The patient reports an allergy to latex. what alterations should be made in the patients care

Overview

What is a latex allergy?

A latex allergy is a reaction to natural rubber latex, a substance that comes from the sap of the rubber tree (Hevea brasiliensis). Many products are made with natural rubber latex, including rubber exam gloves, balloons and condoms. Reactions to latex range from mild to severe and can even be fatal.

People with latex allergies can have an allergic reaction when they inhale (breathe in) latex particles or come into physical contact with latex. Symptoms of a reaction to latex include skin irritation, rash, hives, runny nose and difficulty breathing. There is no cure for a latex allergy. People with this condition should avoid products with latex and consider the use of a med-alert bracelet.

How common are latex allergies?

Latex allergies are rare. Less than 1% of people in the United States are allergic to latex. Latex allergies have decreased in recent years because more hospitals now use latex-free and powder-free gloves.

Anyone can develop a latex allergy, but some people have a higher risk of developing the condition. Risk factors for latex allergy include:

• Repeated exposure to latex: Frequent contact with latex can cause your body to overreact and develop an allergic reaction. People who regularly wear latex gloves are more likely to develop an allergy to latex. Healthcare providers, dentists and people who work in the beauty industry have a higher risk.
• Frequent surgical procedures: Children and adults who have had several surgeries have an increased risk of developing a latex allergy. Children with spina bifida are especially likely to have a latex allergy because treatment for the condition includes multiple medical procedures and surgeries at a young age. Medical supplies for these procedures (including catheters and rubber gloves) often contain latex.
• History of allergies: Other allergies, including allergic rhinitis (hay fever), often occur along with a latex allergy. People who are allergic to latex may be allergic to certain foods, including bananas, kiwis, avocados and chestnuts. The connection between latex allergies and food allergies is called latex-food syndrome.

What are the types of latex allergy?

There are two types of allergic reactions to natural rubber latex. The types of latex reactions are:

• IgE-mediated latex allergy (type I): A person with type I latex allergy is allergic to a protein from the natural rubber tree. Exposure to latex causes the immune system to make IgE (immunoglobulin E) antibodies. These antibodies cause symptoms of an allergic reaction. IgE-mediated latex allergies can be life-threatening.
• Cell-mediated contact dermatitis (type IV): This allergy causes skin irritation and inflammation (contact dermatitis). Blisters may form on the skin, and they may ooze liquid. Cell-mediated contact dermatitis is not life-threatening, but may be very bothersome and in some cases progress to also involve IgE-mediated latex allergy.

Symptoms and Causes

What are the symptoms of latex allergy?

Signs of an allergic reaction to latex can be mild or severe. They can appear right after exposure to latex or up to a few hours later. You might not have symptoms the first time you come into contact with latex. Latex allergy symptoms include:

• Skin irritation: Itching, inflammation, redness and swelling appear after skin contact with latex. For example, you may have itchy lips after blowing up a balloon or vaginal irritation after having sex with a partner who used a latex condom.
• Rash: An itchy rash appears where the latex touched your skin. A latex allergy rash usually occurs within a day after exposure. The rash can spread if it touches skin on other parts of your body. But you can get a rash from other factors, such as using too much hand sanitizer or washing your hands too often.
• Hives, runny nose and sneezing: Itchy, watery eyes and inflammation around the nose and mouth are common. Eyes may become swollen and red.
• Trouble breathing: People who have severe allergic reactions may wheeze or have difficulty breathing. In severe cases, anaphylaxis may occur. Anaphylaxis can be fatal. If you or someone you know is having an allergic reaction and can’t breathe, call 911 or go to the emergency room.

What causes latex allergic reactions?

During an IgE-mediated allergic reaction, your body’s immune system overreacts to a substance (like latex) that isn’t harmful to most people. Your immune system tries to protect you by releasing a chemical called histamine into your bloodstream. Histamine causes symptoms of an allergic reaction. You may experience hives, runny nose and trouble breathing.

