Skin anaphylaxis: what to know

Anaphylaxis is a rapid, severe allergic reaction. The skin may become itchy or develop raised welts, widespread redness, or swelling of the lips, face, eyelids, or tongue. Skin findings can appear with wheezing, throat tightness, hoarseness, dizziness, vomiting, or collapse. A skin rash is not required for anaphylaxis, so do not wait for hives before acting.

Use an adrenaline auto-injector immediately if it has been prescribed and anaphylaxis is suspected. Call emergency services, state that anaphylaxis is possible, and follow the dispatcher’s instructions. Lie down with legs raised unless breathing is difficult; then sit with legs extended. Do not let the person stand or walk. A second auto-injector may be needed if symptoms persist or return, according to the device instructions and emergency advice.

Treat sudden skin swelling or hives with breathing difficulty, wheezing, throat or tongue swelling, faintness, confusion, or repeated vomiting as an emergency. Go to emergency care even if symptoms improve after adrenaline, because symptoms can return and observation may be needed. Arrange follow-up allergy assessment after the event to identify triggers and make an action plan.

Ask which symptoms should prompt adrenaline, how to use and store your auto-injector, whether you need two devices, and how to reduce exposure to a suspected trigger. Ask whether Allergy Testing is suitable and how to explain your emergency plan to family, school, or colleagues.