How are Allergies Treated?
Allergy symptoms occur when the body reacts to an allergen. The most common allergens are pollen, mold, pet dander, dust mites, certain foods, insect stings and medicines. Reactions to environmental allergens can be mild or serious. Reactions to food, insect venom or medications can be life-threatening. Treatment depends on what the body is reacting to and the type of reaction.
For allergic rhinitis (also known as environmental allergies or hay fever), your eyes or nose react to triggers such as pollen, dust, mold, or animal dander. These reactions are usually not severe or life-threatening. Treatment focuses on easing symptoms. Over-the-counter medicines like antihistamines and nasal sprays usually help. Prescription allergy medications are also available. Allergen immunotherapy, or allergy shots, can help desensitize you to allergens over time.
Food, insect venom or drug allergies can cause a dangerous reaction called anaphylaxis. The first line of treatment for anaphylaxis is epinephrine. People with severe or life-threatening allergies should carry epinephrine. Products include auto-injectors and nasal sprays. Treatments like immunotherapy or specific biologic medicines can help the body become less sensitive to these allergens over time.
Work with a doctor or allergy specialist to find the best treatment plan for you. For severe allergies, this may include avoiding allergens and always keeping epinephrine close by in case of an emergency.
What medications are for allergy treatment?
The wide range of allergy medicines may seem overwhelming. If you understand how different medications treat allergies, you’re one step closer to control.
Allergy treatments are available as over-the-counter medications and prescriptions. They can be pills, sprays, or injections. Always read labels and ask your doctor or pharmacist about dosing and side effects, especially if you are pregnant or breastfeeding.
Antihistamines
Antihistamines are the most common medications used to treat allergies. They can help people with seasonal or environmental allergies to pollen, mold, pet dander or dust mites. Antihistamines do as their name suggests. They block histamine, the chemical that causes allergy symptoms such as sneezing, runny nose, hives, and red, itchy eyes.
Antihistamines can be used “as needed” because they relieve symptoms quickly, but they become more effective when used daily. It’s best to use them before your seasonal allergies begin to build up to long-term effectiveness. Antihistamines do not stop a severe allergic reaction and can mask the symptoms, delaying the need for effective treatment.
- How they work: They stop histamine from attaching to cells. Histamine causes the symptoms of sneezing, congestion, runny nose, hives and red, itchy eyes.
- How to take them: Available as pills, liquids, nasal sprays, or eye drops.
- Approved for: These products are suitable for children and adults. Some are for children as young as 2 years old, and others are for kids 6 and older. Check the label.
- Availability: Many are available over the counter. Some require a prescription.
- Side effects: First-generation antihistamines such as diphenhydramine (Benadryl®) tend to make you drowsy. Don’t take them when you have any activities that require you to be alert. Second-generation antihistamines like loratadine (Claritin®), cetirizine (Zyrtec®), levocetirizine (Xyzal®) or fexofenadine (Allegra®) cause less drowsiness. In rare cases, cetirizine and levocetirizine may cause severe itching called pruritis within a few days of stopping the medicine. The itching occurred in people who used the medicines daily for a few months to years.
Talk with a doctor about using these antihistamines for allergy treatment and which is best for you.
Corticosteroid nasal sprays and eye drops
Nasal corticosteroid sprays and eye drops are non-sedating medications. They are designed to prevent and soothe nasal allergies by addressing inflammation in nasal tissues and airways.
They start working quickly, but you may not feel the full effects for several weeks. Doctors generally recommend that you start taking these medications a few weeks before your allergy season starts or regularly if you have year-round symptoms.
- How they work: They lower inflammation in your nasal passages and eyes.
- Approved for: Usually children 2 years and older and adults.
- Availability: They can be bought over the counter or with a prescription. Specific age recommendations can vary by product.
- Side effects: If not used correctly, they may cause mild irritation, and it might take a few weeks to feel the full benefits.
