All About Allergies

 

What is allergy?

A person with an allergy has an overactive immune system. When people have an allergy, their immune systems reacts to harmless things, such as grass pollen, pet fur or a specific food. Something that is normally harmless but causes a reaction is called an allergen.

What causes allergies?

The human immune system is the body’s defense against sickness and infection. It tries to prevent germs, allergens and foreign substances from entering the body and then works to eliminate any that get through.

In people with allergies, the usual way the immune system treats things like pollen, mold, dust mites or animal dander is changed, and the body identifies these as dangerous invaders. Then, your immune system creates a specific IgE antibody to fight it if the allergen enters your body again.

How does an allergic reaction occur?

When you come in contact with the same allergen later, the body is ready to respond with its protective IgE antibodies for that allergen. The antibodies attach themselves to white blood cells called mast cells that line the mucous membrane of the nose, eyes and lungs and cause inflammation. Cilia, the tiny hairs that trap and sweep allergens out of the way, become bogged down with mucus and fluid and allergy symptoms appear.

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Are allergies serious?

Allergies are not just a nuisance – they are a serious health issue. Allergies can interfere with day-to-day activities and impact quality of life. They generally fall into two categories:

Environmental allergies

  • pollen
  • mold
  • pets
  • dust mites
  • cockroaches
  • mice
  • dust mites

Life-threatening allergies

Some allergens that can lead to serious, life-threatening allergic reactions (called anaphylaxis) as a result of exposure. These allergens are commonly:

  • food
  • insect venom
  • latex
  • medication
photo of a woman blowing her nose

Are allergies genetic?

As many at 50 million people in the United States have some type of allergy. The tendency to develop allergies is often – but not always – hereditary, passed down from generation to generation. However, not everyone in a family will be allergic to the same things – and some won’t be allergic at all.

What are the most common allergy symptoms?

Allergy symptoms vary from person to person and each allergy. Seasonal or environmental allergy symptoms include:

  • Runny nose, usually with clear or pale-colored mucus
  • Sneezing
  • Coughing
  • Red, watery eyes
  • Itching around the nose, mouth or eyes

Left untreated, these symptoms can lead to other issues like nasal congestion, headaches, sore throats, and other issues, so treatment is important.

Allergy symptoms can also be very serious and life-threatening, leading to anaphylaxis. Symptoms that may require you to seek emergency care include:

  • Skin: itching, redness, swelling and hives
  • Mouth: itching, swelling of lips and tongue
  • Stomach: vomiting, diarrhea, cramps
  • Respiratory: shortness of breath, wheezing, coughing, chest pain and/or tightness
  • Heart: weak pulse, dizziness, faintness
  • Headache, nasal congestion, watery eyes, sweating
  • Confusion, feeling of impending doom
  • Loss of consciousness

How are allergies diagnosed and tested?

It is important to know which allergens cause you to have symptoms. To get diagnosed and tested for allergies, you should see a board-certified allergist. This allergist will do the following:

  • review your health history and your family’s health history
  • ask about the frequency and severity of your symptoms
  • ask what activities might expose you to allergens
  • ask about your home and work environments
  • perform a physical exam of your eyes, ears, nose and lungs

Based upon the findings, the allergist can determine if allergy testing is needed. Allergy testing may include skin prick testing and blood tests. You can then work with your allergist to understand the results and develop a treatment plan.

What allergy medications and treatments are available?

Several treatment options are currently available for allergies including:

  • avoidance of allergens
  • medication
  • allergen immunotherapy
  • nasal sprays and washes

Medications used to treat allergies include:

  • Antihistamines
  • Decongestants
  • Nasal corticosteroid sprays
  • Leukotriene modifiers
  • Mast cell stabilizers
  • Anticholinergics
Photo of a male doctor talking to a female child and her mother
Allergen immunotherapy, also known as allergy shots, helps build your tolerance to allergens, reducing or eliminating symptoms. It works by the patient being given a gradually increasing amount of the allergen on a regular schedule, until a maintenance level is reached.

