What topical treatment can be applied to an allergy causing a burning sensation?

Topical Treatments for Allergic Skin Reactions with Burning Sensation

For an allergic skin reaction causing a burning sensation, apply a topical 1% hydrocortisone cream as first-line treatment to reduce inflammation and relieve symptoms. 1

First-Line Treatments

• Apply 1% hydrocortisone cream (anti-itch) to the affected area to reduce inflammation and relieve the burning sensation 1
• Use cool compresses on the affected area to provide immediate relief from burning and reduce inflammation 2
• Consider refrigerating topical medications before application, as the cooling sensation can provide additional symptomatic relief 2
• Apply white soft paraffin ointment to affected skin surfaces to provide protection and comfort 3

Second-Line Treatments

• For more severe allergic reactions, consider using topical antihistamines (H1-receptor antagonists) which are more effective than vasoconstrictor agents 2
• Newer combination medications with both antihistamine activity and mast-cell stabilizing properties can be used for either acute or chronic allergic reactions 2
• For persistent symptoms, mast-cell stabilizers may be beneficial when the condition is frequently recurrent 2
• Concomitant use of cooled artificial tears or saline solutions can help dilute allergens and inflammatory mediators on the affected surface 2

Treatment Algorithm Based on Severity

For Mild Allergic Reactions:

• Start with cool compresses and 1% hydrocortisone cream 2, 1
• Apply 2-3 times daily until symptoms resolve 1
• Avoid scratching or rubbing the affected area 3

For Moderate to Severe Reactions:

• Continue with hydrocortisone cream 1
• Add a second-generation oral antihistamine (cetirizine, fexofenadine, loratadine) 2, 4
• If symptoms persist beyond 1-2 weeks, consider a brief course of topical corticosteroids with a low side-effect profile 2

Important Considerations and Cautions

• Avoid chronic use of vasoconstrictor agents as they can cause rebound vasodilation once discontinued 2
• Identify and avoid the triggering allergen to prevent recurrence 2
• Monitor for signs of infection (increasing pain, swelling, fever, purulent discharge) which would require prompt medical attention 3
• If symptoms worsen or do not improve within 7 days, seek medical evaluation 2
• For severe systemic allergic reactions with symptoms beyond skin (difficulty breathing, swelling of lips/tongue, dizziness), epinephrine is the treatment of choice and emergency medical care should be sought immediately 2, 5

Special Situations

• For allergic reactions around the eyes, specialized antihistamine eye drops may be more appropriate than skin preparations 2
• For patients with known asthma experiencing allergic reactions, be vigilant for respiratory symptoms that may require additional treatment 2
• Consider consultation with an allergist or dermatologist for patients with severe or recurrent allergic reactions that cannot be adequately controlled with topical medications 2