➤ See How to Use a Nasal Spray
Leukotriene modifiers
Leukotriene modifiers treat allergic rhinitis, also known as hay fever. They are also sometimes used to treat asthma. It is. recommended that you take a leukotriene modifier at the same time every day. Your doctor will advise you on the best time to take the medication.
- How they work: They are designed to block leukotrienes. These are the chemicals involved in allergic reactions that cause symptoms such as swelling and inflammation. (For asthma, they address constriction of the airways.)
- How to take them: Tablets or chewable tablets once a day and sprinkles (for children).
- Approved for: Adults and children 2 years and older.
- Availability: Prescription only. Montelukast (Singulair®) is a leukotriene modifier available by prescription.
- Side effects: Ask your doctor about potential side effects.
Mast cell stabilizers
Mast cell stabilizers help stop allergy cells (mast cells) from releasing histamine. Histamine is the chemical that causes inflammation in nasal passages. It is responsible for allergic symptoms like runny nose, stuffy nose, sneezing, postnasal drip and red, itchy eyes.
Doctors generally recommend that you start taking these medications a few weeks before your allergy season starts. If you have symptoms year-round, they should be taken regularly. Mast cell stabilizers do not work on symptoms that have already begun.
- How they work: They keep mast cells from releasing chemicals that trigger symptoms.
- How to take them: Often used as a nasal spray or eye drop. They work best if used early.
- Approved for: Children 6 and up and adults; check the product label.
- Availability: Cromolyn sodium (Nasalcrom®) is available as an over-the-counter nasal spray or eye drop and as a prescription nasal spray.
- Side effects: Side effects are usually mild.
Anticholinergics
Anticholinergics, also known as anti-muscarinic agents, are mostly used to treat asthma and COPD, but they are sometimes used to treat allergy symptoms. They relieve runny nose, usually when there is a clear discharge, by reducing the formation of mucus.
- How they work: They block signals between nerves and muscle cells in the respiratory tract, which helps keep the airways open (bronchodilation) and reduces mucus production.
- How to take them: Often as a nasal spray or inhaler. Ipratropium bromide (Atrovent®) nasal spray is a prescription anticholinergic medication.
- Approved for: Typically used by adults and older children. Ask your doctor for guidance.
- Availability: Prescription only.
- Side effects: May cause dryness or irritation in the nose.
Epinephrine for severe allergic reactions
Epinephrine is the first-line medicine to effectively treat severe allergic reactions, also known as anaphylaxis. It is essentially a dose of adrenaline, a natural hormone. People who have life-threatening food, drug or insect sting allergies should always carry epinephrine with them and know how to use the product in case of a medical emergency.
- How it works: It quickly opens airways and improves blood flow.
- How to take it: Delivered by an auto-injector (a special pen-like device that injects the medicine into your thigh) or a nasal spray, which you use in your nose.
- Approved for: All ages. Devices come in different dosages based on age/weight.
- Availability: Prescription only.
- Side effects: Epinephrine is a safe medication and should be used immediately if anaphylaxis is suspected. Side effects may include a fast and irregular heartbeat, sweating, nausea, dizziness, anxiety and restlessness.
Biologics for food allergy
A biologic therapy is available for severe food allergies: omalizumab (Xolair®). You must be diagnosed with a true IgE-mediated food allergy to be prescribed omalizumab. Your doctor will perform allergy tests (skin test and blood tests) and take a detailed patient history before prescribing the biologic therapy.
Omalizumab can make a big difference for people whose allergies or asthma are not controlled by other treatments.
- How it works: Omalizumab blocks IgE, the antibody that triggers allergic reactions.
- How to take it: An injection under the skin, usually at a doctor’s office, every two to four weeks.
- Approved for: Typically prescribed for children 1 year and older and adults. Your doctor will decide based on your allergy tests.
- Availability: Prescription only.
- Side effects: Risk of anaphylaxis. Requires regular check-ups to monitor for side effects.
