皮膚過敏的防治
楊惟婷整理
每當春意盎然，萬物生發之際，總讓人神清氣爽、充滿活力，但是，這個季節也是過敏體質的人好發之季，特別是皮膚過敏。
事實上，過敏是全世界醫學目前沒辦法完全解決的問題！尤其在每年9-10月是過敏的高峰期，有人對大風過敏，會起風疹；有人對花粉過敏，聞了就會打噴嚏；有人吃螃蟹過敏，渾身起紅疹。
一、過敏體質與遺傳有關嗎？
過敏疾病與遺傳有很大的相關。根據統計，如果父母親之一有過敏體質，他們的小孩有超過25%的機會有過敏體質，如果雙親都有，則此數字會超過50%。
二、過敏症怎樣預防？
因為要引起過敏症狀，仍然要環境中有過敏原存在不可。因此，要預防或治療過敏疾病，一個最主要的條件便是減少過敏原的暴露機會。
但怎樣做呢？以下一些方法讓你在生活中，輕鬆預防過敏：
1.有過敏體質的家族，在生產前後，有一些習慣可以降低你的孩子將來發生過敏的機率。
「（孩子）出生前預防，才是最好的辦法，」專長小兒過敏免疫疾病的江伯倫指出。
例如媽媽自懷孕的第二期，也就是懷孕的第四個月起，就必須調整飲食，避免容易引發過敏的食物（如牛奶，橘子、草莓、蕃茄 等柑桔類水果， 核果類、巧克力、蛋白、帶殼的海鮮），才能減少胎兒過敏的機率。
有過敏家族病史的準媽媽，應該避吃花生、松子等核果類，因為這些是常見的過敏原，小寶寶不成熟的免疫系統可能會對這些過敏原過度反應，多位醫師指出。
- 胎兒出生後則應盡量用母乳哺育，能餵多久，儘可能餵多久。因為母奶裡有豐富的抗體，可提升小嬰兒的免疫能力。
母乳是世界公認對嬰兒最好的食物，再好的配方奶粉也無法完全仿效母乳。尤其配方奶粉一定要用牛乳（即一般的配方奶粉）或大豆（所謂的豆類配方奶粉，Soy-based formula ）作基質，這些配方奶粉都含有與人類不同的大分子蛋白質，會像手槍板機一樣， 引發免疫系統產生過敏性抗體（ IgE ），而產生過敏症狀，因此， 最好能親自哺育母乳。
另外，在餵食母乳期間，母親也應避免食用含高量過敏原的食物（如上述），以免經由母乳傳到小孩身上，引發過敏反應。
- 如果家族中有明顯過敏病家族史，又無法餵食母乳者，應選擇低過敏奶粉（如雀巢的Nan-HA系列奶粉 ）。
這種奶粉是將牛奶蛋白經過水解，切成較小的蛋白質分子 (＜1.5kd)，營養不減，卻較不容易引起過敏反應。因此可以有效減少或延後過敏病的機會，尤其對幼兒前兩年常見的異位性皮膚炎的預防效果最好。
- 雖說，母奶的蛋白質比牛奶的蛋白質，較不易引起過敏，但臨床上，還是有極少數的純母奶寶寶，會對母奶的蛋白質過敏，在出生一、兩個月後，出現明顯的異位性皮膚炎或大便中有血絲、拉肚子的症狀。
若媽媽已經避免攝取易導致過敏的食物，小寶寶的症狀仍無改善，就必須考慮改吃將大分子蛋白質，分解成小分子蛋白質的部分水解配方牛奶，讓皮膚症狀有機會獲得較明顯的改善。
這是因為人類的消化系統，原本在吃進蛋白質時，會先將大分子的蛋白質，分解成小分子的蛋白質，然後，進一步分解成胺基酸，再被身體吸收。
