Allergy Treatment

allergy treatment

Summary

Over 50 million Americans suffer from some kind of allergic disease, according to the American Academy of Allergy, Asthma and Immunology. For this reason, there are a number of treatments available to reduce the severity of allergy symptoms, as well as for the prevention of allergic reactions.

Most allergy treatments are designed to relieve one or more of the symptoms of an allergic reaction (e.g., runny nose, sneezing, watery eyes, skin rashes, difficulty breathing). Allergy-relief treatments work for a relatively short amount of time and are usually in the form of medications, including:

  • Antihistamines (prevent the release of symptom-causing chemicals into the body)

  • Decongestants (reduce nasal and chest congestion)

  • Corticosteroids and NSAIDs (reduce inflammation)

  • Bronchodilators (open breathing passages)

  • Other medications (e.g., mast stabilizers cell)

Allergy medications can be administered to an individual through a number of methods, including pills, inhalers, nasal sprays, eye drops, nebulizers and topical creams.

While it is not possible to prevent an allergy from developing, there are some allergy treatments that may prevent allergic reactions (and therefore symptoms) from occurring. These include:

  • Avoidance. The best way to prevent an allergic reaction is to completely avoid the known allergen (e.g., pollen, dust, pet dander). However, avoiding an allergen is often difficult when the allergen is constantly present or an individual is highly sensitive. Although complete avoidance may not be possible, there are ways to limit exposure to allergens.

  • Allergy shots. This treatment is designed to help a person with a known allergy to overcome their sensitivity to a certain allergen. Through a series of shots, usually over a period of months or years, an individual is gradually exposed to increasing amounts of an allergen until their immune system becomes tolerant to that allergen.  However, success is not guaranteed, and there are some risks. Some people fail to respond to the treatment at all, while others may experience severe reactions. In addition, allergy shots are not effective at treating some types of allergies (e.g., food allergies).  Allergy shots

Depending on the symptoms associated with the allergy, a surgical treatment may be available. For instance, a myringotomy (a procedure to drain fluid from the ears) may be used to treat ear infections associated with allergic reactions.

There are many “home remedies” and other alternative allergy treatments that are popular. These include types of acupuncture, homeopathic remedies and traditional Chinese medicine. Some may be accepted by licensed physicians and used widely. However, others are not recommended by licensed physicians. These forms of treatment should not be attempted without first speaking to a physician.

About allergy treatment

Allergies can be triggered by a wide variety of substances. Because the types of known allergens are so varied, most forms of allergy treatment focus on treating the symptoms rather than the causes.

Any treatment plan for an allergy will include avoidance – completely avoiding the allergen known to trigger an allergic reaction. However, avoiding an allergen is not always possible. The allergen may be airborne and constantly present (e.g., dust) or the individual may be highly sensitive so that even minute amounts will trigger a reaction. Therefore, a number of other strategies may be necessary to treat allergic conditions.

The majority of allergy treatments are designed to ease symptoms of an allergic reaction that has already occurred. There are some treatments, however, designed to prevent the onset of allergic reactions in people with known allergies, reduce the frequency of reactions or reduce the severity of symptoms if a reaction does occur.

Most allergy treatments for symptom relief are in the form of medications. Some medications target specific symptoms (e.g., itchiness, difficulty breathing). Others may target the relief of a variety of related symptoms, such as those associated with hay fever (e.g., runny nose, sneezing, watery eyes).

Medications may be effective in one of two ways: symptom relief or symptom prevention. Symptom relief medications are taken after the onset of symptoms to reduce allergy symptoms that are already present. These medications may seek to either:

  • Interrupt the allergic cascade itself (e.g., antihistamines, leukotriene modifiers). These medications interfere with the histamines and leukotrienes released into the bloodstream during an allergic reaction. It is these chemical mediators that promote common allergy symptoms throughout the nose, throat, lungs, skin and gastrointestinal regions.