How to use a nasal spray
Read the package insert instructions for patients before using the first time, as each medication is different. Look for information on how to prime and clean, how to hold and position the canister or pump, and whether to inhale or not.
- Prime the spray as directed before the first use or if you haven’t used it in a while.
- Blow your nose gently to clear out mucus before using the spray. This will allow the medicine to get up into the nasal passages. If you have bad nasal congestion, you may need a nasal wash or a decongestant for a few days to open up your nose before you spray.
- Gently insert the tip of the nasal spray ¼ to ½ inch into your nose. (It’s designed not to go too far; don’t try to push it in and avoid touching the septum with the tip of the nasal spray.) Point it away from the center of your nose, toward your ear, ensuring the spray reaches the back of your nose and less medicine ends up on your septum (the tissue separating the two sides of your nose), which can be damaging. Try holding the spray with your left hand when applying to the right nostril, then switch for the other side.
- Lean forward slightly, press and close the nostril you are not treating. If instructed, inhale gently through the other nostril as you release the spray. Some nasal sprays do not require you to inhale; others may recommend you lean your head back instead of forward.
- Exhale through your mouth. Do not blow your nose for at least 15 minutes after using the spray; just wipe away any liquid that drips.
- Wipe the spray tip clean after every use and replace the cap. If it becomes clogged, check your manufacturer’s instructions for cleaning, but do not use a pin or other instrument to enlarge the hole.
- Keep track of the doses and priming sprays used and replace your nasal spray after you have used the recommended number. There may be liquid left in the container after all the doses have been used, but the medication mix is not likely to be accurate.
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What is allergen immunotherapy?
Allergen immunotherapy helps the body learn to tolerate substances that cause allergies. It has been proven successful for pollen, mold, animal dander, house dust mites, cockroach allergens, insect venom hypersensitivity, and food allergies.
How does immunotherapy work? The doctor will give you small, gradually increasing amounts of an allergen so that your body learns to react less strongly to the allergen over time. Eventually a steady, maintenance dose is reached. You can undergo immunotherapy using allergy shots or tablets.
Immunotherapy is not a cure for allergies. It lowers your sensitivity so you can tolerate exposure to the allergen. This tolerance may continue after treatment ends, though long-term success varies by person.
In addition to easing symptoms, immunotherapy may help prevent new allergies. It can also slow the progression of allergic diseases like rhinitis, eczema and asthma. It can also help control allergic asthma by interrupting the allergic response.
Talk with an allergist to determine if immunotherapy is right for you or your child.
Ask the Allergist covers Allergy Immunotherapy Options in this Q & A
Allergy shots
Allergy shots, or subcutaneous immunotherapy (SCIT), are the most common form of immunotherapy. They are mainly for environmental allergies such as pollen, mold, pet dander and insect stings, as well as indoor allergens like dust mites. Several different allergens can be combined into one injection. This can help build tolerance to multiple allergens at once.
- How to take them: Injections are given in an allergist’s office. At first, you get them once or twice a week. Over 6-12 months, the dose slowly increases until you reach a steady level. Depending on your response, your shots may be given less often, perhaps once a month. After 3-5 years, if you do well, your allergist may stop the therapy.
- Approved for: They are suitable for children, teens, and adults. There is no strict age limit, but your doctor will guide you based on your specific needs.
- Availability: Prescription only.
- Side effects: A serious allergic reaction to allergy shots is rare. The procedure should be conducted in an allergist’s office equipped with epinephrine in case an allergic reaction occurs. Side effects are rare but may include local skin irritation. Patients stay in the office for about 30 minutes after the shot to monitor for reactions. A reaction can happen hours later, however, so be sure to carry epinephrine with you. If anaphylaxis symptoms occur – difficulty breathing, tightness in the throat, hives or swelling, nausea, vomiting, fainting, diarrhea or abdominal pain – immediately administer epinephrine and seek emergency treatment.
How long are allergy shots effective?
Many people experience a long-lasting reduction of symptoms after receiving allergy shots. However, some may eventually lose their immunity. At this point, people can choose to resume allergy shots.
