What is Paraben Allergy?

The FDA doesn’t regulate the chemicals in cosmetics and it’s up to consumers to be aware of the chemicals we put on and in our bodies on daily basis.  More and more, people are experience allergy to their cosmetics and personal care products.  These reactions cause itchy red swollen skin. As a cosmetic allergist, I have many patients who are a loss for what’s triggering the reaction. They know that certain lipsticks make their lips dry and irritated or sometimes a shampoo will trigger itchy dry irritated skin, but are confused about the exact cause.  This type of allergic reaction is called contact dermatitis.  

One common allergen in personal care products that triggers an itchy eczematous rash is parabens. 

What are Parabens?

• Parabens first introduced in the 1920’s are preservatives to help prevent bacterial and fungal growth.  Since their introduction, they’ve become some of the most common preservatives uses. 
•  Parabens come from an aromatic organic acid naturally found in fruits and vegetables called 4-hydroxybenzoic acid.  This forms the basis for parabens.
•  There are many types of parabens, but the most commonly used ones are methylparaben, propylparabens and butyl parabens.  These types of parabens are often mixed into one product type to provide broad spectrum protection against microorganisms.  Manufacturers do these to reduce the concentration of each one individually but provide the same type of preservative effect.

• Parabens can also cross react with chemical commonly used in sunscreens – para-aminobenzoic acid (PABA) esters, and in hair dye (paraphenylenediamine).

·      Parabens may also go by these names:

o   Methylparaben

o   Ethylparaben

o   Propylparaben

o   Butylparaben

o   Benzyl-parahydroxybenzoate (p-hydroxybenzoate)

o   Methyl-parahydroxybenzoate (p-hydroxybenzate)

o   Ethyl-parahydroxybenzoate (p-hydroxybenzoate)

o   Propyl-parahydroxybenzoate (p-hydroxybenzoate)

o   Butyl-parahydroxybenzoate (p-hydroxybenzoate)

o   Parahydroxybenzoate (p-hydroxybenzoate)

Where do you find Parabens?

• Parabens in personal care products:
• According to the American Chemical Society, they are used in almost 85% of all personal care products.  Common products like toothpaste, shampoo, lotions, sunscreens, moisturizers and lipsticks contain parabens.  They are also found in some topical medications like corticosteroid creams and anti-itch sprays. 
• Parabens in food products:
• You might be surprised to learn that parabens are added to food products like: pancake syrup, mayonnaise, salad dressing, baked goods, candy, food dye, soft drinks and fruit juices, spiced sauces, processed vegetables, and jams/jellies
• Parabens are also found naturally in food products like mango, blueberry, mango, strawberries, cocoa beans, carrots, vanilla, and onions.
• You can also find parabens naturally in some wine and beer products.

What is Paraben Allergy?

• Repeat exposure to skin, particularly damaged skin, but parabens can trigger an allergic reaction called contact dermatitis.
•  According to a 2015 study by Warshaw et al, parabens caused anywhere from 1.4% of of all contact reactions. Exposure to parabens can cause your skin to become dry, itchy and swollen.

What Should you Do if You Suspect You Are Allergic to Parabens?

• If you suspect you have paraben allergy, speak with your allergist about having a special chemical allergy test done called patch testing. 

How Can you Avoid Parabens?

• If you have paraben allergy, then you should strictly avoid any product or food that contains these chemicals
• Reading ingredient lists on your personal care products and food labels will be essential to preventing a future reaction.
• Using products that are oil based will help limit your exposure
• Be especially careful with sunscreens, processed foods, topical medications and other unexpected sources of parabens.  
• If you visit gramercyallergy, we will generate a paraben free list of products you can safely use. 

Have further questions regarding paraben allergy or suspect you have paraben allergy?  Visit GramercyAllergy. We are experts in cosmetic allergy.  We will help identify which cosmetic product is triggering your allergy. 

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How To Make Chemical Free Cleaning Products

                              

Does cleaning make your nose stuffy or trigger you to have an asthma attack?

As spring approaches, many of us are planning doing spring cleaning.  This is a dread for many with difficult to control asthma and allergies. Cleaning with strong chemical scents and fragrances triggers chest tightness, sob, and nasal congestion; for some it can land them in their doctors office or even lead to an emergency room visit.  They have difficult to control asthma and are frustrated by the these easily avoidable triggers.  They worry about the impact of these chemicals long term on their nose, lungs and skin.  Or they just want to reduced their overall chemical exposure for themselves and their family.