  • Directly target symptoms caused by the allergic reactions (e.g., decongestants, bronchodilators). These medications often target the cellular swelling or blood vessel constriction that leads to symptoms such as runny noses, itching and redness. Other types of these medications help to relax and open airways and loosen mucus to improve a person’s breathing.

Symptom prevention medications are taken before the person comes into contact with an allergen to lessen the severity of an allergic reaction or prevent symptoms entirely. This usually requires the daily use of medication.

Allergy medications can be administered in a number of ways. These include:

  • Pills. Solid form of medication that is swallowed. The medication dissolves and is absorbed into the bloodstream through the lining of the stomach and intestines.

  • Inhalers. Aerosol devices that allow medications to be delivered directly to the interior of the lungs through inhalation.
  • Nasal sprays. Sprays that distribute medicine – through the nose – directly to the nasal passages in the form of a fine mist.

  • Eye drops. A sterile solution or medicine that is applied directly to the surface of the eye in the form of liquid drops.

  • Nebulizers. Devices that use a compressor to convert liquid medication into a fine mist that can then be inhaled into the lungs.

  • Topical creams. Medications in lotion or ointment form that can be spread directly onto the skin where it is absorbed into the body.

  • Injections. Uses a needle and syringe to push liquid medication directly into body tissue.

Allergy medications are available over-the-counter (OTC), as well as by prescription. However, OTC allergy products are still medications, and should be treated as such.

All allergy medications have the potential to cause side effects, some of which could harm the patient. For instance, people with high blood pressure may be advised against taking decongestants because they can raise blood pressure. Patients should discuss OTC allergy medication with their physicians before using them.

In addition, patients experiencing any side effects from their allergy medication (prescription or OTC) should contact their physician. The physician may be able to prescribe another type of medication.

Patients should take allergy medications exactly as prescribed by their physician, because untreated allergy symptoms can lead to further complications. For instance, people who “ignore” their allergy symptoms and do not treat them can develop sinus and ear infections (otitis media). Overuse of allergy medication can also lead to problems. Those who use OTC decongestant nasal spray for more than three consecutive days can actually worsen their nasal symptoms (e.g., swelling, congestion).        

Another form of allergy treatment focuses on desensitizing an individual to a specific allergen over time. This is accomplished through regular allergy shots, usually over a period of months or years. Each shot exposes the person to greater amounts of the targeted allergen. Eventually, the person’s immune system becomes tolerant to that allergen. Allergy shots can result in severe reactions in very sensitive individuals and some people fail to respond to the treatment at all. For these reasons this treatment is not always effective. They are also not an effective treatment for some types of allergies (e.g., food allergies).

Allergen avoidance

The most effective way to avoid triggering an allergy (outside of effective immunotherapy treatment) is through strict avoidance of the allergen. While avoiding allergens is difficult in many situations, there are preventive measures that can be taken to avoid exposure to specific allergens. Some of the most common allergens include:

  • Pollen. Given off seasonally by trees, grass and weeds, pollen is responsible for triggering most cases of allergic rhinitis (hay fever). Individuals with this allergy should avoid yard work, and stay indoors, with windows closed and the air conditioning running when pollen counts are high.
  • Molds. Often found indoors where the humidity is high, mold can easily become airborne and trigger cases of allergic rhinitis year-round. Running the air conditioner, using a dehumidifier and using a HEPA filter to remove airborne particles can help reduce exposure to mold.

     
  • Animal dander. Small flakes of dried skin from animals (usually cats and dogs) are responsible for many allergy symptoms. Individuals who are allergic to animal dander should remove pets from the home or, at least, the bedroom.

  • Dust mites. These microscopic insects live in the dust found indoors and often trigger allergy symptoms. Special coverings for the bed, box springs and pillows can help reduce exposure to dust mites.

  • Eggs. One of the most common types of food allergy, egg allergies are common in children, but usually are outgrown. Allergic individuals should completely remove eggs, products containing eggs and products derived from eggs from their diet.

