Q: I had bilateral breast reduction done four weeks ago. The doctor used stitches internally and Dermabond externally to close my wounds. I stayed in the hospital over night and was given a continuous IV for nourishment and antibiotics. My doctor knows I am allergic to penicillin, so she prescribed Cephalexin which she told me was a cousin to penicillin and was safe for me to use. I was released from the hospital with a prescription for Cephalexin which I’m assuming was also in my IV.
About three weeks later I started noticing hives underneath my breasts in the area of my wounds. I mentioned it to the doctor and she said I could use cortisone cream for control. Now I’m in a full outbreak of hives all over my body. They just keep getting worse and worse.
The only other thing foreign I’ve introduced to my body in the last month is probiotics. I get them from a company which is not supposed to include any fillers in their products. Now I’m at a loss as to what is going on. It’s a weekend and I cannot get in to see my doctor.
I’ve tried every home remedy there is plus Aveeno. It helps for a little bit and then since I don’t apply it during the night, I’m in a full outbreak in the morning again. The itching is unbearable. Can you please help me? Am I allergic to the Cephalexin, Dermabond, probiotics, or none of the above? Could I be getting hives just because I had surgery? Is there a test to tell me what I am allergic to? I refuse to take anything (over-the-counter or prescription) until I at least have a blood test first. Could I be getting an infection and would that cause hives? Thank you for your help.
A: Cephalexin is used to treat skin, upper respiratory and bacterial infections. It should not be used by individuals who have an allergy to similar antibiotics that include Suprax, Cefzil, Duricef, Ceclor, and many others. There is a small amount of cross-reactivity of this class of antibiotic (cephalosporin) and the penicillins.
Dermabond is a liquid bonding agent that holds incisions, wounds and cuts together and takes the place of having sutures. Once applied and left to dry, it generally lasts up to 10 days on the skin. The American Academy of Family Physicians indicates that a skin infection can occur as a complication of using Dermabond with minor infections being handled with oral antibiotics. Hypersensitivity reactions are possible with this treatment. Allergic reactions such as skin rashes, itching and swelling may occur when a person’s immune system reacts to a specific substance such as cyanoacetate or formaldehyde, the main components of the product.
Probiotics are healthy bacteria that commonly live in the small intestines. Probiotic supplements do not require regulation by the federal government, nor have they been tested for effectiveness. While rare, probiotics may cause an allergic reaction in some individuals since they may contain dairy proteins that have the capability of triggering an allergic reaction in those individuals with a milk allergy. Should a skin rash develop following the ingestion of probiotic supplements, the result is the body’s reaction to the supplement that trigger histamine production. Histamines cause blood vessels to dilate which in turn increases blood flow, triggers a reaction and a rash develops. The skin may cause an itch, red patches and swelling. When scratched, the lesions can ooze and ultimately crust over.
So, could you have a reaction to one or all of the above? Yes, but my money is on the cephalexin being the culprit, even though you have finished the course. And, if this is the case, it will gradually resolve. The only way to make a positive determination is to eliminate one product at a time, beginning with the probiotic. The Dermabond has likely long since been washed from your skin during routine showering, so that would be my last consideration. Speak with your surgeon or primary care physician for guidance.