Here are some “home made” cleaning products that you can use to avoid the potent products available in the drugstores. These recipes can be made with simple products like white vinegar, borax, dishwashing soap, and water.  You'll need several labeled spray bottles to start.  You can purchase these from the dollar store.  

These easy to make products will keep your home smelling fresh while eliminating fumes and irritants that might trigger your asthma. Some people like to add a natural scent by using a drop of lavender or jasmine oil to the mix.  You can purchase these in a health food store.

If you do have to use strong products, make sure the area is well ventilated, you use the recommended amount, and you take frequent breaks.  It's helpful to use a mask as well.

Enjoy and happy cleaning!

Glass and mirrors:

• 3 tablespoons of white vinegar + ¾ cup of water. Mix in a spray bottle

Countertops:

• 2-3 drops of dishwasher soap, 3 tablespoons of white vinegar. Mix with water in spray bottle.

 Disinfectant for Toilets:

• 1/4 baking soda + ½ cup white vinegar + 1 gallon of warm water

Or 

• 1 can of coca cola (yes this does say coca cola- cola has the same acidity as  bleach!)

Mold and Mildew:

• 1 tablespoon baking soda + 2 tablespoons White vinegar + 1 quart of water.  Mix in a spray bottle.

Floors:

• 1 cup white vinegar + 1 gallon hot water mixed in a bucket

Want more help in managing your asthma and allergies?  Reach out to Gramercy Allergy and Asthma for expert advice on allergies.

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Help the American Academy of Allergy Allergy Asthma and Immunology Save Patient access to Allergy Shots.

The American Academy of Allergy, Asthma & Immunology (AAAAI), a professional membership organization of more than 6,800 allergist/immunologists, is spreading the word that newly proposed regulations from the United States Pharmacopeia (USP) could dramatically limit patient access to allergen immunotherapy (allergy shots).

Sign the Petition!

Help the AAAAI save patient access to allergy shots. Sign this petition to let USP know they should keep the existing requirements in place—and not move forward with these new proposed regulations.

What are allergy shots and who is proposing these new regulations?

Allergy shots, also known as allergen immunotherapy, are an important treatment for allergic diseases that has substantially improved patient care, reduced emergency room visits, decreased medication costs and decreased hospitalization.

As mentioned above, the new regulations are being introduced by the United States Pharmacopeia (USP). There is no data in the peer-reviewed medical literature that allergy shots have ever caused infections in patients, but this is the concern driving USP to propose these new guidelines.

Sign the Petition! #saveallergyshots

If these new regulations go into effect, how will it impact patients?

The more extensive procedures for mixing under the new regulations would make it highly unlikely that allergists would be able to continue to mix allergen extracts for their patients in the office setting.

Non-healthcare system employed physicians will have very limited options to secure allergy immunotherapy prescriptions for their patients. There are only two facilities that have been identified as resources for this service in the United States. Having to use outside facilities may limit the timelines of allergy shot treatment, among other consequences. Also Medicare currently does not cover allergen immunotherapy manufactured by a third party vendor. Thus, Medicare recipients, and potentially commercially insured patients, would no longer have allergen immunotherapy as a covered service. USP’s proposed requirements would directly transfer the cost of a previously covered benefit to the beneficiary. 

Sign the Petition! #saveallergyshots

What can I do to prevent these regulations from going into effect?

Again, sign this petition to let USP know: 1) you are concerned about how these proposed changes will impact patient access to allergen immunotherapy and 2) they should keep the existing requirements in place.

Sign the Petition! #saveallergyshots

Want more information about allergy shots and how they work?
Gramercy Allergy and Asthma hopes you gain control over your allergies in the new year.  We are here to help.   Call the office or click her to schedule an appointment.

Why Should You Get Control Over Your Allergies in the New Year?

January is a time of resolutions and change.  The air is always a buzz with self reflection, inspiration, and people taking stock of their lives.  It's a time to ask yourself what's going well and where do you want to improve your life. The change in the calendar inspires us all to start fresh and change.  We tell our friends and family of our goals for the year hoping they'll support and encourage us.  These resolutions help drive the course for the new year and act as reminders of who we want to be and how we want to fill our year.

What are 5 reasons that getting control of your allergies may be one of the best decisions you make for 2016?

