Rashes are often mysterious. They appear unannounced, and leave itchy sufferers desperate to identify a cause. One culprit that doctors increasingly test for is laundry detergents.

“I probably test a handful of patients a week to ingredients in their detergent,” said Dr. Melinda Rathkopf an allergist and immunologist at the Allergy Center of Alaska. “You could easily say it’s one of the common triggers for recurrent skin rashes.”

Still, detergent allergies are relatively rare, So, the Broadcast asked Rathkopf for guidance on how to know if you are suffering from a detergent allergy, what you should do if you are, and whether you should switch to one of the new chemical free detergents on the market. Here’s what you need to know.

What are the symptoms of a detergent allergy?
“Detergent allergies fall under the category of contact dermatitis. And dermatitis is just a fancy word for a rash. If you are specifically talking about detergents, it could be either allergic dermatitis, when you’re actually allergic to it and the allergy is triggering an immune response in the nose, lung and throat, or irritant dermatitis where the skin is reacting to an irritant.”

How can you tell the difference between irritant dermatitis and allergic dermatitis?
“It can actually be really hard to tell just from looking at the rash because they can both itch and they both look very similar. Both rashes are usually bumpy, whether they’re little fine bumps or they’re more blister-like. They’re a little raised, rough. Sometimes they’re a little more weepy. But we can test you for it.”

What chemicals in detergents cause the most common reactions?
“With detergents, one of the most common allergies is to cocamidopropyl betaine. It’s a surfactant, so it’s found in a lot of soapy-type things like skincare products and detergents. The problem is with a lot of detergents it’s proprietary information what surfactant they use. I’ve actually called companies to find out what surfactant is in their detergent, because they may not list it. Amidoamine and fragrance mixes are also a common contact allergen and irritant.”

Where would you see the rash?
“Pretty much anywhere clothing comes into contact, and it could be especially worse where clothing may be tight. So with detergent you want watch out for areas that rub, like underwear.”

What do you suggest people do if they think they might have a detergent allergy?
“I think a lot of times people jump to, ’Oh it must be an allergy. I must be allergic.’ An allergy is a specific immune response, and while it could be an allergy, and, obviously, as an allergist, I’d love to help you with that kind of thing, an irritant reaction’s going to be more common so just look at what’s new, what’s different, what you’ve added. And try to just go back to what worked, and if that’s not helping or if there’s any other concerning signs or symptoms, then be seen for it.”

What should you do if have a detergent allergy?
“I tell women to double rinse their underclothes, and put them in a separate load and make sure you double rinse. Also, use liquid detergents instead of powder because liquids tend to rinse off better — powder can kind of get caked in. Using fragrance-free, dye-free, like the Free and Clear lines can also help. But if you’re allergic to these items, you need to identify it first so you can use ones that don’t have them. There’s a really good website called SkinSAFE that has a database of thousands of products and their ingredients.”

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