An allergic reaction to latex can happen when you touch or come into contact with latex products. Your immune system may also react if you breathe in tiny latex particles in the air. You may not have a reaction the first time you’re exposed to latex. With each exposure, your allergic reactions may get worse.

Diagnosis and Tests

How is a latex allergy diagnosed?

Your healthcare provider will examine you and ask about your symptoms and exposure to latex. You should share information about other allergies you have, including reactions to foods. If you have a family history of allergies, tell your provider.

Your provider may order a blood test to check if you’re allergic to latex. Providers also use a skin prick test to diagnose a latex allergy.

What is a skin prick test?

This common test might be a little uncomfortable, but it isn’t painful. Your provider puts a small amount of latex on your skin (usually on your forearm or back) and scratches or pricks the skin with a needle. Scratching the skin allows a bit of latex to get under the surface.

If you’re allergic to latex, the area will become red and itchy. You may develop raised welts called wheals (they look like hives). The skin irritation and wheals show that your immune system is reacting. It usually takes about 15 to 30 minutes for a reaction to occur.

Management and Treatment

Can a latex allergy be treated?

There is no cure for latex allergy. If you are allergic to latex, you should:

• Avoid products that contain latex.
• Tell providers, caregivers, teachers and friends that they’re allergic.
• Avoid areas where latex may be in the air, such as a hospital room where providers use latex gloves.
• Talk to your healthcare provider about wearing a medical alert bracelet. In a medical emergency, the bracelet lets others know you’re allergic to latex.
• If an IgE-mediated allergic reaction to latex is diagnosed, you should carry injectable epinephrine with you. Show caregivers, friends and family members how to give you an injection if you’re having a reaction and can’t inject yourself.

Prevention

Can I prevent an allergic reaction to latex?

There is no way to prevent a latex allergy, but you may be able to avoid an allergic reaction. If you’re allergic to latex, you should avoid products that contain latex. Before a medical procedure or dental work, tell your providers about your allergy. Ask them to use latex-free gloves and equipment.

When ordering from a restaurant, if you have a severe latex allergy, ask the person who prepares your food to wear latex-free gloves.

Many everyday household items, medical equipment and clothing contain latex. It’s essential to read labels carefully. You should avoid products that contain latex, including:

• Balloons.
• Parts of clothing and shoes, such as elastic in underwear, raincoats and rain boots, and the soles of sneakers or other shoes.
• Items around the house, including rubber bands, carpet backing, and some toys and bandages.
• Personal care items like sanitary napkins, condoms and diaphragms.
• Pacifiers and nipples for baby bottles.
• Some types of makeup, face paint and masks used for costumes.

What foods should I avoid if I have a latex allergy?

Several foods can cause an allergic reaction in people with a latex allergy. Most people with latex allergy are not allergic to these foods, and you should only avoid them if directed by your allergy/ immunology healthcare provider. Foods more likely to cause a reaction in people with latex allergy include:

• Chestnuts.
• Fruits such as apples, bananas, avocados, peaches, kiwi, nectarines, melon, figs, papayas and tomatoes.
• Vegetables such as potatoes, celery and carrots.

Outlook / Prognosis

What is the outlook for people with a latex allergy?

Most people manage a latex allergy with the help of an allergist (healthcare provider who specializes in allergies). By making lifestyle changes and avoiding foods that can cause a reaction, it is possible to avoid an allergic reaction. Talk to your healthcare provider about steps you can take to stay away from latex and stay safe.

Living With

When should I see my healthcare provider about a latex allergy?

If you think you’re having an allergic reaction to latex, see your provider right away. If your throat is swelling or you’re having trouble breathing, call 911 or go to the emergency room. Don’t ignore signs of an allergic reaction. A latex allergy can be fatal, and it’s essential to get help immediately.

A note from Cleveland Clinic

Millions of people manage allergies by making lifestyle changes, such as reading labels carefully and avoiding certain foods. These changes aren’t always easy, but they are a vital part of staying well. With the help of an allergy specialist, you can lower your risk of an allergic response. Learn to recognize signs of a reaction so you can get help right away, and let others know about your allergy so they can act fast if you need assistance.

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