Stages of skin allergy

Skin allergy does not have formal stages, but the reaction usually passes through recognisable phases. Knowing them helps you choose the right care at the right time.

Sensitisation (silent phase) In allergic contact dermatitis, the immune system first becomes sensitised to a substance after repeated or first exposure. No rash is seen during this period, which can last days to years.

Acute phase After re-exposure, the skin becomes red, swollen and very itchy within hours to days. Blisters may form and ooze. In hives, welts appear suddenly, and fade in hours.

Subacute phase The blisters dry and form crusts, scales and cracks. Itching remains, and the skin looks dry and flaky.

Chronic phase With repeated exposure or constant scratching, the skin thickens, becomes dark and leathery (lichenification) and the itch continues. Eczema often reaches this stage during repeated flares.

Complicated phase Scratching breaks the skin and bacteria such as Staphylococcus can cause infection, with pus, crusts and pain. Sleep loss and distress can follow.

Healing phase After the trigger is removed and treatment given, the rash fades in one to three weeks. Dark or light marks may stay for weeks to months.

Relapse Re-exposure to the trigger, dry weather, stress or infection can bring the rash back.

Emergency stage Rarely, a skin reaction is part of anaphylaxis or a severe drug reaction, and needs emergency treatment (112).

Ayurvedic view (interpretive) Traditional texts describe acute inflammation (Pitta), oozing (Kapha) and chronic dryness (Vata) as stages of skin disease. This is a conceptual comparison only.

Remember Early treatment and trigger avoidance prevent the rash from becoming chronic.