If you completed allergen immunotherapy and are experiencing symptoms, see your allergist for testing and treatment. Your symptoms may not necessarily be caused by old allergies returning. It’s possible you developed a new allergy, perhaps after moving or starting a job in a different environment.
Sublingual immunotherapy: Under-the-tongue tablets
Sublingual immunotherapy (SLIT) involves taking a daily allergy tablet that dissolves under the tongue. The goal is the same as an allergy shot: to boost tolerance to allergens. SLIT tablets approved by FDA treat grass and ragweed pollens and house dust mites. Each SLIT tablet covers one type of allergen.
- How to take them: A daily tablet placed under the tongue builds tolerance over time. The first dose is given in a doctor’s office. Thereafter, tablets are taken at home every day. Epinephrine must be available in case of anaphylaxis.
- Approved for: Tablets for certain grass pollens are available for children as young as 5 years old, while ragweed tablets are for patients 18-65.
- Availability: Prescription only.
- Side effects: Mild side effects like mouth or throat irritation can occur. Always have epinephrine available in case of a severe reaction.
Do you have to take the sublingual immunotherapy tablets every day?
Take SLIT tablets for house dust mites year-round. It can take 8-14 weeks of daily dosing to experience a noticeable benefit.
Start SLIT tablets for grass and ragweed pollen 3-4 months (depending on the tablet given) prior to the start of pollen season, as well as during pollen season, for peak effectiveness.
What is food allergy oral immunotherapy (OIT)?
Food allergy oral immunotherapy (OIT) is relatively new. The only FDA-approved oral immunotherapy for peanut allergy is Palforzia®. This treatment is not meant to cure peanut allergies. Rather, it is to help reduce the frequency and severity of peanut allergy symptoms in case of accidental exposure.
OIT starts by giving a tiny amount of the food allergen and then gradually increasing the dose until a target is reached. This helps desensitize the patient should there be an accidental exposure to the allergen.
Food allergy OIT should only be done in a medical setting such as an allergist’s office. Do NOT attempt oral immunotherapy on your own.
- OIT protocol: At first, you take the food allergen in a controlled medical setting, usually an allergist office. Later, once you reach a steady maintenance dose, you can take OIT at home with your allergist’s guidance.
- Who OIT is for and age range: Typically for children and adults with a confirmed peanut allergy. Specific age guidelines depend on the treatment protocol.
- Availability: Prescription only. Currently, only peanut OIT is FDA-approved.
- Side effects: This procedure must be performed under close medical supervision to monitor for possible allergic reactions. Patients must continue to carry epinephrine in case of anaphylaxis.
Is OIT available for other allergens besides peanut?
Peanut OIT is the only FDA-approved food allergy immunotherapy. What about other food allergens, such as cow’s milk, soy or egg? Some allergists who specialize in food allergy may offer an in-office oral immunotherapy treatment. These may treat other food allergens besides peanut. They are not FDA-approved, however.
Researchers continue to study additional food allergens and the combination of biologics and oral immunotherapy to treat people with multiple food allergies.
Natural ways to treat seasonal or environmental allergies
In addition to allergy medications, you can use more natural ways to help you manage your symptoms. Simple methods like using saline nasal sprays, keeping your home clean, and avoiding allergens can reduce irritants and provide relief.
Do saline sprays and nasal washes relieve allergy symptoms?
Saline sprays and nasal washes are common drug-free natural treatment options to reduce allergy symptoms and provide some relief. They work by flushing out allergens, mucus and irritants from your nasal passages, making it easier to breathe.
How are saline sprays different from nasal washes?
Saline sprays are quick and easy to use. They deliver a gentle mist directly into your nose and are small enough to carry with you. Nasal washes require a device (like a neti pot or bulb syringe). Mix your own saltwater solution for a deeper clean. Both methods help reduce allergy symptoms, but nasal washes are especially useful for clearing out heavy mucus or congestion.
