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You wake up one morning and discover a small rash on your tummy, just above your belly button. It does not itch at first. In the next couple of days, the rash gradually spreads towards your chest and your upper legs. You feel otherwise well except for mild-flu like symptoms. 

The rash starts to itch more and more. You visit your local drugstore and the woman behind the counter recommends a menthol gel to rub on your rash to relieve the itch. However this does not work. It is almost 12 days since you had these symptoms and panic really starts to set in. 

You are convinced it is due to an allergic reaction you have and call your GP practice for an appointment. 

The assistant is very understanding and arranges an appointment with your GP the same day. 

At the GP, you are asked several questions like:

  1. When did it start?
  2. How does it affect your daily life?
  3. Are you taking any medication?
  4. Have you ever had this before?
  5. Did you feel generally unwell before the onset of the rash?
  6. Have you developed any fever, weight loss, changes in appetite?
  7. Any possible factors that cause this for instance changes in your diet or new hobbies?
  8. Does this type of condition occur with other family members?

You answer accordingly and note that you had taken ibuprofen a few days prior to your rash due to throat pain and general aches. Then your GP performs a focused physical examination. She then says you have a urticaria (a medical word for rash) possibly due to the Ibuprofen you took. She concludes it will go away and would like to send you home with some medication against the itch and review if things get worse.  However, you are convinced that it could be your diet or something else you are allergic to and would like to have blood tests. 

In general screening tests for dietary causes of allergies or IgE specific allergens are not needed for a rash that is persistent for less than 6 weeks without any other serious complications.

Your GP will only consider doing further tests for allergies if the following occur

  1. You develop a rash within 60 minutes of ingesting one specific food type. 
  2. You have no rash when you do not ingest that specific type of food

If symptoms persist for more than 6 weeks your GP will refer you to a dermatologist. 

Here are other reasons your GP will refer you to a specialist if you have urticaria

  • If they suspect that you are allergic to a certain type of medication for which there are no alternative treatments
  • If you suffer from a hereditary condition called C1-esterase inhibitor deficiency. This condition is when you have angio-oedema (swelling), abdominal complaints, laryngeal oedema but NO rash. 

Your GP has managed to convince you that for now you do not need further tests. 

She prescribes you antihistamines. Here are 2 antihistamine medications you will most likely receive from your GP for a rash that is itchy.

  • Levocetirizine or 
  • Desloratadine 

If you are pregnant then your GP will prescribe you

  • Loratadine or 
  • Cetirizine

Levomenthol gel is not effective in treating the rash however can be used in combination with the antihistamines for a soothing effect.

You try the medication for a few days but see no effect. You contact your GP as she suggested. This time an appointment is not made, but your GP increases the antihistamine dose to one tablet twice a day. She reassures you that this will eventually go away in 3 to 4 weeks.