Wheezing cough and itchy back: what should you know?

An itchy back may be caused by dry skin, heat, contact with a new product or an allergic skin reaction. Wheezing and cough can occur when the airways react to an allergen, smoke or a respiratory infection. Asthma presents with wheezing and cough, sometimes alongside other allergy symptoms, but an itchy back by itself does not establish that diagnosis. Allergic Rhinitis may cause sneezing and nasal drainage that aggravates cough without causing the skin itch. Acute Bronchitis can produce cough and wheeze after airway inflammation. Hives, facial swelling or sudden breathing symptoms raise concern for Anaphylaxis.

Think back to recent changes such as food, medicine, detergent, fabric, pets, dust or outdoor exposure. Stop using a new skin product and rinse irritated skin with lukewarm water; avoid scratching and use a plain moisturiser if the skin is dry. Move away from smoke or fragrance and follow any existing asthma action plan. Do not test a suspected food or medicine trigger again on your own. A clinician can examine the rash and breathing, review timing and decide whether treatment or allergy assessment is needed.

Get emergency help immediately for wheezing with swelling of the lips, tongue or throat, widespread hives, repeated vomiting, dizziness, faintness or rapidly worsening breathing. These can be features of Anaphylaxis. Seek prompt assessment for a first wheeze, breathing symptoms after a new medicine or food, chest pain, blue or grey lips, confusion, or a child who cannot feed comfortably. Arrange a routine review if the cough or wheeze keeps returning, the itch spreads or the skin becomes painful, cracked or infected.

Could the skin and breathing symptoms share a trigger? Does the rash look like hives, eczema or contact irritation? What should I do if the wheeze returns? Should I carry an emergency medicine or keep an asthma plan?