  • Seafood. This type of food allergy is triggered by the ingestion of fish or shellfish. Anyone with this kind of allergy should avoid eating fish and shellfish as well as any food with fish or shellfish as an ingredient.

  • Latex. Allergies to the sap in rubber trees cause some people to be allergic to latex products (made from rubber tree sap), usually when skin-to-skin contact is made. People with this allergy should avoid contact with any latex product, including latex clothing, gloves and condoms.
  • Penicillin. This common type of drug allergy can cause a range of symptoms including anaphylactic shock. The drug penicillin is commonly used to treat infections. Anyone allergic to penicillin should avoid using the drug and wear a medical alert bracelet or necklace.

Some people consider moving away from an area as a way to “treat” allergies. However, moving may only provide temporarily relief. A person who is allergic to one type of pollen, for example, may become allergic to another type of pollen in a different region.

When avoidance is not possible, management becomes the next step. As noted, this involves medication and reducing exposure to the allergen. Some management techniques include:

  • Checking the ingredients on food labels to make sure they do not contain an allergen likely to cause a reaction.  

  • Keeping the home cool (between 68 and 72 degrees Fahrenheit [20 an 22 degrees Celsius]).

  • Providing good ventilation with HEPA filters, fans and other devices.

  • Maintaining humidity to between 40 and 50 percent.

  • Wearing a mask when cleaning the house or performing yard work – or better yet, delegating this task to others.

  • Adding mold inhibitor to paint, especially in damp places like the bathroom.

  • Replacing carpeting with hard flooring.

Patients can consult their physician for other tips on avoidance.

Symptom relief

There are several different types of medication available for relief from allergy symptoms. While many of the medications come in an over-the-counter (OTC) form, some require a physician’s prescription.

Because different people respond to medications in different ways, physicians will often recommend first starting with the lowest dose of the least expensive medication. If an individual does not respond to one type of treatment, others are available at the physician’s discretion. Individuals suffering from allergies should always consult their physicians before taking any type of drug treatment, including any “natural,” “herbal” or “alternative” products.

The following types of medication are used to treat allergy symptoms:

  • Antihistamines. Medications used to treat allergy symptoms such as sneezing, runny nose and itchy and watery eyes. Antihistamines work by neutralizing the histamines that are released into the bloodstream during an allergic reaction. Antihistamines can reduce symptoms when taken after the allergic reaction begins. However, they are most effective when taken 3 to 5 hours before coming into contact with an allergen – or on a regular basis. Antihistamines are available in both OTC and prescription forms. They can be taken as pills, liquids, nasal sprays or eye drops. Some types of antihistamines cause drowsiness.

  • Decongestants. Medications used to reduce nasal congestion, swelling and redness. They work by constricting swollen nasal tissues, which prevents fluid and mucus from forming. Decongestants are available in both OTC and prescription forms. They can be taken as pills, nasal sprays or eye drops. Using nasal spray decongestants for longer than three days can actually cause a rebound and increase in congestion. Side effects may include increased blood pressure, insomnia and a quickened pulse.

  • Bronchodilators. Medications used to open up constricted airways by relaxing tightened muscle bands. These drugs are also effective at loosening mucus in the lungs, which can then be more easily coughed out. Bronchodilators are often used to quickly treat symptoms of wheezing, chest tightness and difficulty breathing. They can be inhaled, injected or taken in pill or liquid form.  

    One specific type of bronchodilator, epinephrine, is used to treat a potentially life-threatening allergic reaction known as anaphylactic shock, which can involve a sudden constriction of the airways. An epinephrine shot can be administered to anaphylactic individuals to quickly open up the airways and improve blood circulation Physicians may instruct patients with severe allergies to carry epinephrine with them at all times.

  • NSAIDs (nonsteroidal anti-inflammatory drugs). Medications used to reduce pain and inflammation associated with allergy symptoms.  This type of medication avoids many of the side effects associated with corticosteroids, while producing many of the same results. Two examples of NSAIDs are aspirin and ibuprofen.