Tolerance for the allergen typically continues after immunotherapy ends – however the long-term success rate varies from person to person.

Allergy shots and under-the-tongue tablets are types of immunotherapy that your allergist may recommend for treatment of your allergies. Visit your allergist to determine the best treatment option for you.

What are the most common allergies?

Many different substances trigger allergic symptoms. Common allergens include:

Food Allergies

Eight foods account for 90 percent of all reactions in the United States. These eight foods are known as the “top 8” food allergies:

  • cow’s milk
  • hen’s eggs
  • peanuts
  • tree nuts
  • wheat
  • soy
  • fish
  • shellfish

Pollen Allergy

Pollen allergy is an allergy to pollen, tiny particles released by trees, grasses and weeds. Pollen grains float through the air in spring, summer and fall – or year-round in areas with mild winters.

Symptoms of pollen allergies may be:

  • sneezing spells
  • watery or itchy eyes
  • congestion
  • itchy throat

Pollen allergies may occur throughout the year. Tree pollens are common in late winter and early spring, followed by grasses in late spring and summer. Then towards the end of the summer allergies from the pollen released by weeds are more common.

There are ways to limit exposure to pollen allergens and minimize symptoms. However, pollen allergies may require medications to control symptoms, so treatment options should be discussed with a board-certified allergist.

Mold Allergy

Molds are microscopic organisms called fungi, found virtually everywhere, indoors and out. Molds reproduce through spores spread by water, insects or air, so tiny and lightweight they can float through the air like pollen. These spores can be inhaled and cause allergic symptoms.

These symptoms include:

  • Nasal and sinus congestion
  • Sore Throat
  • Sneezing
  • Watery or burning eyes
  • Dry cough
  • Shortness of breath
  • Irritation of the nose, throat, or skin

Mold spores are especially dangerous for people with asthma and may trigger asthma attacks, but the exact reason is not known

Testing for mold allergy is done by a board-certified allergist and may include both skin prick and blood tests.

Treatment for mold allergies includes:

  • Nasal corticosteroids
  • Antihistamine
  • Decongestants
  • Montelukast (Singulair)

Mold hides both indoors and outdoors, so limiting exposure is key.

Pet Allergy

Allergic reactions to cats, dogs and other furry animals are caused by proteins found in flecks of the pets’ skin, called dander, as well as in their saliva and urine. You are really not allergic to the fur of your pet. You are allergic to pet dander.

Pet allergens can cause reactions when they’re inhaled, get in the eyes, or come in contact with skin. Reactions may happen within minutes, but may be delayed for hours.

The best way to eliminate a pet allergy is to remove the pet from the home. However, the pet dander can remain in the home for weeks to months.

Dust Mite Allergy

Dust mites are tiny insects that live in mattresses, pillows, upholstered furniture. They look for moisture along with their favorite food, tiny bits of shed human skin.

Allergens from dust mite droppings and dead bodies collect in bedding, furnishings and dust, then irritate airways and eyes on contact.

Symptoms of dust mite allergy include:

  • itchy eyes,
  • scratchy throats,
  • runny nose and
  • other allergy symptoms
  • Dust mites are also a potent trigger of asthma.

There are changes you can make to your home environment to reduce dust mites.

Dust mite allergies can be treated with over-the-counter decongestants, antihistamines, or nasal sprays. Seek care from a board-certified allergist to discuss medications as well as immunotherapy.

Cockroach & Mice Allergy

Cockroaches and mice are mostly nocturnal, scavenging at night for food and water – and leaving behind trails of allergens that cause symptoms on contact or when inhaled. Cockroach allergens are believed to be feces, saliva and body parts. Mice allergens are skin, saliva and urine.

Allergen levels are usually highest on kitchen cabinets and floors, while moisture-laden bathrooms are secondary areas. Poorly contained food and garbage in kitchens is a well-known risk factor. The bedroom is another prime location for cockroaches, particularly in heavily infested homes.