不過，小孩子腸道的上皮細胞還在發育中，沒有辦法像成人一樣完全密合，有些大分子的蛋白質，有可能還沒被分解，就直接進入腸道的血管，較易引起過敏症狀，此時，建議在治療上改喝小分子蛋白質的部分水解配方牛奶來改善過敏的症狀。
5.嬰兒稍大後，應注意不要在四個月大前添加副食品，麥粉應等到六個月後 ，蛋白最好等到九個月後再添加，其他上述的過敏食物也應避免。
6.高危險群的嬰幼兒出生後，更應該注意。1歲以前儘量避免會引起過敏的食物，包括牛奶、蛋白、有殼海鮮、核果、小魚乾等。
「早期注意飲食，避免發生異位性皮膚炎，有助於降低未來發生氣喘的機率，」江伯倫指出。
7.研究發現，父母有過敏疾病、未滿1歲的嬰兒，出生後吃母奶或低過敏奶粉，到5歲左右發生過敏的機率，是不吃母奶或低過敏奶粉的嬰兒的三分之一。
醫界也建議，最好等寶寶1歲後，再餵他吃副食品（solid foods），因為這時候孩子的免疫系統較成熟，能抵抗一些潛在的過敏原。不過，像米粉、麥粉、粥、水果泥、蔬菜泥等，在1歲前吃，應該無妨。
8.避免暴露於過敏原
遠離過敏原是減少過敏的第一要件。「過敏就像個皮球，不去拍它，它就跳不起來，」台大耳鼻喉科主治醫師劉嘉銘比喻。
（1）在台灣，絕大部份的過敏肇因於塵蟎，徹底防蟎，是避免過敏的首要關鍵，尤其是幾乎會佔去你一天中三分之一時間的臥室。
例如，每隔二週以攝氏54度以上的熱水清洗床單、枕套、被套，可有效殺死塵蟎；衣服先用熱水燙過；再來，要常清洗冷氣濾網濕布徹底清理床鋪，避免堆積灰塵；避免成疊堆起書本、文件等。
（2）消除屋內黴菌，也是重點。
根據統計，約十分之一的過敏性氣喘病人，肇因於黴菌過敏。台灣氣候高溫潮濕，許多建築物的水泥牆壁常出現白粉毛狀的「壁癌」，不但有礙觀瞻，也容易孳生黴菌，尤其一旦長壁癌的牆面由白轉綠或黑時，就代表你甜蜜的家，已被黴菌攻佔，這些黴菌會隨空氣飄往家的各角落，不斷繁殖，成為引發過敏的一個重要禍首。
解決壁癌的根本辦法是徹底處理居家的滲漏水問題，並降低濕度。
一般建議，除了利用除濕機降低濕度，可避免塵蟎與黴菌生長外，也可在出太陽時，打開門窗、保持通風。
再來可用漂白水殺菌。用法，將洗衣用的漂白水，稀釋成0.02％的濃度（例如，漂白水濃度標示如果是6％，1杯漂白水需要用300杯水稀釋），然後用牙籤或棉花棒沾漂白水，擦容易孳生黴菌的地方，例如廚房磁磚接縫等潮濕處。
（3）蟑螂脫下的皮屑、糞便也是引發過敏的一個來源。
（4）有過敏的人最好不要養寵物，或不要讓寵物進臥室、或經常以吸塵器清掃寵物活動的房間、每週清洗寵物，降低牠的皮屑、尿液與乾唾液量。
9.正確飲食
儘量少吃加工或精製的食物，儘可能少吃糖類，避免高油、高熱量。
吃 對營養也很重要。確認你吃的食物裡，是不是富含可以降低過敏機率的下列營養素：omega-3脂肪酸（鮭魚、沙丁魚等魚類）、蛋白質（包括雞、魚、豆莢 類，但黃豆是常見的過敏原）、抗氧化物（水果蔬菜，例如綠色蔬菜中有維生素C，深色有色蔬菜中有β胡蘿蔔素），台大免疫學研究所教授江伯倫並建議，成人一 天可攝取400國際單位的維生素E。