Saline sprays to relieve allergy symptoms
Think of them as a moisturizer for the nose that can also cleanse the nasal membranes. They may be especially helpful in winter when the air is cold and dry.
- What they are: Saline sprays are a simple saltwater solution. They do not contain medication. The saline is delivered from a small spray bottle that you press to release a fine mist into your nostrils.
- How they help: They clean and moisturize your nose, soothing irritation from colds, allergies or overuse of decongestant nasal sprays.
Nasal wash (rinse) to clear allergy triggers
Nasal washes are helpful for people of all ages who experience nasal congestion and postnasal drip.
- What is a nasal wash: It’s a saltwater (sodium chloride) solution sometimes mixed with a little baking soda (sodium bicarbonate). A nasal wash can clear congestion and open sinus passages. They are available as premixed solutions packets available at pharmacies, or you can make your own. Done with a rinsing device such as a squeeze bottle, bulb syringe, neti pot, or battery-powered irrigator.
- How it helps: Nasal washes shrink swollen membranes and open up sinus passages, improving airflow.
- Tip: Always do a nasal wash before using nasal sprays like corticosteroids. This helps the spray reach your nasal passages better.
How to use a nasal wash to treat allergies:
- Fill a rinsing device with the saline solution. Many devices are available, such as a squeeze bottle, bulb syringe, neti pot, or battery-powered sinus irrigator.
- Lean over a sink and gently squirt the solution into one nostril. Aim for the back of your nose so it can drain out the other side. Do not inhale while doing this. Finding the right head position may be tricky at first. Tilt your head forward, touching your chin to your chest.
- Repeat this with the other nostril until you have used all the solution. If the salt feels too strong, add more water to dilute it.
For Children: Use a small saline spray bottle and squirt a few times into each nostril while the child sits or stands. (Avoid lying down.)
Lifestyle modifications to help minimize allergy symptoms
You can reduce allergy symptoms by making changes in your home and daily habits. First, it is key to know your allergy triggers and how to minimize exposure to them. Here are some tips:
- Use HEPA filters. High-efficiency particulate air (HEPA) filters help remove tiny particles like pet dander and dust from the air. Consider using them in your bedroom and main living areas.
- Use allergen-proof bedding. To prevent dust mites and other allergens from entering your mattress and pillows, cover them with allergen-proof covers. Wash your bedding regularly in hot water.
- Control indoor humidity and temperature. Keep your indoor humidity between 30% and 50% and your home at a comfortable temperature (68–72°F). This helps prevent mold and dust mites from growing.
- Do regular cleaning. Dust and vacuum your home often. If possible, use a vacuum with a HEPA filter. Avoid hanging clothes and sheets outdoors during high pollen counts.
- Clean or declutter soft surfaces. Carpets, drapes, and stuffed toys can collect dust and allergens. Vacuum carpets with a filter and wash drapes and stuffed toys regularly. Reducing clutter can also help keep allergens away.
- Reduce pet allergens. If you have pets, bathe them regularly and try to keep them out of your bedroom to lower pet dander levels.
- Avoid irritants. Avoid smoke, strong perfumes, and cleaning products with harsh chemicals, as they can aggravate allergy symptoms.
Questions & answers (Q&A) about allergy treatment
Allergies can come from various sources and can be life-threatening or mild. Here are some questions that we are often asked. Want to see another question addressed? If there’s something you’d like to see covered here, email our editor.
Reviewed by:
Purvi Parikh, MD, FACAAI is an adult and pediatric allergist and immunologist at Allergy and Asthma Associates of Murray Hill in New York City. She is on faculty as Clinical Assistant Professor in both departments of Medicine and Pediatrics at New York University School of Medicine.
Are there other conditions that can look like or complicate allergies
There are other types of conditions that can mimic allergies, but are different than an IgE-mediated allergy. The symptoms, diagnosis and treatment can vary depending upon the condition. Here are some of them.
Food-related conditions that can have symptoms similar to food allergies include:
