Anyone who has suffered from eczema as a child would be well advised to avoid exposure to irritants in later life, even if their eczema appears to have cleared up. Surveys have shown that such people are far more likely to suffer from irritation to the skin on their hands. Occupational dermatitis – a common complaint of cleaners, beauticians, hairdressers, motor mechanics, nurses and laundry-workers – is roughly ten times more likely among those who once suffered from eczema. Such jobs should be avoided, and so should the use of cosmetics – sparing use and a regular change of brands is the best policy. ‘Hypoallergenic’ cosmetics are useful, in that they lack perfumes and other potential irritants, but the name is somewhat misleading, because they too can provoke allergies if used often enough.

Housework, of course, is a necessary evil, which only the lucky few can avoid. The obvious way to prevent trouble is to wear rubber gloves. Unfortunately, rubber itself can be an irritant, especially in the warm, humid conditions that prevail within such gloves. Wear cotton gloves inside the rubber ones to prevent direct contact with the skin, and avoid using very hot water because the cooler the hands are within the gloves the better.

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One particular set of symptoms calls for a special mention here. In the case of nasal polyps, especially if accompanied by urticaria (nettle-rash), sensitivity to aspirin should be a prime suspect. How aspirin might produce this cluster of symptoms is unknown: the aspirin may be acting as an allergen, but it is more likely to be having some direct pharmacological (‘drug-like’) effect on the nasal membranes and skin.

Avoiding aspirin and aspirin-containing painkillers is simple enough as long as you remember that the following synonyms may be used: salicylate, salicylic acid and acetylsalicylic acid. Most brand-name painkillers contain some aspirin, and it is important to read the contents list carefully. Plain paracetamol tablets are aspirin-free.

For most people, simply avoiding aspirin drugs should be sufficient. However, some people also react to related drugs.

If avoiding aspirin and related drugs proves ineffective, then some doctors suggest that restricting the diet may be worthwhile. Aspirin-like compounds (salicylates) occur in various plants, the drug originally being extracted from the bark of willow trees. Certain fruits, nuts, vegetables and spices are rich in salicylates: a complete list is given on p292. If you are sure aspirin aggravates your symptoms, but are still not well despite avoiding aspirin drugs, then you could consider trying a low-salicylate diet to see if you improve.

There are unconfirmed reports that sensitivity to aspirin is linked with an inability to tolerate benzoate preservatives, azodyes and metabisulphites, used to preserve wines and some foods.

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