caused by Gegenin injection, Qingkailing injection, and fishy grass injection in the National Adverse Drug Reaction Bulletin. Clinical medical research found that contact dermatitis accounted for 94.18% of patients with allergic reactions caused by topical application of Chinese medicine, accounting for the majority. Gastrointestinal and circulatory system reactions were less common. There is a lack of reports of liver and kidney damage and anaphylaxis caused by contact drug use.
What groups of people are at risk for allergy?
1. Allergic patients
Patients who develop drug contact allergy are mostly allergic. What is an allergic body? In layman’s terms, people who are prone to allergic reactions and cannot find the cause are called “allergic”. People with “allergies” can have allergic reactions and allergic diseases due to various reasons, such as eczema, urticaria, allergic asthma, and some are particularly sensitive to certain drugs and can develop drug dermatitis or even exfoliative dermatitis. However, if you have a high reactivity to a known factor, you cannot be called “allergic”.
The causes of “allergy” are complex. Immunologically, “allergic” people tend to have higher immunoglobulins than normal people; or some lack of certain enzymes, such as digestive enzymes, secretory immunoglobulin A, histaminase, etc. The root cause of these immune deficiencies is often genetically related, perhaps in the genes. So allergic constitution has a certain heredity.
2.Patients with allergy history. Middle-aged and elderly patients suffering from asthma, patients with allergic rhinitis, and young children who have suffered from eczema are all potential allergists.
3.History of other diseases such as liver, kidney, heart, ulcers, etc., the body itself has some diseases.
4.The elderly and children
5.People with poor physical fitness
6, repeated exposure to certain types of drugs. The original use of a certain drug did not allergic, and then used again but allergic. The reason is: the body has not been exposed to a certain drug, there is no antibody to the drug in the body, no allergic reaction will occur. After being exposed to the drug, antibodies are produced in the body, and when the drug is encountered again, an allergic reaction may occur.
Which seasons are allergic?
Spring is the season when allergic reactions are more common. According to Chinese medicine, spring is a wood in the five elements, the main source of growth and development, wind in the five gases, green in the five colors, liver in the five organs, and acid in the five tastes. It is the time when the human body grows and develops metabolically. It is also the season when the immune system is active.
Spring is windy, dry skin and prone to allergies.
Various flowers open in spring and a lot of pollen floats in the air, which are also the reasons for the high incidence of allergies in spring.
As the temperature rises, the skin gradually “wakes up”, the metabolism accelerates and the secretion of sebaceous glands increases.
People’s skin becomes delicate under the protection of winter clothes, and spring is the time of the year when skin resistance is the weakest. The warmer the weather, the more skin is exposed and the more likely it is to be irritated and produce allergic reactions. According to Chinese medicine, the human body has established a defense system around the surface of the body to ensure that the pores open and close at the right time, so that external wind and evil disease-causing substances cannot invade, which is called “Wei Qi” in Chinese medicine. In spring, people’s defenses are not sufficient, so it is easy for various allergens to take advantage of the situation.
Which drugs need special attention?
For allergic reactions, there is a corresponding allergen, i.e. the substance that causes the allergy. Allergens are divided into several categories: inhalation, ingestion, and contact.
The inhalation category is inhaled through the respiratory tract, such as dust, pollen, mold, mites, paint, Chinese medicine particles, etc.
Ingestion includes plant and animal foods, such as fish, shrimp, milk, beef and mutton, which produce allergic reactions in the gastrointestinal tract, such as vomiting, diarrhea, etc.
The contact category includes fuel, paint, asphalt, pesticides, cosmetics, plastic additives, and topical Chinese herbal medicines.
Allergic reactions to herbal medicines can have various manifestations and the mechanisms of their production are not identical and need to be further studied. At present, there are more than 100 kinds of herbs known to cause allergic reactions, and the common herbs that can cause allergic reactions are: fishy grass, andrographis paniculata, senna, salvia, safflower, rhubarb, sanguisorba, pseudostellaria, panax ginseng, ginseng, ice chips, comfrey, stellaria, gypsum, kudzu, leech, dried dragon, bee’s milk, catkins, cogongrass, dacquoise, Chuanbei, crow’s nest, fat sea, aconite, rehmannia, bupleurum, bupleurum, toadstools, etc. Bupleurum, Toadstool, etc.
According to the available information, there are more than 90 kinds of traditional Chinese medicines and their preparations that cause allergic skin diseases, with 12.45% of single drugs, 2.61% of compounded external lotions, 56.63% of home-made preparations, and 28.31% of compounded adult medicines.
