Treatment for Allergy

How are allergies treated?

Specific treatment for allergies will be determined by your physician based on:

Your overall health and medical history
Extent of the allergic disease
Your tolerance for specific medications
Expectations for the course of the allergic disease
Your opinion or preference

The three most effective ways to treat allergies are avoidance, immunotherapy, and medication.

What is avoidance?

Avoidance is staying away from a substance that causes an allergic reaction.

Suggestions for avoiding (some) allergens:

Remain indoors:
- When the pollen count is high
- On windy days
Dust proof the home, particularly the bedroom.
- Eliminate, when possible: wall-to-wall carpet, Venetian blinds, down-filled blankets or pillows, closets filled with clothes.
- Wash bedding, curtains, and clothing often and in hot water to eliminate dust mites.
- Keep bedding in dust covers when possible.
Use air conditioning instead of opening the windows.
Consider putting a dehumidifier in damp areas of the home, but remember to clean it often.
Wear face masks when working in the yard.
Go on vacation to the sea shore during the heaviest part of the pollen season.

Your physician will also have suggestions for avoiding the allergens that cause reactions.

What is immunotherapy (allergy shots)?

Immunotherapy is a type of treatment for allergic patients with rhinitis (hay fever), conjunctivitis, or asthma, or for patients with stinging insect allergy. It is also called desensitization, hyposensitization, and allergy shots. A mixture of the various pollens, mold spores, animal danders, and dust mites to which the patient is allergic is formulated. This mixture is called an allergy extract (vaccine). By administering increasing doses of the allergy extract, the person's natural immune system is enhanced and learns to fight off the allergens. This extract contains no medication such as antihistamines or corticosteroids.

How is immunotherapy administered?

Immunotherapy is given by injection under the skin usually into the fatty tissue in the back of the arm. It is not painful like an injection into the muscle such as a penicillin shot.

How often are immunotherapy injections necessary?

Injections may be given weekly or twice a week until a maximum dose is tolerated. This is called the maintenance dose. It may take about one year to reach the maintenance dose. At this point, the frequency of injections may be decreased to every other week and finally to once a month. Your physician will establish the appropriate schedule of injections to meet your medical needs.

Symptom improvement and immunotherapy:

About 80 to 90 percent of patients improve with immunotherapy. It usually takes from 12 to 18 months before definite reduction in allergy symptoms is noticed. In some patients, a reduction in symptoms is evident in as soon as 6 to 8 months.

Immunotherapy is only part of the treatment plan for allergic patients. Since it takes time for immunotherapy to become effective, you will need to continue the allergy medications, as prescribed by your physician. It is also important to continue eliminating allergens (such as dust mites) from your environment.

Are there side effects to immunotherapy?

There are two types of reactions to immunotherapy: local and systemic. The local reaction is redness and swelling at the injection site. If this condition occurs repeatedly, then the extract strength or schedule is changed.

A systemic reaction is one that involves a different site, not the injection site. The symptoms may include nasal congestion, sneezing, hives, swelling, wheezing, and low blood pressure. Such reactions can indeed be serious and life threatening. However, deaths related to immunotherapy are rare. If a systemic reaction occurs, the patient may continue taking shots, but of lower dosage.

If you have any questions concerning immunotherapy, always consult your physician or allergist.

Medication as treatment for allergy:

For people who suffer from allergies, there are many effective medications. This is a brief overview of the most commonly used types of medications. The American Academy of Pediatrics recommends against some over-the-counter medicines for infants and young children. Always consult your physician before taking any over-the-counter medications.

What are antihistamines?

Antihistamines are used to relieve or prevent the symptoms of allergic rhinitis (hay fever) and other allergies. Antihistamines prevent the effects of histamine, a substance produced by the body during an allergic reaction. Antihistamines come in tablet, capsule, liquid, or injection form and are available both over-the-counter and by prescription.

What are decongestants?

Decongestants are used to treat nasal congestion and other symptoms associated with colds and allergies. Decongestants cause the blood vessels to narrow, thus, leading to the clearing of nasal congestion. Decongestants are available both over-the-counter and by prescription. The most commonly used forms are liquid and tablet. However, nose sprays or drops may be prescribed by your physician. The American Academy of Family Physicians does not recommend decongestants for children ages 4 and younger.

What are types of medications used for asthma and respiratory symptoms resulting from an allergic reaction?

The use of medications for asthma or respiratory symptoms from allergies is highly individualized based on the severity of the symptoms. The following are the most commonly used medications:

Bronchodilators These medications are used to help open the narrowed lungs and may relieve coughing, wheezing, shortness of breath or difficulty in breathing. These are usually considered "rescue medications" for acute attacks of asthma. Types of bronchodilators are beta-agonists, theophylline, and anticholinergics. These medications come inhaled, in pill form, liquid or injectables. The short-acting bronchodilators are used as needed as symptoms occur. Longer-acting bronchodilators may be used for maintenance or on a daily basis to help control flare-ups from occurring.
Anti-inflammatory medications These medications help to decrease the inflammation that occurs in the airways with asthma. These include two types of medications:
- Nonsteroidal anti-inflammatory medications Cromolyn and nedocromil are two types of nonsteroidal medications that are usually inhaled.
- Corticosteroids These medications can be given in a variety of ways. Some of them are inhaled, while others may be taken as a pill or liquid, or even injected. The steroids taken by mouth can have more side effects than those that are inhaled. Talk with your physician about the best choice.
Anti-leukotrienes These are a relatively new type of medication being used to help control the symptoms of asthma. These medications help to decrease the narrowing of the lung and to decrease the chance of fluids in the lungs. These are usually given by mouth.
Anti-IgE antibody Omalizumab, a monoclonal antibody that attacks an immunoglobulin associated with allergic reactions, can be used for severe asthma attacks in adults and children age 12 and over.