Treatments for Allergies

A recent study found that people with asthma and allergies may be able to alleviate asthma symptoms by reducing allergen levels in their homes.

“Some simple measures—washing bedding in hot water, vacuuming and steam-cleaning, and using high-efficiency particulate air purifiers (HEPA) and mattress and pillow covers that do not allow allergens to pass through—can decrease the levels of household allergens,” Gergen says.

Source: NIH News in Health (NIH)1

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Back to: « Allergies

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If you’re 1 of the 23 million Americans who suffer from asthma, you might get some relief by taking steps to reduce indoor allergen levels and modifying your lifestyle to avoid the ill effects of air pollution.

Source: NIH News in Health (NIH)2

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Treatments include medicines, allergy shots, and avoiding the substances that cause the reactions.

Source: MedLinePlus (NIH)3

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If you have a more severe reaction, you should seek immediate medical attention at an emergency room or call 911.

Severe reactions include difficulty breathing or low blood pressure, which can cause confusion, paleness, a weak pulse, or a lack of consciousness. Dr. Guerrerio said if the reaction is severe or if it involves multiple organ systems—for example the person has hives and is also vomiting—you should administer an EpiPen if you have one and call 911.

Once the initial reaction has been treated, you should see an allergist to get tested for a food allergy and discuss a course of action.

Source: MedLinePlus Magazine (NIH)4

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Treatment for Allergies:

For allergy sufferers, it is worth trying to avoid the offending allergens. This may be difficult, however, when the very air we breathe is loaded with allergens, such as ragweed pollen. Various over-the-counter or prescription medications can relieve symptoms.

  • Antihistamines. These medications counter the effects of histamine, the substance that makes eyes water and noses itch and causes sneezing during allergic reactions. Sleepiness was a problem with the oldest antihistamines, but the newest drugs do not cause such a problem. Antihistamines come as pills or nose sprays.
  • Nasal steroids. These anti-inflammatory sprays reduce the sensitivity of the nose to allergens and decrease inflammation, swelling, and mucus production. They work well alone and in combination with antihistamines, particularly antihistamine nasal sprays; in recommended doses, they are relatively free of side effects.
  • Cromolyn sodium. A nasal spray, cromolyn sodium may reduce symptoms, perhaps by blocking release of histamine and other symptom-producing chemicals. It has few side effects, but requires frequent dosing.
  • Decongestants. Available in pill and spray form, decongestants reduce swelling and sinus discomfort. Intended for short-term use, they are usually used in combination with antihistamines. Long-term usage of spray decongestants can actually make symptoms worse, while decongestant pills do not have this problem.
  • Immunotherapy. Immunotherapy (allergy shots or tablets that dissolve under the tongue) might provide relief for patients who don't find relief with antihistamines or nasal steroids. Immunotherapy alters the body's immune response to allergens, thereby helping to prevent allergic reactions. It is the only form of treatment that can induce long-lasting protection after therapy is stopped. Allergy shots can be used for many other allergies, seasonal and non-seasonal. Allergy shots can sometimes cause allergic reactions, which may go beyond local itching and swelling. In rare instances, these reactions can be severe. Immunotherapy, with under-the-tongue, self-dissolving tablets, is only available for ragweed and grass, but it is a very safe form of treatment.

Source: MedLinePlus Magazine (NIH)5

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Treatment

Airborne Allergy

Source: MedLinePlus Magazine (NIH)6

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Treatment

For allergy sufferers, the best treatment is to avoid the offending allergens altogether. This may be possible if the allergen is a specific food, like peanuts, which can be cut out of the diet, but not when the very air we breathe is loaded with allergens, such as ragweed pollen. Various over-the-counter or prescription medications can relieve symptoms.

  • Antihistamines. These medications counter the effects of histamine, the substance that makes eyes water and noses itch and causes sneezing during allergic reactions. Sleepiness was a problem with the oldest antihistamines, but the newest drugs do not cause such a problem.
  • Nasal steroids. These anti-inflammatory sprays help decrease inflammation, swelling, and mucus production. They work well alone and, for some people, in combination with antihistamines; in recommended doses, they are relatively free of side effects.
  • Cromolyn sodium. A nasal spray, cromolyn sodium can help stop hay fever, perhaps by blocking release of histamine and other symptom-producing chemicals. It has few side effects.
  • Decongestants. Available in capsule and spray form, decongestants may reduce swelling and sinus discomfort. Intended for short-term use, they are usually used in combination with antihistamines. Long-term usage of spray decongestants can actually make symptoms worse, while decongestant pills do not have this problem.
  • Immunotherapy. Immunotherapy (allergy shots) might provide relief for patients who don't find relief with antihistamines or nasal steroids. Allergy shots alter the body's immune response to allergens, thereby helping to prevent allergic reactions. They are the only form of treatment that can induce long-lasting protection for several years after therapy is stopped. Current immunotherapy treatments are limited because of potential allergic reactions; rarely, these can be severe.

