There are three general approaches to the treatment of allergic diseases such as allergic rhinitis: avoidance of the allergen, medication to relieve symptoms and allergy shots.
- Wear a pollen mask when mowing the grass or housecleaning.
- Stay indoors in the morning (when the pollen count is at its highest) and on windy days.
- Read and understand food labels (for people with food allergies).
- Keep windows and doors closed during heavy pollination seasons.
- Use the air conditioner in the house and car.
- Rid the home of indoor plants and other sources of mildew.
- Don't allow dander-producing animals in the house.
- Change feather pillows, woolen blankets and clothing to cotton or synthetic materials.
- Enclose mattress, box springs and pillows in plastic barrier cloth.
- Wash sheets, mattress pad and blankets weekly in hot water (at least 130F).
- Remove carpets and upholstered furniture (drastic measure).
- Use acaricide (a chemical that kills house-dust mites) or a tannic acid solution (solution that neutralizes the allergen in mite droppings).
- Use air filters.
- Use a dehumidifier.
When avoidance or control of an allergen isn't possible, medications may be necessary. Common allergy medications are:
When avoidance, environmental control measures and medications fail to control allergy symptoms, the doctor may suggest allergy immunotherapy ("allergy shots"). Immunotherapy involves the injections of allergen extracts to "desensitize" the person.
Typically, the treatment begins with injections of a weal solution of allergen given one to five times a week, with the strength gradually increasing. When the maximum dose is reached, maintenance injections are given at increasing intervals until the patient receives injections only once a month.
It may take up to six months or so to show results. It usually takes about three to four years for the patient to be free of symptoms.
Treatment of asthma
Asthma treatment involves two major groups of medications - anti-inflammatories (corticosteroids) and bronchodilators. Anti-inflammatories reduce inflammation and lessen the risk of acute asthma attacks. They may be inhaled via a metered dose inhaler (MDI) or taken orally via pill/tablet or liquid form. The inhaled corticosteroids include fluticasone (Flovent), budesonide (Pulmicort), flunisolide (AeroBid), triamcinolone (Azmacort) and beclomethasone (Beclovent and Vaceril). The oral corticosteroids (pill/tablet form) include prednisone (Deltasone, Meticorten or Paracort), methylprednisolone (Medrol) and prednisolone (Delta Cortef and Sterane). The oral corticosteroids for children include are Pedipred and Prelone.
A new class of anti-inflammatories called leukotriene inhibitors, including zafirlukast (Accolate) and zileuton (Zyflo), work by inhibiting fatty acids that mediate inflammation from binding to smooth muscle cells lining the airways. These drugs prevent rather than reduce symptoms and are intended for long-term use.
Other inhaled anti-inflammatory drugs include cromolyn sodium (Intal) and nedrocromil (Tilade).
Bronchodilators increase the diameter of the air passages and ease the flow to and from the lungs. The short-acting bronchodilators are metaproterenol (Alupent, Metaprel), ephedrine, terbutaline (Brethaire) and albuterol (Proventil, Ventolin). The long-acting bronchodilators include salmeterol (Serevent), metaproterenol (Alupent), and theophylline (Aerolate, Bronkodyl, Slo-phyllin, and Theo-Dur). Serevent and Alupent are inhaled and theophylline is taken orally.
Advair combines fluticasone and salmeterol as a preventive medication that reduces both inflammation and airway constriction.
Treatment of Eczema, Contact Dermatitis and Urticaria
Eczema (allergic dermatitis) and contact dermatitis (such as with poison oak or ivy) can be treated with cold compresses for 30 minutes 3 times a day, and/or corticosteroid creams or ointments (topical steroids). Hives (urticaria) can be relieved by applying calamine lotion or by taking type H1 antihistamine drugs. More severe cases of hives may require corticosteroid drugs.
Should skin testing be done?
Do you recommend nasal sprays or drops? What are the side effects?
What other medications are recommended to relieve the symptoms of allergies?
Do you recommend desensitization with injections?
What measures can be taken minimize the reactions?
Do allergic rhinitis (hayfever) reactions lead to sinus infections or asthma or any other condition?
Are foods causing the allergies?
Am I at risk for anaphylactic shock? If so, what precautions can I take?