Uncontrolled Allergies Affect Our Day-to Day Life.
Those who suffer from allergies know how to well the social embarrassment of being on a day with a runny nose, a business meeting where you can stop sneezing our having to cancel a day to the park because of an asthma attack.  Allergies sufferers are often thought to have recurrent colds and to be sick all the time.  Allergies change our voice and the authority and confidence we present ideas with in meetings or school.  Asthma attacks and food allergies drive us to the emergency room every year.
Knowing what is triggering your symptoms and having a plan for prevention puts you back in control over the cause of these attacks. An allergist and immunologist will help you determine a specific plan to prevent your symptoms.  Treatments for allergies including action plans, environmental control measures, medications and immunotherapy (allergy shots).

                           

Uncontrolled Allergies affect our sleep.
Daily fatigue and poor sleep is a common complaint of those who suffer from allergies.  Children and adults have difficulty concentrating during the daytime secondary to poor allergy control.  Nasal congestion during sleep and waking from sneezing can trigger snoring and sleep apnea.  Uncontrolled asthma can cause a persistent dry cough and frequent interruptions in your sleep cycle. Both of these disease leads to "allergic" inflammation that makes many feel groggy and tired.  Improved control over your asthma and allergies will improve your energy levels and focus.

                     
                                     

Uncontrolled Allergies and Asthma are Preventing you From Exercising
So many of my patients tell me that they want to start to exercise, but feel they can't because of uncontrolled asthma or hives with exercise.    Asthma and hives are often triggered by exercise.  You don't have to have asthma at any other time other than during exercise to have exercise induced asthma.  Symptoms include chest tightness, air hunger, cough and shortness of breath.  Seeing an allergist will help you get control over your exercise induced symptoms so you can exercise and do the activities you want to do like hiking or run a race.
                        \

Your Allergies are Causing Skin Problems
Did you know that 12-17% of the population is affected with skin allergies including eczema  and chemical allergies.  Skin allergies cause social embarrassment, sleep disruption, and change the way we interact with others. Every day we put over 200 chemicals on our bodies that can cause allergic sensitization over time.  Treating skin allergies with topical steroids is only a band-aid approach- it stops the reaction, but does nothing to prevent it from happening in the future.    Knowing what is triggering the eczema or rash on your face and avoiding it can stop the cycle.  Seeing an allergist advice will help you determine the cause of your rash and how to prevent it from starting.

                                             

You Want to To Get Back to Nature
Many who suffer from allergy tell me how they dread the spring, summer and fall because despite wanting to go and enjoy nature, they get terribly sick from trips to the park, golf course, and being outside with their friends.  They say no to social engagements for fear of an allergy attack. They change the way they date because they are allergic to cats and dogs.  They suffer from "sinusitis" every spring and fall and have to take multiple courses of antibiotics before feeling well.Seeing an allergist now can help you put together a plan to prevent your symptoms.  Knowing what triggers your symptoms is the first step to taking back your life from you allergies.
                                                




Good luck with all of your resolutions in 2016! Gramercy Allergy and Asthma hopes you gain control over your allergies in the new year.  We are here to help.   Call the office or click her to schedule an appointment.

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How Can You Get Control Over Uncontrolled Asthma?

                             

Gramercy Allergy and Asthma is a referral site for patients with uncontrolled asthma.  We see some of the toughest cases of allergic asthma in New York City.  Patients with uncontrolled asthma often visit the emergency room several times a month or year. They have little control over there symptoms of cough, chest tightness, shortness of breath and wheezing and feel trapped by asthma symptoms.  They are woken up in the middle of the night with coughing and a feeling that they can't catch their breath.  Asthma symptoms prevent many from doing the things they love like dancing, going for walks with their loved ones or just going outside.  

But what many who have uncontrolled asthma don't realize is that you don't have to live with uncontrolled asthma.  Here's a few things you can do to gain control over your asthma.

Get a Control of Your Asthma!
1) Knowing What You're Asthma Triggers is Vital To Gaining Control.  

Approximately 85% of asthma is associated with allergic triggers.  Animals, dust, change of season, thunderstorms, and pollens will often trigger an asthma attack.  Avoidance measures like using dust mite covers for your pillows, removing feathers from your bed, repairing leaks and knowing when you use your inhalers can often make the difference between being symptom free and an asthma attack.  Uncontrolled nasal and sinus allergies are often the spark that leads to uncontrolled asthma.  Speak with your allergist about a comprehensive plan for tackling your asthma and allergies.

2) Know Your Level of Total IgE.