Source: MedLinePlus Magazine (NIH)7

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Unintentional exposure

When you have food allergies, you must be prepared to treat unintentional exposures. Talk to your healthcare professional and plan to protect yourself by taking the following steps:

  • Wear a medical alert bracelet or necklace
  • Carry an auto-injector device containing epinephrine (adrenaline), such as an EpiPen
  • Seek medical help immediately if you are having symptoms

Source: MedLinePlus Magazine (NIH)8

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For mild symptoms

Mild symptoms may not need treatment. A variety of over-the-counter pharmacy medicines can help with allergy symptoms, including decongestants and antihistamines.

For more severe symptoms

For more severe symptoms, your doctor may prescribe steroid medication or quick-acting inhaled bronchodilators and/or other medicine to treat breathing problems.

Immunotherapy is another possible treatment designed to make you less sensitive to an allergen so you don’t react to it so strongly. This involves injecting you with tiny but increasing amounts of the allergen. The treatment phase can last up to 6 months, followed by a maintenance phase for 2-3 years or longer.

Epi-pen emergency kits may be prescribed by your doctor for severe reactions. The epi-pen is a ready-to-use syringe of adrenaline, which is essentially designed to keep you alive until you get to hospital. Teach family members, friends and work colleagues about how to use an epi-pen and make sure they know that you must also get to hospital straight away.

Source: New Zealand Health9

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Treatment

Treatment for allergic rhinitis depends on how severe your symptoms are and how much they're affecting your everyday activities.

In most cases treatment aims to relieve symptoms such as sneezing and a blocked or runny nose.

If you have mild allergic rhinitis, you can often treat the symptoms yourself.

You should visit your GP if your symptoms are more severe and affecting your quality of life, or if self-help measures haven't been effective.

Source: NHS Choices UK10

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Self-help

It's possible to treat the symptoms of mild allergic rhinitis with over-the-counter medications, such as long-acting, non-sedating antihistamines.

If possible, try to reduce exposure to the allergen that triggers the condition. See preventing allergic rhinitis for more information and advice about this.

Cleaning your nasal passages

Regularly cleaning your nasal passages with a salt water solution - known as nasal douching or irrigation - can also help by keeping your nose free of irritants.

You can do this either by using a homemade solution or a solution made with sachets of ingredients bought from a pharmacy.

Small syringes or pots that often look like small horns or teapots are also available to help flush the solution around the inside of your nose.

To make the solution at home, mix half a teaspoon of salt and half a teaspoon of bicarbonate of soda (baking powder) into a pint (568ml) of boiled water that's been left to cool to around body temperature - do not attempt to rinse your nose while the water is still hot.

To rinse your nose:

  • stand over a sink, cup the palm of one hand and pour a small amount of the solution into it
  • sniff the water into one nostril at a time
  • repeat this until your nose feels comfortable - you may not need to use all of the solution

While you do this, some solution may pass into your throat through the back of your nose. The solution is harmless if swallowed, but try to spit out as much of it as possible.

Nasal irrigation can be carried out as often as necessary, but a fresh solution should be made each time.

Source: NHS Choices UK11

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Medication

Medication won't cure your allergy, but it can be used to treat the common symptoms.

If your symptoms are caused by seasonal allergens, such as pollen, you should be able to stop taking your medication after the risk of exposure has passed.

Visit your GP if your symptoms don't respond to medication after two weeks.

Antihistamines

Antihistamines relieve symptoms of allergic rhinitis by blocking the action of a chemical called histamine, which the body releases when it thinks it's under attack from an allergen.

You can buy antihistamine tablets over the counter from your pharmacist without a prescription, but antihistamine nasal sprays are only available with a prescription.

Antihistamines can sometimes cause drowsiness. If you're taking them for the first time, see how you react to them before driving or operating heavy machinery. In particular, antihistamines can cause drowsiness if you drink alcohol while taking them.

