Hi,
Thanks for writing to us.
Contraceptive pills are known to cause urticarial reactions and can also precipitate or exacerbate the same in patients with known urticaria.
I have seen the uploaded image and it looks like an urticarial rash only.
To treat the same,
Take oral antiallergic like cetirizine or loratidine two times in a day
Apply calamine lotion or calamine lotion with menthol to soothe the rashes.

If in case above two does not help, then a short course of oral steroid might be required. Usually prednisolone is given in tapering doses. But as it is a prescription drug, doctor's consultation is mandatory.

Urticarial rash become an emergency if associated with difficulty in swallowing or respiratory distress. As fortunately, you are not having these associated symptoms taking oral anti allergics alone should suffice.

Hope that answers your query. Should there be any doubt, feel free to write back.
Wish you a speedy recovery.

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Hi XXXXXXX,
Thanks for writing back.
Drugs can induce urticaria by allergic reaction.
Urticarial rashes too can manifest as itchy burning rashes with feeling of tightness over skin and can resolve spontaneously.
Flushing too at times has similar features and can be associated with urticaria as a part of allergic reaction to drug.
So in simpler words, the rash that you are having is just because of allergic reaction to the pill that you took.
Morning after pills are basically progesterone pills that prevent release of egg from ovary and may also irritate the uterus lining to prevent fertilised egg from getting implanted. The effect of morning after pill may persist for upto 10 days.

Right now, I would advise you to start with antiallergic pill cetirizine, loratidine or Benadryl and apply calamine lotion too soothe area. Continue with the treatment and let me know in a day or two, if you are responding well.
Do not hesitate to write back, if any doubt exists.
Take care.

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Hi,
Any drug can induce an allergic reaction and can manifest as urticarial drug rash with or without flushing. So basically hormonal pills and antibiotics both can be the culprit. But if you have taken the same antibiotic previously also many a times without any problem, chances are less that it could cause an allergic reaction. The same applies to hormonal pill also.

Caffeine is known to induce flushing but the point is do you have history of flushing previously too with intake of tea coffee or caffeinated drinks. If this is a phenomenon of recent occurrence, chances are more of it being due to allergic reaction. However avoid taking caffeine for few days.

Allergic reactions develop in our body when the body's immune system overreacts to a substance that is normally harmless. The immune system mistakenly identifies the medicine or drug taken as harmful substance. When the immune system starts to fight off by releasing histamine, allergy symptoms, which may include urticarial rash or facial flushing develop. This process may go on for few days even when drug intake has been withheld.
Lastly Zyrtec or cetirizine is an antihistaminic, its use and relief in your symptom is self explanatory that the rash you are having is allergic in nature.

So the whole point of discussion is take antihistaminics cetirizine or loratidine or Benadryl twice in a day irrespective of occurrence of rash for few days and apply calamine to soothe the area.

Hope that clears all your doubts.

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Hi XXXXXXX,
You seem to be getting confused and in the process have confused me too!
Flushing is basically increased vascular response over face, chest etc.
Now in your case, you have to be specifically clear whether you had earlier history of such redness over your face and chest on exposure to sun, hot spicy food, caffeine and alcohol or not. From what I gather from your response is that you had previous history of flushing irrespective of intake of hormonal pills and antibiotics and also that you have history of urticaria and dermographism.
Why did you feel at first place that these rashes were drug induced?

As I have already mentioned medicines too can cause urticarial reactions in form of flushing and hives

In your first query, you had mentioned that you developed this reaction after taking the pills without mentioning any previous history of flushing. So obviously one would think of allergic reaction with drugs.

But now as you say that you did not take any caffeinated drink and there is no rash, so I would like to conclude that medicines might not have been the reason for flushing over face at all

To treat the redness over your face,
Firstly avoid causative factors
Apply a sunscreen
If rash develops do cold water or ice compresses
Apply calamine to soothe area
If still not much response take tab cetirizine.

Regards

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Dear XXXXXXX,
It's true that many people get flushed when exposed to sun, alcohol and caffeine. It is not a big thing to worry about unless its bothering you. Flushing is just a body's response to certain stimuli that leads to increased blood flow or vascular response.
Many people get flushed with alcohol because they lack a liver enzyme to metabolise liver properly and hence concentration of acetaldehyde which is a byproduct of alcohol metabolism increases leading to flushing
Histamine is also known to induce flushing. People who tend to get urticaria have high levels of histamine release. Drug allergies also lead to flushing by histamine release
Caffeine too can increase flushing by causing blood vessels to dilate. Sometimes it is the hot temperature of the beverage that causes flushing. In your case you will have to see whether you get flushing with hot or cold caffeinated drink.

Certain foods like sea foods, preservatives like MSG, aspartame, very sugary foods, hot spicy foods like chillies, peppers etc and emotions like anger or anxiety may induce flushing too.

But all the above mentioned causes lead to physiological flushing and the treatment is to avoid causative agent, do cold compresses, apply calamine lotion to counter burning and take cetirizine if the need be.

One should worry if flushing is persistent and is associated with symptoms of respiratory distress, abdominal pain and diarrhoea as in such cases proper work up needs to be done.

I would advise you not to worry too much and avoid the precipitating factors as much as possible.

If there is any other query, do not hesitate in writing back.

Regards.

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Hi,
Though you might be having history of urticaria and dermatographism, the redness that you experience with stress, anxiety, alcohol or caffeine is flushing.

In cholinergic urticaria one usually gets small itchy red bumps over a red base and the images that you have attached are nothing close to it. One gets cholinergic urticaria on getting exposed to sun, hot spicy food, exercise etc

Unfortunately to relieve or prevent flushing, one has to keep away from exacerbating factors. There is no medicine to prevent physiological flushing as it is your body's response to particular stimulus. In your case I would advise you to avoid stress, alcohol, sun exposure etc.
If flushing develops, do ice compresses, apply calamine lotion.
Hope that answers all your queries.

Ps should there be no more queries we may close the discussion.

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