Immunoglobulin E (IgE), one of 5 types of immunoglobulins (Ig) in our body.  Immunoglobulins are proteins important in fighting bacterial, virus and in causing allergy.  IgE is one of the proteins responsible for triggering an allergic attack and is a marker of total body allergic inflammation.  Have an elevated IgE?  See an allergist.  They can help you.  There are medications that help block IgE from triggering an asthma attack.  Your allergist can help identify which medications will be best for you to prevent an asthma attack. Having elevated IgE can be a marker of more difficult to control asthma

3) Verify you are using your medications correctly.  

Asthma medications are complicated, confusing and often look alike.  Verify with your doctor that you are using yours correctly- it's easy to make a mistake.  Something simply as correcting your delivery of medication may keep you out of the emergency room.

4) Get your Vitamin D Level Checked.

Low vitamin D levels are associated with more frequent attacks according to a study published in The Journal of Allergy.  Persons in this study with low vitamin D levels were 25% more likely to have an asthma attack according to researchers.  Have low vitamin D?  Vitamin D known as the sunshine vitamin is naturally made by our skin when exposed to sunshine.  If you're not able to get outside regularly then take a supplement.  Aim for at least 600 IU/day.

5) Look for Eosinophilia

Eosinophils are a type of blood cell associated with allergic inflammation.  They are often elevated in persons with severe allergic asthma.  Having elevated eosinophils can be a marker of more difficult to control disease.  Elevations in eosionphils are detected via a simple blood test.

6) Look for Other Problems

Not all asthma is created equally.  Persons not responding to typical medications may have something else going on that's causing them to have poorly controlled asthma.  Uncontrolled sinus disease (sinusitis), allergy to aspirin (aspirin exacerbated respiratory disease), loss of smell, recurrent nasal polyps,  frequent infections (ear, sinusitis and pneumonia), and long term use of oral steroids are signs that something might be missing from your asthma care.  

6) Still Have Difficult to Control Symptoms- See an Allergy, Asthma and Immunlogy Specialist

Allergist/Immunologists are specially trained to deal with difficult to control asthma.  Expect a detailed history of your environmental and job exposures, environmental testing,and medication teaching.  They will help identify the cause of your uncontrolled symptoms and help you avoid it whenever possible.  Allergists may prescribe medications like omalizumab (xolair) or mepoluzimab (nucala) that required monthly injection to fight the proteins that are causing your asthma. They are highly trained to deal with immune problems and will help you get to the root cause of your problem.  

Need specific advice regarding your asthma?  Visit us at gramercyallergy.com or click here for an online appointment.

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How to Go Hiking When You Have Allergies?

People mistake New Yorkers for not loving the great outdoors. They forget that the Catskills are just a quick train/drive away and for us it’s the perfect getaway weekend.  The Hudson Valley/Catskills offer hiking, camping and apple picking.  The warm weather makes leaf peaking this time of the year a true treat.  Golden yellows, brilliant orange and vibrant reds fill the valleys and mountainscape.  But if you have allergies, this type of interaction with nature can be a bit of a perilous adventure. What's the best way to deal with allergies and hiking?

Here are a five tips to handle your allergies before you head out for your next big hike.

Use and Bring your Asthma Medication

• Any experience hiker will tell you to always be prepared when you go hiking.  Elevations can bring about dramatic temperature changes and winds.  If you have asthma, the change in temperature and/or exercise required to climb the mountain might trigger an attack.
  
• Pack your inhaler with you in your bag.  Make sure you use it before you start your climb to prevent your lungs from getting tight.  When you’re on the mountain, you might have limited resources to emergency care so prevention of symptoms is key.

Know What You Are Allergic To Before You Head Out

• Get tested!  Find allergy relief by knowing what you are allergic to so you can prepare and avoid it.  About 5% of Americans are allergic to molds. Common molds that cause problems are Alternaria. Aspergillus, Cladosporium, and Penicillium. The dirt and decomposing leaves are full of molds, fungi, smuts, and rusts that might trigger you to have an allergy attack. As you hit the trail you’ll potentially disturb these molds causing them to release spores into the air that may cause you to have an allergy attack.
  
• If you are among those who are allergic to molds, speak with your allergist about developing a plan for treating acute symptoms. Toss in a few anti-histamines into your bag to stop acute symptoms.

                           

Allergic to Insects? Bring your Epinephrine

• We forget that there are stinging insects in the woods.  Bees over live underground, wasps and hornets build nests on fallen trees, and fire ants are on the ground. If you have or suspect you are allergic to any of these insects, make sure you pack your epi for your next hike.
  