Corticosteroids

If you have frequent or persistent symptoms and you have a nasal blockage or nasal polyps, your GP may recommend a nasal spray or drops containing corticosteroids.

Corticosteroids help reduce inflammation and swelling. They take longer to work than antihistamines, but their effects last longer. Side effects from inhaled corticosteroids are rare, but can include nasal dryness, irritation and nosebleeds.

If you have a particularly severe bout of symptoms and need rapid relief, your GP may prescribe a short course of corticosteroid tablets lasting 5 to 10 days.

Source: NHS Choices UK12

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Add-on treatments

If allergic rhinitis doesn't respond to treatment, your GP may choose to add to your original treatment.

They may suggest:

  • increasing the dose of your corticosteroid nasal spray
  • using a short-term course of a decongestant nasal spray to take with your other medication
  • combining antihistamine tablets with corticosteroid nasal sprays, and possibly decongestants
  • using a nasal spray that contains a medicine called ipratropium, which will help reduce excessive nasal discharge
  • using a leukotriene receptor antagonist medication - medication that blocks the effects of chemicals called leukotrienes, which are released during an allergic reaction

If you don't respond to the add-on treatments, you may be referred to a specialist for further assessment and treatment.

Source: NHS Choices UK13

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How to manage an allergy

In many cases, the most effective way of managing an allergy is to avoid the allergen that causes the reaction whenever possible.

For example, if you have a food allergy, you should check a food's ingredients list for allergens before eating it. The Food Standards Agency has more information about food allergen labelling.

There are also several medications available to help control symptoms of allergic reactions, including:

  • antihistamines - these can be taken when you notice the symptoms of a reaction, or before being exposed to an allergen to stop a reaction occurring
  • decongestants - tablets, capsules, nasal sprays or liquids that can be used as a short-term treatment for a blocked nose
  • lotions and creams, such as moisturising creams (emollients) - these can reduce skin redness and itchiness
  • steroid medication - sprays, drops, creams, inhalers and tablets that can help reduce redness and swelling caused by an allergic reaction

For some people with very severe allergies, a treatment called immunotherapy may be recommended.

This involves being exposed to the allergen in a controlled way over a number of years, so your body gets used to it and doesn't react to it so severely.

Read more about treating an allergy and avoiding allergic reactions.

Source: NHS Choices UK14

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Treatment

The treatment for an allergy depends on what you're allergic to. In many cases, your GP will be able to offer advice and treatment.

They'll advise you about taking steps to avoid exposure to the substance you're allergic to, and can recommend medication to control your symptoms.

Avoiding exposure to allergens

The best way to keep your symptoms under control is often to avoid the things you're allergic to, although this isn't always practical.

For example, you may be able to help manage:

  • food allergies by being careful about what you eat
  • animal allergies by keeping pets outside as much as possible and washing them regularly
  • mould allergies by keeping your home dry and well-ventilated, and dealing with any damp and condensation
  • hay fever by staying indoors and avoiding grassy areas when the pollen count is high
  • dust mite allergies by using allergy-proof duvets and pillows, and fitting wooden floors rather than carpets

Read more about preventing allergic reactions.

Allergy medications

Medications for mild allergies are available from pharmacies without a prescription, but always ask your pharmacist or GP for advice before starting any new medicine, as they're not suitable for everyone.

Antihistamines

Antihistamines are the main medicines for allergies. They can be used:

as and when you notice the symptoms of an allergic reaction

to prevent allergic reactions - for example, you may take them in the morning if you have hay fever and you know the pollen count is high that day

Antihistamines can be taken as tablets, capsules, creams, liquids, eye drops or nasal sprays, depending on which part of your body is affected by your allergy.

Decongestants

Decongestants can be used as a short-term treatment for a blocked nose caused by an allergic reaction.

They can be taken as tablets, capsules, nasal sprays or liquids. Don't use them for more than a week at a time, as using them for long periods can make your symptoms worse.

Lotions and creams

Red and itchy skin caused by an allergic reaction can sometimes be treated with over-the-counter creams and lotions, such as:

Steroids

Steroid medications can help reduce inflammation caused by an allergic reaction. They're available as:

Sprays, drops and weak steroid creams are available without a prescription. Stronger creams, inhalers and tablets are available on prescription from your GP.

Immunotherapy (desensitisation)

Immunotherapy may be an option for a small number of people with certain severe and persistent allergies who are unable to control their symptoms using the measures above.

