Latex Allergies: What Your Doctor Probably Won't Tell You

Latex allergies are not the sort of thing everyone will discuss with the doctor. Latex is a milky fluid produced by rubber trees (Hevea brasiliensis). Using different methods, latex can be processed into a variety of products, such as gloves and balloons. During manufacturing, chemicals are added to increase the speed of curing (vulcanization) and to protect the rubber from oxygen in the air. Several types of synthetic rubber are also referred to as "latex," but these do not release the proteins that cause allergic reactions. With more and more people using condoms and surgical gloves for the prevention of sexually transmitted diseases (STDs), particularly HIV, there is a corresponding rise in the number of people with latex allergies and sensitivities.

There are two types of allergic reactions to latex. The first is delayed-type contact dermatitis, a poison ivy-like rash that appears 12-36 hours after contact with a latex product. This most commonly appears on the hands of people who wear latex gloves, but it may occur on other parts of the body following contact with rubber products. The prevalence of this form of latex allergy does not seem to be increasing. Contact dermatitis is usually the result of sensitization to chemicals that are added during rubber processing. While very irritating, this form of allergy is not life-threatening.

Immediate, or IgE antibody-mediated allergic reactions, are potentially the most serious form of allergic reactions to latex. Like other common forms of allergy, these reactions occur in people who have previously been exposed to latex and have become sensitized (latex-specific IgE antibody positive). With re-exposure, symptoms such as itching, redness, swelling, sneezing, and wheezing may occur. Rarely, a person will experience life-threatening symptoms. This severe allergic reaction is called anaphylaxis, and is characterized by symptoms such as shock, severe trouble breathing or loss of blood pressure. If not immediately treated, it can be fatal.

The severity of the immediate reaction depends upon the person's degree of sensitivity and the amount of latex allergen to which the person is exposed. The greatest danger of severe reactions occurs when latex comes into contact with moist areas of the body or internal surfaces during surgery, because more of the allergen can rapidly be absorbed into the body.

Who has a problem with latex sensitivity and latex allergies? Certain groups of individuals who are frequently exposed to latex are at high risk for developing immediate allergic reactions. Individuals with spina bifida (a congenital problem in the development of the back) and those with congenital urinary tract problems who need multiple surgeries seem to have a risk of nearly 50 percent. Health care workers and others whose jobs require wearing latex gloves or working around them have a risk of about 10 percent. Others who may be at increased risk are those who have had many medical or surgical procedures, resulting in repeated exposure to latex gloves. Rubber industry workers also are at increased risk. Even in normal adults, the risk of sensitization to latex may be as high as 6 percent.

Some people experience mild reactions when they use latex. This is referred to as a latex sensitivity. Reactions to latex tend to worsen with time and exposure to latex. There are also people who are truly allergic to latex. A latex allergy can resemble, and be mistaken for, a reaction to spermicide (for example, nonoxynol-9) or lube, a vaginal or anal infection, or a sexually transmitted disease (STD). People with severe hypersensitivity (that is, allergy) to latex experience a strong reaction immediately upon contact or exposure. Products that commonly cause reactions can include gloves, balloons and condoms.

In rare instances, people who are allergic to latex may also react to rubber bands, erasers, rubber parts of toys, various rubber components in medical devices, rubber elastic in clothes, or feeding nipples and pacifiers. Products molded from hard, crepe rubber, such as soles of shoes, are unlikely to cause reactions. Almost all latex paints are not a problem since they do not contain natural rubber latex. Symptoms usually include one or more of the following: skin rash, dryness, itching, eczema, and, in rare cases, welts. At the extreme, a person could experience difficulty breathing, and even go into anaphylactic shock. Severe latex allergies, however, are rare.