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Allergy and Asthma Season

By Desmond Lew, MD
Pediatrician 

Spring is just around the corner and patients with allergies should start to thinking about signs of allergies and strategies to avoid symptoms.  As the weather warms up, trees and flowers will start to bloom that can trigger allergy and asthma symptoms.  In addition there are year round allergy triggers that can cause chronic respiratory symptoms.  Allergy symptoms can vary from itchy rashes to full-blown asthma attacks so awareness of early warning signs can help you treat them.

Allergy symptoms can sometimes mimic viral infections like common colds.  Symptoms include clear runny nose, itchy, red eyes, coughing, and rashes.  Non-prescription medications that treat allergy symptoms include antihistamines, decongestants and topical steroid creams. If untreated, allergies can progress to more serious infections such as ear infections, sinusitis, or conjunctivitis.  Your health professional can help you differentiate between allergy symptoms and viral illnesses. He can recommend the most appropriate medication regimen for you.  There is also blood and skin tests that can help identify specific allergies.

Allergy Symptoms:

  • Runny nose
  • Itchy or red eyes
  • Persistent cough
  • Itchy rashes

The best way to treat allergies is to avoid the offending allergens and to minimize exposure.  One of the most common allergies is to dust mites that are concentrated in the bed.   We spend about 1/3 of our life in the bedroom and not surprising that is where dust mites concentrate.  Dust mites eat the dead skin that flakes off your skin and excrete feces which we inhale while we sleep.  Washing the blankets and pillowcases in hot water once a week should minimize dust mites.  In addition to frequent washing, encasing pillowcases and mattresses in special dust mite covers prevent allergy exposure.  Also dusting with a wet cloth is better than a feather duster.  Vacuuming once a week with a HEPA filter bag should keep the bedroom clear of dust.  For severe allergies, a portable HEPA air filter purifier can be placed in the bedroom can help remove additional allergens.
Indoor Allergen Avoidance:

  • Wash blankets in hot water weekly
  • Vacuum weekly with a HEPA filter bag
  • Dust with a wet cloth
  • Minimize animal exposure
  • Eliminate mold sources in the home
  • HEPA air purifier

Outdoor allergies can be difficult to avoid but one can minimize symptoms by taking a non-sedating antihistamine before going outside.  The American Academy of Allergy and Immunology tracks pollen counts in the United States that you can use their webpage to determine when pollen counts are high.  After coming into the home, remove your clothing and shower will help remove any pollens that attach to your hair and body.  In addition, keep the windows in your house closed to prevent pollen from coming into your home.  Pets also bring outdoor allergens into the home so bathing them regularly will decrease the your exposure.

If avoidance and over-the-counter medications do not relieve your symptoms, your physician my run additional tests to make the correct diagnosis.  Some tests would include a blood test for allergies.  This test identifies the levels of antibodies against allergens that your body has reacted; a high level of these antibodies would indicate an allergy to that particular allergen.  Allergists can perform a skin prick test; in this test, the patient’s skin is pricked and a specific allergen is introduced into the skin.  The size of reaction to this prick would indicate the presence of an allergy.

Outdoor Allergen Avoidance:

  • Avoid outdoor activities when pollen count was high
  • Change clothes and shower after being outdoors
  • Wash pets regularly

After allergies are identified, there are a number of treatment options.  Prescription medications include antihistamines, nasal steroids, leukotriene modifiers, and mast cell modifiers.  These medications reduce the production of the inflammatory chemicals that are released during an allergic reaction.  For those patients who do not respond adequately to prescription medications, allergy desensitization shots also known as “allergy shots” may be recommended.  This procedure involves injecting a very small amount of allergen to your skin and slowly increases the amount of allergen to induce tolerance to that allergen.  An alternative controversial method to induce tolerance is Sublingual Immmunotherapy (SLIT).  This method involves introducing small amounts of allergens under the tongue to induce tolerance.   A recent study indicates that 35% of patients respond favorably and 38% of patients had no response.  In addition, for those patients who did respond to SLIT, the response was not as effective as traditional immunotherapy.

Treatment Options

  • Prescription medications
  • Immunotherapy
  • Sublingual Immunotherapy