1.The medicine itself has toxicity or irritation
Some Chinese ointments for rheumatism and bone pains are very strong, or have toxicity and irritation in themselves.
Some plucking ointment, decay and muscle ointment, such as descending Dan, the role of the decay component is mainly to remove rotten flesh, with a certain corrosive and stimulating effect. The number of cases of skin allergy caused by drugs such as zebra and crow’s nest is relatively high compared to other drugs. There is special attention before use.
Although these drugs generally have a relatively strong irritation. However, the adverse reactions can be controlled. For example, the instructions of the finished drug will detail the method of use of the drug and limit the time of use. They should also be used under the supervision and guidance of an experienced physician. Be sure to follow medical advice and read the instructions carefully before using the drug.
2.Solvents and additives in drugs
Some people have allergic reactions mainly to the impurities, excipients and additives in the drugs. Different manufacturers use different production processes or production equipment, different excipients, additives, products with different impurities, some additives and excipients can be the culprit of allergies. The incidence of allergy has been increased by adding excipients to traditional Chinese topical medicines or making compounded adult medicines. It can be seen that the pathogenicity of Chinese medicine and its preparations is closely related to excipients and dosage forms, especially when combined with white wine! When combined with excipients such as alcohol and vinegar, many of them cause primary irritant dermatitis, which is related to excipients such as white wine, alcohol and vinegar with strong irritation.
3.Worm medicine
Drug types of Chinese medicine can be divided into plant drugs, animal drugs and mineral drugs, of which insect drugs are the most common to cause allergies because they contain large molecules of protein, and many doctors in the clinic have more knowledge of this. Those who are allergic to heterogeneous proteins should use insect drugs with caution.
4. Drugs that may contain pollen
Plant pollen is an important allergen and can cause allergic reactions. Some flowers are plant-based herbs. Be cautious with flower medicines such as wild chrysanthemum, aster, celosia, celandine, safflower, dandelion, etc. for those with a history of pollen allergy.
5, there are differences in the allergenicity of different dosage forms of drugs: according to clinical analysis, among the drugs that cause contact dermatitis, there are significantly more topical finished preparations than fresh single or multi-flavored drugs; the direct topical use of raw drugs causes significantly more disease than the topical use of single or multi-flavored drug decoctions and extracts; the allergic reactions to topical preparations with excipients such as liquor, alcohol and vinegar are significantly more than those to compounded adult drugs and homemade creams.
The irritant contact dermatitis caused by direct topical application of fresh Chinese medicine was also significantly more than allergic contact dermatitis, indicating that toxic reactions play an important role in the adverse skin reactions caused by topical application of Chinese medicine, probably because the concentration of irritants contained in fresh drugs is higher, while the decoction and processing of the drug concoction can both reduce the irritation of the drug and destroy some of the antigenic components, so that the concentration of irritants or antigens is greatly reduced .
How to use topical Chinese medicine to reduce adverse reactions?
1. Be sure to inform your doctor of the details of your allergy to medicine when you visit him/her. Do not conceal the history of previous allergies for fear of trouble or because of embarrassment. Previous allergies can often prompt doctors to avoid using allergy-prone drugs.
2. Topical medications must be used according to medical advice or instructions, and strictly following the correct timing can reduce the occurrence of adverse reactions.
There was an older man who had a shoulder strain and his doctor prescribed him 2 boxes of very common creams. The uncle used a plaster and applied it for 12 hours as recommended in the instructions, which should have been removed to let the skin rest. But he thought it was too wasteful to remove such an expensive medicine, so he put it on for another day. As a result, a rash appeared on the entire skin where the medication was applied. This is the skin allergy caused by overtime use of topical medication.
Another grandmother, because of a foot fracture, after a week of external herbal medicine, not only did not reduce the swelling, but also the surface of the foot are swollen. After detailed inquiry, the doctor learned that the grandmother was so eager to cure the disease that she took the initiative to soak the medicine for three hours instead of 10 to 20 minutes. This is another case of overtime use of topical drugs.
After reading the above two cases, the overtime use of topical Chinese medicine does not bring double the efficacy, but increases the possibility of adverse reactions.
3. Topical herbal medicines must be used at the temperature as prescribed by the doctor.
We have to remind every patient, especially elderly patients, that we do not recommend “scalding” of Chinese medicine. Instead, it is recommended that warmth is sufficient. Especially for patients with swollen limbs, the rapid expansion of limb capillaries at high temperatures may aggravate the exudation of local tissue fluid, which in turn may increase the swelling. The phenomenon of more and more swelling occurs with soaking. Some skin diseases, varicose veins, atherosclerosis, plaque and thrombosis of patients more disapprove of scalding with very hot water.