The treatment involves being given occasional small doses of the allergen - either as an injection, or as drops or tablets under the tongue - over the course of several years.

The injection can only be performed in a specialist clinic under the supervision of a doctor, as there is a small risk of a severe reaction. The drops or tablets can usually be taken at home.

The aim of treatment is to help your body get used to the allergen so it doesn't react to it so severely. This won't necessarily cure your allergy, but it will make it milder and mean you can take less medication.

Source: NHS Choices UK15

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Treating severe allergic reactions (anaphylaxis)

Some people with severe allergies may experience life-threatening reactions, known as anaphylaxis or anaphylactic shock.

If you're at risk of this, you'll be given special injectors containing a medicine called adrenaline to use in an emergency.

If you develop symptoms of anaphylaxis, such as difficulty breathing, you should inject yourself in the outer thigh before seeking emergency medical help.

Read more about the treating anaphylaxis.

Source: NHS Choices UK16

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Treating specific allergic conditions

Use the links below to find information about how specific allergies and related conditions are treated:

Source: NHS Choices UK17

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Adrenaline auto-injectors

If you have a particularly serious allergy, you may be given adrenaline auto-injectors to use if you experience a severe allergic reaction (anaphylaxis).

There are several types of auto-injector, which are used in slightly different ways.

Read about preventing anaphylaxis for more information.

Source: NHS Choices UK18

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Using an adrenaline injection pen

Because of your increased risk of anaphylaxis, you may be given an adrenaline auto-injector to use in an emergency.

Adrenaline is a natural chemical that helps fight the effects of too much histamine, while also relieving breathing difficulties. Each pen contains a single dose of adrenaline - 0.3mg for adults or 0.15mg for children.

There are three types:

  • EpiPen
  • Jext
  • Emerade

These auto-injectors release adrenaline when jabbed or pressed against the outer thigh. The injections can be given through clothing.

If you're given an adrenaline auto-injector, you need to keep an eye on its expiry date because it won't be effective beyond this date.

Source: NHS Choices UK19

Emergencies: Allergies

If someone is having a serious allergic reaction, call 9-1-1. If an auto-injector is available, give the person the injection right away.

Source: MedLinePlus (NIH)20

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When to call an ambulance

Sometimes an allergic reaction may be severe. This is called anaphylaxis. Anaphylaxis is a life-threatening emergency, which can affect breathing and circulation within minutes.

Call 111 straight away if you or a family member has an allergic reaction with any of these symptoms:

Insect stings, drugs such as penicillin, and certain foods are some of the more common causes of severe allergic reactions.

Source: New Zealand Health21

Treatments for Allergies

EpiPen: EpiPen(R) and EpiPen Jr(R) are pre-loaded syringes that inject a single dose of adrenaline for the emergency treatment of adults and children who experience severe and potentially life-threatening allergic reactions (anaphylaxis, or 'allergic shock').

Source: Queensland Health22

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Desensitization therapy: Immunotherapy

Immunotherapy, also known as hyposensitisation or desensitisation, is another type of treatment used for some allergies.

It's only suitable for people with certain types of allergies, such as hay fever, and is usually only considered if your symptoms are severe.

Immunotherapy involves gradually introducing more and more of the allergen into your body to make your immune system less sensitive to it.

The allergen is often injected under the skin of your upper arm. Injections are given at weekly intervals, with a slightly increased dose each time.

Immunotherapy can also be carried out using tablets that contain an allergen, such as grass pollen, which are placed under your tongue.

When a dose is reached that's effective in reducing your allergic reaction (the maintenance dose), you'll need to continue with the injections or tablets for up to three years.

Immunotherapy should only be carried out under the close supervision of a specially trained doctor as there's a risk it may cause a serious allergic reaction.

Source: NHS Choices UK23

Management of Allergies

How to Control Your Seasonal Allergies

Treat respiratory allergy with antihistamines, topical nasal steroids, cromolyn sodium, decongestants, or immunotherapy. (See page 24 for details.)

Plant Pollen

Ragweed and other weeds, such as curly dock, lambs quarters, pigweed, plantain, sheep sorrel, and sagebrush are prolific producers of pollen allergens. Ragweed season runs from August to November, but pollen levels usually peak by mid-September in many areas in the country. Pollen counts are highest in the morning, and on dry, hot, windy days.