  • Anticholinergics. Medications used to open airways by dilating the breathing tubes and loosening mucus. The effects of these drugs are similar to those of bronchodilators, but anticholinergics generally do not work as fast. Some patients who are unable to tolerate the quick reaction or side effects caused by bronchodilators use anticholinergics instead.

  • Nasal saline solutions. OTC products used to rinse the nose out with a saltwater solution. It may relieve minor types of congestion, loosen mucus and prevent crusting. However, this treatment is not effective at preventing allergy symptoms from occurring.

These medications are used to relieve allergy symptoms in progress. However, these and other medications may also be effective at preventing symptoms from ever occurring (or at least reducing their severity). A combination of symptom relief and symptom prevention medications may be prescribed.

Symptom prevention

Most allergy treatments are designed to relieve symptoms of allergic reactions that have already occurred. However, a growing number of therapies have been successful at allergy symptom prevention. The goal of such treatments is one or more of the following:

  • Prevent the onset of symptoms
  • Lessen the frequency of reactions
  • Lessen the severity of symptoms resulting from a reaction

Allergy shots (immunotherapy) are the only treatment currently available for preventing allergy symptoms over a long period of time. By using this method, an individual can become gradually desensitized to a specific allergen (e.g., a specific food, pollen, latex).

Allergy shots involve the injection of small, diluted doses of a specific allergen into a closely monitored individual. These shots continue at regular intervals (first weekly, then less frequently), and with a slightly higher dose of the allergen, for a period of several years. Eventually, the allergic individual builds up a tolerance to a specific allergen. At this point, the person does not experience the same degree of allergic reaction after coming into contact with that allergen.

Allergy shots may be inconvenient and are not universally effective. Therefore, these treatments are generally reserved for individuals who cannot use drug treatments or cannot avoid their allergen. Allergy shots are not effective at treating some types of allergies (e.g., food allergies).

Aside from allergy shots, there are a growing number of treatments effective at preventing allergies and allergy symptoms. These are primarily medications, including:

  • Leukotriene modifiers. Medications used to prevent both nasal allergy symptoms and asthma-related symptoms. This form of treatment effectively disrupts the leukotrienes that the immune system produces during an allergic reaction. Leukotrienes are often involved with the constriction of airways in the lungs.

    Leukotriene modifiers are effective when used prior to an allergic reaction because they work to disrupt a specific chemical process in the allergic cascade, preventing some types of leukotriene from forming in the body. While these medications are primarily used in the prevention of asthma-related symptoms, some forms are finding increased use in the prevention of allergic reactions. They are taken orally, in pill form, daily or several times daily.

  • Antihistamines. Medications that block the histamines that cause the majority of symptoms associated with allergies. Histamines are released into the bloodstream during an allergic reaction. When antihistamines are present in the bloodstream, the histamines are still released. However, they are blocked from carrying out their normal functions. Taking this medication prior to being exposed to an allergen can completely prevent the onset of symptoms. In other cases, the severity of symptoms is reduced. Antihistamines are available as pills, liquids, nasal sprays and eye drops.

    Individuals suffering from hives, allergic conjunctivitis or allergic rhinitis (hay fever) can take antihistamines before coming into contact with an allergen to reduce the symptoms associated with these conditions. For best effects, an antihistamine should be taken 3 to 5 hours before coming into contact with an allergen – or on a regular basis. Because they can effectively prevent allergy symptoms, some people take antihistamines daily. While antihistamines can effectively block the symptoms associated with many allergies, the drugs may not be effective at treating some serious allergies (e.g., food allergies).  

  • Corticosteroids. Medications used to reduce the inflammation associated with symptoms such as nasal stuffiness, sneezing and runny nose. Also known as steroids, corticosteroids work by enhancing the body’s ability to counteract the swelling, inflammation and mucus secretions caused by an allergic reaction. They are available as nasal sprays, inhalers, pills, topical creams and by injection.

