Overview of Adhesive Allergy

An adhesive allergy is a form of contact dermatitis in which a person experiences an allergic reaction to topical glues used in products like adhesive bandages, artificial nails, transdermal patches, and continuous glucose meters.

Allergic contact dermatitis occurs when the skin touches something that a person is allergic to (known as an allergen). Symptoms may include rash, itching, swelling, blisters, and skin darkening. Removing the allergen will usually resolve the reaction, though healing may take days or weeks.

This article explores the causes and symptoms of adhesive allergies, including how the rash looks. It also explains how adhesive allergies are diagnosed and treated and whether there are alternatives you can try.

What Does an Adhesive Allergy Look Like?

The symptoms of contact dermatitis are usually limited to the area of contact. But, with allergic contact dermatitis (as opposed to an irritant contact dermatitis), symptoms may extend to the surrounding skin as well.

Symptoms of an adhesive allergy may include:

• A red, itchy rash
• Tiny bumps (papules)
• Swelling
• Dry, flaking skin
• Tiny blisters (vesicles) or larger blisters (bullae)
• Temporary darkening of the skin (hyperpigmentation)

Depending on how sensitive you are to the allergen, symptoms may persist for hours, days, or even weeks once the allergen is removed. This differentiates allergic contact dermatitis from contact urticaria (hives), which often resolve within minutes.

What Causes an Adhesive Allergy?

Contact dermatitis is a localized skin reaction affecting the outermost layer of skin (called the epidermis) and the layer just below (called the dermis). With allergic contact dermatitis, the reaction occurs when an allergen triggers a localized immune response.

Within the skin are immune cells called mast cells that degranulate (break open) when confronted with an allergen, spilling chemicals called histamine, heparin, and cytokines that trigger swelling, itching, and rash.

With an adhesive allergy, the two main allergens are ingredients in the glue called liquid 2-octyl cyanoacrylate and n-butyl cyanoacrylate monomers. Studies show that certain people may be reactive to only one or both of these topical adhesives.

It is also possible that the allergy may not be caused by the glue but by the applied object itself. An example is adhesive bandages made with latex. A latex allergy is a form of allergic contact dermatitis affecting 1% of the general population and between 8% and 12% of healthcare workers in the United States.

Healthcare workers are disproportionately affected because of their frequent use of latex gloves. While it may seem reasonable to assume that a person becomes less sensitive to latex the more they are exposed, the opposite is true, and the risk and severity can increase rather than decrease.

In some cases, latex may not be the problem. For instance, you may also be allergic to medications placed on an adhesive bandage, such as iodine in Betadine skin disinfectant. The frequent use of topical antibiotic creams like Neosporin can also lead to allergic skin reactions.

Diagnosing an Adhesive Allergy

An adhesive allergy is often evident in that symptoms appear where the adhesive is applied. In such instances, a healthcare provider may proceed directly with treatment and forego further testing.

However, if the cause is uncertain, different allergy tests can be used to help pinpoint the exact culprit or culprits. These include:

• Patch testing: Common allergens are applied to the skin of the back using non-latex adhesive patches. Anywhere from 30 to over 100 different allergens can be applied at a time.
• Skin prick test: Tiny amounts of different allergens are inserted beneath the surface of the skin to see if an allergic reaction occurs. These are typically used to detect allergies to pollen, mold, pet dander, dust mites, and foods. In adults, the test is usually done on the forearm.
• Immunoglobulin E (IgE) tests: This is a blood test mainly used to detect allergies to pollen, mold, pet dander, food, and certain drugs. Total IgE tests can confirm you have some form of allergy, while specific IgE tests can confirm specific types of common allergies.

Treating an Allergy to Adhesives

Treatment for an adhesive allergy will vary depending on the severity of the reaction.

If you have a minor allergic reaction, you can simply remove the adhesive and allow the rash to heal on its own over the next few days. If you have a more serious reaction, your healthcare provider may prescribe one or more treatments to help alleviate symptoms as well as the underlying allergic response. These may include:

• A cold compress: This can be applied to the skin for 10 to 15 minutes at a time to help reduce swelling and itching.
• Topical corticosteroids: This includes over-the-counter (OTC) hydrocortisone 1% cream or stronger prescription ointments that help temper inflammation.
• Calamine lotion: This OTC remedy can help ease itching and burning when blisters develop.
• OTC oral antihistamines: These include options like Claritin (loratadine) or Zyrtec (cetirizine) that block the action of histamine (the main chemical involved in allergic reactions)

Alternatives to Adhesives

If you find that you are allergic to adhesive bandages, there are alternative wound coverings you can try that may help:

• Gauze rolls: These are typically made of cotton that can be wrapped around a wound and affixed with surgical tape.
• Skin barrier film: This is a spray or wipe that forms a protective layer between your skin and the gauze bandage.
• Hypoallergenic bandages; These are non-latex bandages that are less likely to cause allergy. However, as glue ingredients aren't commonly listed, try them out on hidden parts of the body first to see if a reaction occurs.

If you have an allergy to a transdermal patch that delivers medication through the skin, speak to your healthcare provider about other versions of the drug that may help. These include ointments that can be applied to a hypoallergenic adhesive bandage.

Summary

Adhesive allergies are a form of contact dermatitis mainly caused by ingredients in the adhesive glue. Symptoms include an itchy rash, swelling, blisters, skin dryness and flaking, and skin discoloration. Removing the adhesive usually resolves the symptoms. Medications like topical steroids and oral antihistamines may be prescribed to bring the reaction under control.