Q: Exposure to dust mites plays a significant role in triggering asthma and allergies. What are the options available for dust mite immunotherapy? 

Purvi Parikh, MD: Dust mites are a common trigger for allergies and asthma. Not only do they cause itchy eyes, stuffy nose, coughing, wheezing and other symptoms, they can also cause skin allergies such as eczema or hives. For this reason, dust mite allergy can be difficult to control and manage.

Fortunately, there are two options for dust mite immunotherapy, also known as desensitization. Immunotherapy, over time, makes your body less reactive or allergic to an allergen.

The first option is the oldest and most conventional – allergy shots. With allergy shots, you get a weekly injection of dust mite allergen in your allergist office for about 6-8 months. By getting increasing doses, it makes your immune system more tolerant over time. Thus, you experience fewer reactions. After this buildup phase, you have to get a shot just once a month for the next 2-3 years. This allows you to maintain your immunity to dust mites.

If you’re fearful of injections or you don’t have time to come into your doctor’s office frequently, allergy shots can be burdensome.

A second option now exists for people who suffer from dust mite allergies. There’s now an oral tablet available for dust mite immunotherapy.

Similar to allergy shots, the tablets provide increasing doses of dust mite allergen that make your body less allergic over time. You take the first dose in the doctor’s office to make sure you don’t have a severe reaction and that you’re safe. After that, you can take the tablets at home every day. You need to have epinephrine auto-injectors at home in case you need treatment for a severe reaction.

Some pitfalls of allergy tablets is that if you suffer from severe or uncontrolled asthma, you are not eligible to take the oral tablet. Also, if you have multiple allergens, such as pollen, mold or pet dander, oral tablets may not be the best option since they can only treat one allergen. Allergy shots are able to treat multiple allergens at once.

One important thing to remember about the oral tablet is you need to be diligent about taking it on a daily basis. If you happen to miss too many days in a row, you need to contact your doctor because it can be dangerous to restart immunotherapy on your own.

Purvi Parikh, MD, is a board-certified allergist and immunologist with Allergy and Asthma Associates of Murray Hill and New York University School of Medicine in New York City. She is also a member of the American College of Allergy, Asthma and Immunology.

Have a medical question? Email editor@allergyasthmanetwork.org or write to Ask the Allergist, Allergy & Asthma Network, 8229 Boone Blvd., Suite 260, Vienna, VA 22182.

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