The best way to remove mice from the home are mouse traps; place them against walls where mice often scurry as they search for food in your home.

For severe infestations, it may be best to call a professional exterminator.

Minor home improvements can improve your chances of keeping cockroaches and mice out.

Insect Venom Allergy

For most people, insect stings are a short-term annoyance. Others allergic to the venom in a stinging insect can cause an allergic reaction.

The most common insects to cause an allergic reaction are:

  • Yellow jackets
  • Hornets
  • Paper wasps
  • Bees
  • Red ants (“fire ants”)

Symptoms of an insect venom allergy can range from a mild local reaction to a severe systemic reaction known as anaphylaxis. The danger is that an allergic reaction can happen to anyone, even people with no other allergies and people who have been stung before with no problems

Localized reactions may be managed at home with cold compresses, antihistamines, or itching creams.

  • Severe, life threatening symptoms are:
  • Hives or generalized itching other than at the site of the sting
  • Swelling of the throat or tongue
  • Difficulty breathing
  • Dizziness
  • Severe headache
  • Stomach cramps, nausea or diarrhea

If you develop these symptoms, the only treatment is an injection of epinephrine, which should be given first and fast. If you need an injection of epinephrine, you should also follow-up with emergency care.

If you have a known insect allergy you should always carry an epinephrine auto injector.

Eye Allergies

Eye allergies, also known as allergic conjunctivitis, occur when the protective outer covering of the eye and eyelid, called the conjunctiva, becomes swollen and inflamed due to allergens or irritants.

Common symptoms include:

  • red, irritated, teary and itchy eyes
  • burning
  • eyelid swelling
  • blurred vision
  • sensitivity to light

Environmental triggers and irritants cause eye allergies.

Environmental triggers include:

  • Pollen
  • Mold
  • Dust mites
  • Pet dander

Irritants include:

  • Cigarette smoke
  • Cosmetics
  • Perfume
  • Contact lenses
  • Contact lens solution

The most effective treatment for eye allergies is avoiding environmental triggers and irritants.

Medication Allergy

Drug allergies may cause hives, cause light-headedness, nausea, difficulty breathing or stomach cramps, or make your throat or mouth swelling. Symptoms can begin within moments of ingesting a medication or up to several hours later.

Medications that most often cause a reaction include:

  • Antibiotics
  • Aspirin and non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen
  • Drugs used in anesthesia
  • Insulin (rarely)
  • Chemotherapy drugs

If you develop flushing or hives within a few hours of taking a medication, call a board-certified allergist. If symptoms are severe and involve multiple body organs – a skin rash, respiratory problems and/or digestive issues – it could be anaphylaxis. Call 911 and go to the emergency department immediately.

Not all reactions are a drug allergy, so it is important to get tested by a board-certified allergist.

Latex Allergy

Latex allergy is an allergic reaction to the proteins present in the milky sap of the Hevea brasiliensis rubber tree.

Latex allergy generally develops after repeated exposure to medical and consumer products containing natural rubber latex.

Allergy to latex poses a serious health risk to:

  • healthcare workers
  • spina bifida patients
  • workers with occupational exposure
  • patients with multiple surgeries
  • the general population

Symptoms of latex allergy may be mild at first, progressing to more serious types of symptoms.

Symptoms of latex allergy include:

  • skin redness
  • urticaria (hives)
  • itching
  • nasal drainage
  • sneezing
  • itchy eyes
  • throat irritation
  • asthma

A latex allergy reaction can also result in anaphylaxis, a life-threatening allergic reaction.

Do I have allergies or a cold?

Sometimes it is hard to tell if you have allergies, or if your symptoms could be due to a cold, or flu or sinus infection. The following chart can help you tell the difference.

Chart depicting the different and overlapping symptoms of colds, allergies, flu, or sinusitis

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