What is the treatment for an allergic reaction to acid (acetic acid) wipes?

From the Guidelines

The treatment for an allergic reaction to acid wipes involves immediately stopping use of the product and seeking medical attention if symptoms are severe, as the first-line treatment for anaphylaxis is epinephrine administered intramuscularly in a dose of 0.01 mg/kg of a 1:1000 solution to a maximum of 0.5 mg in adults and 0.3 mg in children 1. For mild reactions with redness and itching, the following steps can be taken:

• Apply a topical corticosteroid cream like hydrocortisone 1% three to four times daily for up to a week
• Take an oral antihistamine such as diphenhydramine (Benadryl) 25-50mg every 6 hours or cetirizine (Zyrtec) 10mg once daily to help reduce itching and inflammation
• Apply cold compresses for 10-15 minutes several times a day to provide relief However, it's crucial to note that for severe reactions involving widespread rash, blistering, facial swelling, or breathing difficulties, seeking emergency medical attention immediately is paramount, as these symptoms may indicate anaphylaxis requiring epinephrine and hospital care 1. The use of epinephrine is the cornerstone of anaphylaxis management, and despite a lack of clear evidence supporting the role of antihistamines and glucocorticoids in anaphylaxis, these agents continue to be routinely used in anaphylaxis management 1. In the context of allergic reactions, it's essential to prioritize the patient's safety and well-being, and the most recent and highest quality study 1 emphasizes the importance of prompt epinephrine administration in cases of anaphylaxis.

From the FDA Drug Label

Emergency treatment of allergic reactions (Type I), including anaphylaxis, which may result from allergic reactions to insect stings, biting insects, foods, drugs, sera, diagnostic testing substances and other allergens, as well as idiopathic anaphylaxis or exercise-induced anaphylaxis.

Adults and Children 30 kg (66 lbs) or more: 0.3 to 0.5 mg (0.3 mL to 0. 5 mL) of undiluted Adrenalin® administered intramuscularly or subcutaneously in the anterolateral aspect of the thigh, up to a maximum of 0.5 mg (0.5 mL) per injection, repeated every 5 to 10 minutes as necessary.

The treatment for an allergic reaction to acid wipes is epinephrine (IM) administration. The dosage is as follows:

• Adults and children 30 kg (66 lbs) or more: 0.3 to 0.5 mg (0.3 mL to 0.5 mL) of undiluted epinephrine administered intramuscularly or subcutaneously in the anterolateral aspect of the thigh, up to a maximum of 0.5 mg (0.5 mL) per injection, repeated every 5 to 10 minutes as necessary 2, 2.
• Children less than 30 kg (66 lbs): 0.01 mg/kg (0.01 mL/kg) of undiluted epinephrine administered intramuscularly or subcutaneously in the anterolateral aspect of the thigh, up to a maximum of 0.3 mg (0.3 mL) per injection, repeated every 5 to 10 minutes as necessary 2.

From the Research

Treatment for Allergic Reaction to Acid Wipes

• The treatment for an allergic reaction to acid wipes is not explicitly mentioned in the provided studies, but general guidelines for managing allergic reactions and anaphylaxis can be applied 3, 4.
• For anaphylaxis, a life-threatening systemic reaction, the management involves removal of the trigger, early administration of intramuscular epinephrine, and supportive care for the patient's airway, breathing, and circulation 3.
• Adjunct medications such as histamine H1 and H2 antagonists, corticosteroids, beta2 agonists, and glucagon may be considered after epinephrine administration 3.
• However, the use of corticosteroids in anaphylaxis should be revisited, as recent findings suggest that prehospital corticosteroid use is associated with a higher likelihood of requiring intravenous fluids and hospital admission 5.
• Antihistamines may be beneficial in managing allergic reactions, but hypersensitivity reactions to antihistamines themselves can occur, although rarely 6.
• It is essential to note that the treatment for an allergic reaction to acid wipes may vary depending on the severity of the reaction and the individual's medical history, and should be guided by a healthcare professional.

Management of Anaphylaxis

• Anaphylaxis is a medical emergency that requires prompt treatment with epinephrine, followed by supportive care and monitoring for potential biphasic reactions 3, 4.
• The use of epinephrine in the prehospital setting is associated with improved outcomes, including reduced likelihood of uncontrolled reactions, receipt of intravenous fluids, and hospital admission 5.
• Patients with a history of anaphylaxis should be educated on the use of an epinephrine auto-injector and develop an emergency action plan to ensure timely and effective treatment in the event of a future reaction 3.