4, diabetic patients are more important to monitor the water temperature to avoid burns and allergies. Skin ulcers are more risky for diabetic patients and can easily cause infection and even gangrene of the limb.
5, pay attention to the route and use of drugs, especially to prevent the misuse of topical drugs or misuse caused by serious adverse events. A 20-year-old male patient, who mistakenly took topical orthopedic water about 8-10mL, developed dizziness, headache, numbness of the mouth and tongue, palpitations and premature beats about 1h later, and was treated by hospitalized gastric lavage and emergency treatment, and only returned to normal after 1 week.
6. It is strictly forbidden to contact mucous membranes with drugs used topically on the skin. The literature reports that a 52-year-old female patient mistakenly used “bruise oil” as rifampin eye drops into her right eye. At that time, she felt burning pain, could not open, lacrimation, eyelid swelling, spasm, bulbar conjunctiva edema and congestion, corneal epithelial lamellar detachment, stromal layer edema, and after symptomatic treatment, she eventually had permanent damage of corneal thin opacity. The permeability of the mucosa is much greater than that of the dense skin, so irritating or toxic drugs are absorbed more and faster through the mucosa, and are more harmful. It is also important to wash hands after contact with topical medications.
7. Follow the theory of Chinese medicine to use drugs. The essence of Chinese medicine lies in the dialectical treatment and the prescription of the right medicine. “The cold is hot”, “the hot is cold”, ” the solid is diarrhea”, ” the deficient is tonic”. Do not be hot and cold do not distinguish, deficiency does not check, take Chinese medicine as Western medicine lumped use, in violation of the principle of dialectical treatment, will be the opposite, not only the efficacy of poor, may also lead to a variety of adverse reactions.
8, to avoid drug abuse: most topical Chinese medicine are non-prescription drugs, which can be bought at any time in pharmacies without restriction, and the phenomenon of abuse based on experience or just reading the name of the drug as a matter of course is quite common.
9. Avoid using the same drug for a long time. Especially the topical herbs containing a certain degree of toxicity, long-term use of the same can cause toxic accumulation of effects and physical dependence and other adverse reactions.
10, pay attention to the use of drugs in the process of dietary contraindications. Avoid eating cold, greasy, spicy and stimulating food.
11.Pay attention to storage methods. Store in a cool place to avoid changes in drug properties.
12. Pay attention to drug interactions. If used together with other drugs, drug interactions may occur, please consult your physician or pharmacist for details.
13.Watch closely for drug reactions during use, especially if you are allergic or weak, you should use the drug with caution.
What should I do if an allergic reaction occurs?
1. Observe the drug reaction closely during the use of the drug, especially if you are allergic or weak, you should use the drug with caution. Once the discomfort occurs, pay attention to it. However, it is important to distinguish between normal reactions and allergic reactions in drug treatment. If you can’t tell the difference on your own, communicate with your doctor in time.
2. Once you have an allergic reaction, you should stop using the medication immediately.
3.Keep the consultation data and drug packaging and samples. It is convenient for the doctor to judge quickly and deal with it in time.
4.Distinguish the degree of allergic reaction, whether it is a local reaction or a systemic reaction. Local allergic reactions are limited to the limbs and areas in contact with the drug, and are not accompanied by systemic symptoms. It can be relieved by stopping the medication and simple symptomatic medication. However, if abnormal reactions occur in areas other than those in contact with the drug, such as abdominal distension, abdominal pain, diarrhea, nausea and vomiting, chest tightness, palpitations, tachycardia, dyspnea, cyanosis, arrhythmia, weakness of the limbs, dizziness and even symptoms of anaphylaxis, the patient should be sent to the hospital for treatment.
5, mild symptoms can be treated with anti-allergy drugs such as paracetamol, diphenhydramine, promethazine (finasteride), or vitamin C, calcium gluconate and other calcium preparations.
6, heavy symptoms such as anaphylaxis patients should be immediately sent to the hospital to give epinephrine, dexamethasone, high sugar, respiratory stimulants, elevated pressure, oxygen and other comprehensive rescue treatment. If the treatment is timely, the patient can usually be turned into a safe person.
By correctly understanding the allergic reactions of Chinese medicine and paying attention to the combination of prevention and treatment, we can surely avoid many accidents and let Chinese medicine play more unique advantages in clinical practice. Self-medication will become a safe and happy thing.