• Love the outdoors, and allergic to stinging insects?  Did you know that there's treatment for stinging insect allergy that's almost 99% effective? Talk to your allergist about getting treatment for insect allergy it can potentially save your life. 

                                         

Don’t touch The Pines

• Many forget about delayed allergic reactions when they go hiking.  There are many substances in the woods that can cause a rash up to 10 days after your home.  This is called contact dermatitis.
  
• A sticky resin leaking from pine tree bark causes rashes in about 5% of the population.  This is called colophony allergy.  You can potentially exposure your
  
• About 5% of the population is sensitive to the sticky resin from pine trees known as colophony.  This can cause a severe rash on your skin that might require your allergist’s attention.

 

Be Cautious of 3 Leafed Plants.

• In New York we have 3 main types of plants that can causes severe contact dermatitis- poison ivy, poison oak and poison sumac.  All three have similar characteristics and classically will have 3 leaves clustered together.
  
• Did you know that poison ivy loves to grow in apple orchards?  The vines climb wrap around the trunk of the tree.  Bringing back fall foliage as a souvenir? Be careful there's not poison ivy or poison oak in your beautiful fall foliage mix.  You'll typically find poison sumac, the least prevalent poisonous plant, in wet marshy areas.   The reaction will typically take place several days later and be characteristic of an itchy linear rash.
  
• Collecting fire wood for the bonfire?  Don't burn the poison ivy.  You will aerosolize, uroshiol, the chemical that causes the reaction, into the air allowing it to cover your body and enter your lungs.

Want to know what’s triggering your symptoms or need help with your next hike?

 Gramercy Allergy , New York City's Top allergy offices, would love to help!  Dr Collins brings over a decade of experience treating allergy and immunology.  She's happy to solve the most difficult problems.  Visit us anytime for more specific advice and to determine what is causing your symptoms. Book an appointment online here.

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How to Run a Race When You Have Asthma?

 Over 50,000 people will head out to run 26.2 miles around all five boroughs of New York City for the New York City Marathon.  Did you know that 10% of the people running on Sunday will have exercise induced asthma?  This is a disease where exercise triggers spasm, chest tightness and shortness of breath.  As if running 26.2 miles where hard enough, people with exercise induced asthma, need all the help  they can get to help prevent their symptoms. 

Here are Five Tips to Help you Finish Strong this Weekend!

1)     Stay Hydrated

-Persons with exercise induced asthma get dehydrated faster.  When you lungs are dehydrated, this can trigger symptoms of asthma

-A study from the University of Buffalo in 1999, showed that persons with asthma had improved lung function when they were hydrated.

-Make sure all week long, you are drinking plenty of water.  Take water frequently along the run to keep your muscles and lungs well hydrated.

2) Eat Diet Rich in Omega 3 Fatty Acids.

- In a subset of people with exercise induced asthma, eating a diet rich in omega 3 fatty acids 3 weeks before exercising, reduced inflammation typically seen in mucus associated with asthma.  Lung function was improved and they used less rescue inhalers like albuterol.

- Fish, flax seed oil, walnuts and chia seeds are all excellent sources of omega 3 fatty acids.

3) Use Medications Early

- Make sure you use your albuterol and other asthma medications at least 15 minutes before exercising.  This will keep you lungs open during your run.  

-Check to make sure they haven't expired.

-You may need a 2^nd dose during the run.  Albuterol only lasts for 4 hours so if you are expecting your marathon time to be longer than that, make sure you give your self a 2^nd dose at the 3.5 hour mark. 

4) Warm Up Your Lungs

-Warm up your lungs with light exercise 5-10 minutes the morning before your race.  This will help them get used to temperature changes.

5) Check the Weather Report

-When you have asthma, knowing what the weather’s going to be like is especially important.  In the early part of your run, you may need a scarf to help keep your lungs warm.  A scarf will help humidify and warm the air before it enters into your lungs.

- Bring one you won’t care about loosing if you are running on Sunday. As the day warms, you may want to drop it. 

-Look at the pollen counts.

-If allergies are a trigger for your asthma, using your allergy medication can prevent you from having an allergy attack.  You’re covering a lot of ground running a marathon.  As New Yorkers, we know how drastically the weather can change around the city.  Make sure you look at all the areas your running through to keep yourself healthy.

Good luck at your next race! Need other last minute tips before Sunday or your next race?  Call the office or click her to schedule an appointment.