GUIDE TO THE REACTIONS TO NATURAL RUBBER LATEX
SYMPTOM
DELAYED TYPE
HYPERSENSITIVITY
IRRITATION
IMMEDIATE TYPE
HYPERSENSITIVITY
Also known as:
Irritant contact dermatitis
Type IV hypersensitivity
(allergic contact dermatitis; chemical allergy)
Type I hypersensitivity
(urticaria; anaphylaxis; protein allergy)
Causative agent:
insufficient hand rinsing,
disinfectants,
glove powder, surfacants,
pH extremes, amino derivatives,
preservatives (eg. formaldehyde)
accelerators:
(thiurams, carbamates, mercaptobenzothiazole),
antioxidants (BHA, BHT), antiozonates,
preservatives (eg. formaldehyde)
proteins from the Hevea braziliensis (rubber
tree)
Approximate % of population
vulnerable:
100%
7-18%
general population:
hospital population:
surgical)
0.8%
3-5% (non7-12% (surgical)
Time to onset of symptoms:
minutes to hours
6 to 48 hours
minutes to 1 hour
Initial sensory reaction:
itch or burn
itching first; continuing to pain
itching, tingling
red, scalded appearance, swelling
red appearance; small blisters
urticaria (pink raised hives, often blanched in
the center), swelling
dry thickened skin; crusting;
fissures (cracks in skin);
scabbing sores; papules; peeling
dry, thickened skin; crusting; scabbing sores;
papules; peeling; vesicles
urticaria (same as above except more
extensive)
Boundaries of the reaction:
sharp, definite reaction: limited to
area of glove contact
undefined: reaction may move up the arm
undefined: may affect any part of the body
beyond area of glove contact
Predisposition:
(history of allergies)
no
yes
yes
Potential for respiratory
involvement
no
no
runny nose, wheezing, difficulty breathing
Potential for facial
involvement:
only if face is touched
only if face is touched
swelling of eyelids, lips, face; tearing, itchy
eyes; runny nose
Potential for systemic
involvement
no
no
hives, facial swelling, runny nose, nausea,
abdominal cramps, rapid heart rate, difficulty
breathing, low blood pressure, anaphylactic
shock
How acquired:
skin contact
skin contact
skin/mucous membrane contact; invasive
procedures; injection; aerosolized allergen
(eg. on powder)
Potentially life threatening?
no
no
yes
Treatment:
try another lot number or switch
glove brand; anti-inflammatory
creams may help
switch to latex glove proven/documented low in
chemical contact sensitizers; anti-inflammatory
cream may help - see a dermatologist
switch to a non-latex or proven documented
low-protein allergen latex glove only under
guidance of physician - see an allergist
Dermal reactions
acute:
chronic:
Information provided by Safeskin Corporation at 1-800-462-9989