Protecting Yourself

  • Between 5:00 and 10:00 in the morning, stay indoors. Save outside activities for late afternoon or after a heavy rain, when pollen levels are lower.
  • Keep windows in your home and car closed to lower exposure to pollen. Keep cool with air conditioners. Don't use window or attic fans.
  • Use a dryer, not a line outside; dry your clothes and avoid collecting pollen on them.

Grass Pollen

Grass pollens are regional as well as seasonal. Their levels also are affected by temperature, time of day, and rain. Only a small percentage of North America's 1,200 grass species cause allergies, including:

  • Bermuda grass
  • Johnson grass
  • Kentucky bluegrass
  • Sweet vernal grass
  • Timothy grass
  • Orchard grass

Protecting Yourself

  • Between 5:00 and 10:00 a.m., stay indoors. Save outside activities for late afternoon or after a heavy rain, when pollen levels are lower.
  • Keep windows in your home and car closed to lower exposure to pollen. Keep cool with air conditioners. Don't use window or attic fans.
  • Use a clothes dryer, not a line outside, to avoid collecting pollen on them.
  • Have someone else mow your lawn. If you mow, wear a mask.

Tree Pollen

Trees produce pollen earliest, as soon as January in the south, and as late as May and June in the northeast. They release huge amounts that can be distributed miles away. Fewer than 100 kinds of trees cause allergies. The most common tree allergy is against oak, but others include catalpa, elm, hickory, sycamore, and walnut.

Protecting Yourself

Follow the same protective strategies related to time of day, closed windows, and clothes dryers noted in "Protecting yourself" under Grass Pollen, above.

Plant species that do not aggravate allergies, such as crape myrtle, dogwood, fig, fir, palm, pear, plum, redbud, and redwood trees, or the female cultivars of ash, box elder, cottonwood, maple, palm, poplar, or willow trees.

Source: MedLinePlus Magazine (NIH)24

Treatment Failure: Allergies

Everyone's Different

  • Certain allergy and asthma medicines work well for some but not at all for others.

Source: NIH News in Health (NIH)25

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References

  1. Source: NIH News in Health (NIH): newsinhealth.nih.gov/ 2008/ May/ docs/ 01features_02.htm
  2. ibid.
  3. Source: MedLinePlus (NIH): medlineplus.gov/ allergy.html
  4. Source: MedLinePlus Magazine (NIH): medlineplus.gov/ magazine/ issues/ summer17/ articles/ summer17pg9-10.html
  5. Source: MedLinePlus Magazine (NIH): medlineplus.gov/ magazine/ issues/ spring15/ articles/ spring15pg26-27.html
  6. ibid.
  7. Source: MedLinePlus Magazine (NIH): medlineplus.gov/ magazine/ issues/ spring13/ articles/ spring13pg24.html
  8. Source: MedLinePlus Magazine (NIH): medlineplus.gov/ magazine/ issues/ spring11/ articles/ spring11pg24-25.html
  9. Source: New Zealand Health: health.govt.nz/ your-health/ conditions-and-treatments/ diseases-and-illnesses/ allergies
  10. Source: NHS Choices UK: nhs.uk/ conditions/ allergic-rhinitis/ treatment/ 
  11. ibid.
  12. ibid.
  13. ibid.
  14. Source: NHS Choices UK: nhs.uk/ conditions/ Allergies/ 
  15. Source: NHS Choices UK: nhs.uk/ conditions/ allergies/ treatment/ 
  16. ibid.
  17. ibid.
  18. Source: NHS Choices UK: nhs.uk/ conditions/ angioedema/ treatment/ 
  19. Source: NHS Choices UK: nhs.uk/ conditions/ mastocytosis/ treatment/ 
  20. Source: MedLinePlus (NIH): medlineplus.gov/ anaphylaxis.html
  21. Source: New Zealand Health: health.govt.nz/ your-health/ conditions-and-treatments/ diseases-and-illnesses/ allergies
  22. Source: Queensland Health: conditions.health.qld.gov.au/ HealthCondition/ condition/ 1/ 25/ 46/ epipen
  23. Source: NHS Choices UK: nhs.uk/ conditions/ allergic-rhinitis/ treatment/ 
  24. Source: MedLinePlus Magazine (NIH): medlineplus.gov/ magazine/ issues/ spring13/ articles/ spring13pg22-23.html
  25. Source: NIH News in Health (NIH): newsinhealth.nih.gov/ 2005/ June2005/ docs/ 01features_01.htm

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Note: This site is for informational purposes only and is not medical advice. See your doctor or other qualified medical professional for all your medical needs.