Allergen Information Handouts
Allergen information should be presented in both verbal and written formats as well as in the patient’s preferred language and education level. Patch test counseling is detailed and complex. Patients rarely remember everything that is discussed; written information allows them to review again when necessary. Allergen information sheets typically include the name of the allergen, alternative names, types of products that might contain the allergen, and other pertinent facts. They also can be helpful for the physician who does not patch test full time; in this case, they can be used as a quick reference to guide patient counseling. It is helpful to highlight or underline important points and make notes when relevant. Importantly, reviewing information sheets with the patient allows time for questions.
Allergen information sheets are provided by manufacturers of patch test materials, including SmartPractice (allergEAZE, T.R.U.E. Test) and Chemotechnique (Dormer)(Table 2). The ACDS also provides a selection of allergen information sheets for members to share with their patients. The ACDS allergen handouts are designed for patient use, are vetted by practicing patch test dermatologists, and contain up-to-date information for patients. We recommend that you choose the handout(s) that are most appropriate for your patient; this decision can be made based on patient education or reading level, the region of the world where you are patch testing or where the patient lives, the patient’s primary language, and the specific allergen. Information on rare or new allergens may not be available on every website resource.
Identification of Allergen-Free Products
We ask patients to bring their personal care products to their patch test reading visit, and once positive allergens are known, we search for the presence of that allergen in their products. It is helpful for patients if products that are “safe” and “not safe” are sorted for them. We frequently emphasize that just one exposure to an allergen in a personal care product can be the source of the dermatitis. If a product label does not include ingredients, they often can be identified with a quick web search (use your favorite search engine or see Table 2 for websites); however, caution is advised, as lists found online may not match those found on in-store products.3 Reviewing the patient’s own products in the clinic is preferred over searching for ingredient lists online. If the product’s ingredients cannot be found (eg, ingredients that are found on external packaging), the patient has several choices: do not use, complete repeat open application testing if it is a leave-on product, or check to see if it is on a product database safe list.
We explain to patients that once they have confirmed that they are using only “safe” allergen-free products, it can take up to 6 to 8 weeks for dermatitis to improve, and at that point, the skin may only be about 75% to 80% clear. A clear description of what to expect and when is needed for a strong patient-physician partnership. For example, if the patient expects to be clear in 2 days but is not and stops avoiding their allergens because they think the process has failed, their dermatitis will not improve.