Management and Treatment of Allergies

An allergy develops when the immune system overreacts to an otherwise harmless substance. Anything that causes an allergic reaction is called an allergen. When the body reacts, it creates immunoglobulin E (IgE) antibodies. These antibodies trigger cells to release histamine and other chemicals which in turn cause allergy symptoms.^1-4

There are several ways to treat and manage allergies. It depends on the type of allergy and how mild or severe your reaction is. The most common treatments are:^1-4

• Avoiding the allergen
• Lifestyle changes
• Over-the-counter and prescription drugs
• Immunotherapy (allergy shots)

Types of allergies and their symptoms

Different allergens trigger different allergic reactions. Some allergies are seasonal, while others are year-round. Common allergens include:^1-4

• Food (milk, wheat, egg, sesame, soy, peanut, tree nuts, shrimp, shellfish)
• Pollen (trees, grass, weeds)
• Animal dander
• Dust
• Mold
• Certain drugs
• Insect bites and stings
• Latex

The type of treatments that work for you will depend on what you are allergic to and your symptoms. Itchy skin or hives may sometimes be treated with the same drugs as sneezing and watery eyes.

Managing your allergies

Managing your allergies usually begins with avoiding any triggers that cause symptoms. Other management techniques include changing your environment and treating symptoms with allergy medicines.^1-4

Managing exposure and treating symptoms allows most people to live life normally. However, for some people, allergies can be life-threatening. These allergies require a different level of care and vigilance.^3,4

Sometimes you know what you are allergic to without being diagnosed by a doctor. This may happen if you notice you sneeze every time you are around cats. Or, you may learn that you sneeze, cough, and get a runny nose every spring when certain trees and flowers bloom. This is something to mention to your doctor at your next visit, along with any self-treatment that brings you relief.

Severe reactions, like trouble breathing, facial/throat swelling, vomiting, nausea, coughing, wheezing, hives, or anaphylaxis, require emergency treatment, usually with an injection of epinephrine.^3,4

Avoidance

Avoidance is an important approach in managing allergies. Staying away from triggers as much as possible is the best way to avoid an allergic reaction. However, complete avoidance is often impossible. That is why avoidance is only 1 part of allergy management.^1-4

Lifestyle changes

Some basic lifestyle changes can help you reduce symptoms. Improving indoor air quality is 1 way to reduce reactions to dust mites, mold, pet dander, and pollen. People with allergies to these household allergens can take many steps, including:^1-4

• Washing bedding (both people and pet) in hot water and stuffed animals regularly
• Vacuuming rugs and carpet often
• Eliminating rugs and carpet in favor of wood, tile, or concrete floors
• Installing a HEPA filter for the whole house or just a bedroom
• Using special covers for bedding
• Cleaning floors with a damp rag or mop
• Not allowing smoking in or around your house
• Staying indoors during allergy season
• Turning on the air conditioner to filter indoor air and reduce humidity
• Keeping pets out of the bedroom

If you have food allergies or are allergic to insect bites and stings, always carry your emergency medicine with you in case of a severe reaction.

Allergy treatments

When an allergen cannot be avoided, there are several medicines people use to control their symptoms. Some are available over-the-counter, and some require a prescription by your doctor. These include:^1,2

• Nasal sprays
• Antihistamines
• Mast cell stabilizers
• Steroid creams or ointments
• Steroid pills
• Leukotriene receptor antagonists
• Epinephrine injectables

Your doctor may consider biologic therapy if you have severe disease that does not respond to the typical treatments above. For more severe allergies, your doctor may recommend immunotherapy. Immunotherapy comes in 3 forms: allergy shots, sublingual immunotherapy (SLIT), and oral immunotherapy. The goal of immunotherapy is to help the body build a tolerance to an allergen. As the body desensitizes itself to the allergen, symptoms become milder or go away.²

Things to know

Allergy treatments are not all the same. They come in many forms and treat symptoms in different ways. Over time, your medicines may become less effective for you. That is why your doctor may suggest alternating a few different treatments.⁴

Always let your doctor know about any other health conditions and all the drugs and supplements you take. This will help in creating an allergy management plan right for you.