另外，過敏的人不要喝冰水，中醫甚至主張不要多吃涼性食物，以免刺激誘發過敏。
10.喝足夠的水
當你體內的水分不足時，呼吸系統和腸胃道內壁黏膜的細胞會收縮，造成細胞之間有裂隙，而使得像花粉等外來物質可趁機穿透細胞，並引起過敏反應。
11.運動
適度的運動可以活化你的免疫細胞，提升第一型免疫力，江伯倫解釋。
游泳是多位醫師共同的建議。因為很多過敏病人，不見得是由塵蟎引起，而與天氣變化、早晚溫差大有關。游泳可以訓練你適應冷水、適應溫度與濕度，另方面，也可以改善你的肺活量，避免因肺功能不佳引起過敏疾病。
12.家中最好適量使用空氣清靜機與除濕機，少用地毯，減少塵蟎的產生。家人最好戒菸，少燒香，保持無煙的環境。保持清潔，減少蟑螂的孳生。
13.善用自然療法
如果你深受過敏所苦，除了求醫治療外，可以利用一些自然療法來安撫它。
《戰勝鼻竇炎》（Sinus Survival）作者、羅伯．艾可醫生在《Natural Health》雜誌中建議，呼吸系統過敏的人可以：
■保持黏膜濕潤
如果你有呼吸道過敏問題，你的黏膜大概很容易受刺激敏感。艾可醫師認為，可以使用鼻噴劑來緩和黏膜。
天然鼻噴劑的做法是：拿一個有噴頭的瓶子，到入一杯不冷不熱濾過的水，混合半茶匙的鹽、少許烘烤用的蘇打，做成噴劑。先按住你的右鼻孔，噴左鼻孔，再換邊噴右鼻孔。當你覺得鼻塞時，可以每2～3小時使用這個自製鼻噴劑。
■利用蒸氣
如果你的過敏問題會造成鼻塞，可以一天兩次吸15～20分鐘的水蒸氣。水蒸氣能緩解濃稠的鼻黏液以及乾燥、易受刺激的鼻黏膜。你可以坐在浴室把熱水水龍頭打開，或買個蒸氣機，吸水蒸氣。
7.生活放輕鬆
壓力會影響身體荷爾蒙分泌，讓免疫力變差，激發各類過敏反應，所以必須學會放輕鬆生活。即使生活再忙、再累，不要忘了利用一些方法減壓，而睡眠充足、良性適度的人際互動，就是其中的方法。
另外，有過敏的人不妨養成寫日記的習慣。一旦出現過敏症狀，例如濕疹復發或狂打噴嚏，記下先前正做什麼或正想什麼，或許有助於找出引發過敏的壓力源。
三、為什麼春天容易皮膚過敏？
春天陽光明媚，是個出遊的好時機，但是有些人外出遊玩就會出現皮膚紅腫、瘙癢的情況，容易皮膚過敏，這是為什麼呢？
專家告訴我們，在春季之前，我們經歷了一個冬季，在冬季的時候皮膚的黑色素會變少，角質層也會變薄，這樣我們皮膚對紫外線的防護能力也會變差，春天陽光中紫外線比較強，對光敏感的朋友到了春天就容易過敏，另外，粉塵和花粉也是導致過敏的一大原因。
四、皮膚過敏的高危人群
皮膚排異反應（俗稱過敏）是十分正常的現象。並且，以下這幾種人特別容易出現皮膚過敏：
第一：很少用化妝品的人；
第二：長期使用一個牌子，換護膚品後有個適應過程；
第三：皮膚本身敏感；
第四：之前使用過激素類產品；
第五：敷面膜時間過長，一般10-20分鐘即可，時間太長也會導致皮膚缺氧性過敏；
第六：連續幾天使用，皮膚營養達到飽和，皮膚吸收不了，導致營養過剩，不建議天天使用，根據肌膚狀況而定。