    Corticosteroids are most effective at reducing allergy symptoms when taken on a daily basis – even when symptoms are not present. This medication often requires one to two weeks of use before reaching its full effect.
  • Mast cell stabilizers. Medications effective at treating mild or moderate inflammation in the bronchial tubes as well as sneezing, watery eyes and congestion. Mast cell stabilizers prevent mast cells from releasing histamine and other chemicals that can cause allergy symptoms. This medication has fewer side effects than antihistamines. However, they take more time to work, require more doses and may not be as effective in relieving symptoms. Available as a nasal spray, in prescription metered-dose inhalers or as eye drops. This type of treatment is available both over-the-counter and as a prescription.

  • Anti IgE antibody. These medications are used to reduce asthma and allergy reactions. The drug interferes with the immune system’s release of histamine by blocking IgE antibodies from binding with mast cells. Available only by prescription, the drug is given through an injection every two to four weeks. It is only Food and Drug Administration (FDA) approved for certain patients with asthma.

Other allergy treatments

Several other types of allergy treatment are occasionally used, though they have not been clinically shown to be effective. These alternative allergy treatments are generally not accepted or used by licensed physicians or other licensed healthcare providers. Still, many of these therapies are popular and available without a prescription. An individual should discuss any alternative treatments with their physician before using them. These treatments include:

  • Homeopathy. Homeopathic remedies usually vary by patient. However, some common types of remedies include raw onion (for nasal discharge), eyebright (an herb for eye care) and trioxide of arsenic (for sneezing and nasal discharge).
  • Acupuncture. This treatment involves the placement of needles into specific points in the skin. The procedure is said to relieve allergic rhinitis symptoms.
  • Traditional Chinese Medicine. This culturally influenced field of treatment includes the use of Chinese skullcap (herb with high content of antioxidants) as an anti-inflammatory with antihistamine properties and biminne (Chinese herbal formula) for the treatment of allergic rhinitis.

Home remedies have always been a popular treatment for relief from allergies. Most home remedies have not been clinically tested and have not been shown to be effective in any controlled studies. People should be careful using any type of home remedy and always consult a physician before their use. Some popular home remedies include:

  • Castor oil. This substance is a natural emollient that comes from the seeds of the castor plant. It is often used to treat allergies of the intestinal tract, skin and nasal passages.
  • Lime. Lime juice is believed by some people to be capable of flushing toxins out of the body and preventing allergies from occurring.
  • Bananas. This type of food is believed to be useful in treating certain food allergies and can prevent the resulting skin rashes, digestive disorders and asthma. It should be noted that some people have a specific food allergy to bananas.
  • Vitamin C. This vitamin is commonly found in many fruits and vegetables and helps keep the immune system functioning properly. Recent studies have shown it may be effective at treating allergies by lowering histamine levels in the bloodstream.

While rarely used, some types of surgical procedures are effective at reducing allergy symptoms. These include:

  • Adenoidectomy (surgical removal of the adenoid glands at the back of the throat). Occasionally a patient will have their adenoids surgically removed to help prevent sinusitis or a related allergy condition.  
  • Myringotomy (surgical insertion of tubes in the eardrums to drain fluid). This procedure equalizes the pressure between the middle and outer ear. It may be performed to relieve recurrent ear infections or hearing loss due to fluid buildup.

Questions for your doctor

Preparing questions in advance can help patients have more meaningful discussions with their physicians regarding their conditions. Patients may wish to ask their doctor the following questions about allergy treatment:

  1. What are my treatment options? How effective are they?
  2. Am I a candidate for allergy shots?
  3. How will this treatment help my allergies?
  4. How will I know if the treatment is working?
  5. What will be the next step if my allergy treatment does not work?
  6. Will I have to take medication for the rest of my life?
  7. Will I have to take medication every day or just at certain times?
  8. Are these drugs safe for me to use?
  9. Would I benefit from any alternative allergy treatments or home remedies?
  10. Will this drug prevent my symptoms or relieve them once they have developed?
  11. Should I carry an allergy kit with me?
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