第七：孕婦。女性在懷孕期間會產生一種孕激素，處於這個時期的女性整個抵抗能力和皮膚包括身體都會發生改變，這個時候人體特別容易過敏。
五、過敏症發病的正確處理方法
在日常護膚中，最常見到的過敏症狀是：感覺痛、有點發紅、發癢，長疹子或長痘，最嚴重就是浮腫、脫皮。
1、痛。
痛極有可能是因為面部缺水和有隱形傷口引起，特別在使用高肌能面膜產品時，如果出現痛的情況，最好先停一下，沒有任何問題，隔一天再敷。
2、輕微的發紅或輕微的發癢。
首先停用家裡所有的化妝品，然後冰鎮水（純淨水）–用冰箱裡的冰鎮水，把壓縮面膜紙完全浸濕，敷在臉上十至十五分鐘；如果家裡沒有鬼臉貼，就用乾淨的毛巾，浸水之後用一個乾淨的保鮮袋裝好，放冰箱裡冷藏10分鐘，然後敷臉15分鐘，一天四次，基本上一天就解決了。
如果還有癢的情況，可以用香蕉泥（把香蕉剝皮搗爛）敷在臉上15分鐘左右再洗乾淨。
3、疹子。
疹子就是那種面部皮下突出的，紅色點狀的小疙瘩。會出現這類問題，有兩種可能：
第一種：之前絕對使用過功效類產品。大家能不能理解什麼是功效類產品，就是以前什麼美白、祛斑、煥膚的，當這些產品進入肌膚時，會有一定的刺激，它有排毒的過程，絕對會出現紅疹；
第二種：經常化妝的女性，用彩妝的女性，而且不注意清潔的人，也一定會出，她會出那種紅色的小疹子或沒有顏色的疹子，是因為毛孔堵塞，她本身的毛孔裡面就有很多髒東西，堵塞了。
4、長痘。
會出現這類問題，也有兩種可能：
第一種是本身肌膚就有痘的潛伏期，當塗抹護膚品加速它代謝的時候，痘就會往外長，其實這是個好現象。公眾號脈脈養生只做最專業的養生知識。當痘成熟以後，排出膿點後，就會好了；還有就是自我可以吸收這兩種方式。所以說長痘也不用擔心。
還有一種方式是他本身就長痘的。像是這種皮膚不適宜使用高營養的護膚品，這時正確的處理方法是：一定注意清潔，用泡沫型洗面乳或者硫磺香皂，有清潔、消炎作用，那種皮膚很油、長痘、長座瘡的皮膚都適用。
5、眼睛腫和面部腫
（1）輕微有點腫，不是很厲害的，就用香蕉泥，每次十五分鐘，連敷三天
（2）嚴重一點的，就用香蕉泥加上息斯敏一粒。將一粒息斯敏研成粉末加在香蕉泥裡面，同時敷上10-15分鐘，一天一次。
（3）如果比上面還厲害的，或者是手邊沒有香蕉。可以用冰鎮純淨水，加一至兩粒撲爾敏，浸濕壓縮面膜紙後敷臉一次十至十五分鐘，並注意不時向臉部補拍混合有撲爾敏的純淨水，同樣不超過三天。
注意：
在過敏期間，第一停用家裡所有的化妝品，第二不能用濕熱水洗臉，用涼水洗臉，不要用任何的洗面乳，第三過敏期間忌辛辣，刺激性食物、特別是海鮮類的食物，海鮮類的食物是絕對不能吃的。
溫馨提醒：
不管是哪個護膚品牌，包括很多國外大牌護膚品，也都會有消費者過敏的情況。因此在使用之前請在耳後進行小範圍過敏皮試，尤其是敏感肌膚的人，這樣才能減少皮膚過敏情況的出現。
另外，過敏是皮膚免疫力降低，需要一段時間的調理，期間必須要有耐心。
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