Treatment for allergies runs the gamut from avoiding allergy triggers to allergy immunotherapy. For the nearly 30 percent of Americans who have allergies, it may be difficult to decide which treatment option should be pursued. While your physician can help you determine which treatment is best for you, having an understanding of your options can help you manage your allergy symptoms.
Identifying Your Allergy Triggers
An allergic reaction is one in which your immune system overreacts to the presence of what is normally a harmless substance (allergen). Common inhalant allergens include things like dust mites, mold, pollen, and animal dander. Exposure to an allergen triggers the immune system to produce IgE, an immunoglobulin antibody that binds to the allergen, causing the production of histamines and other immune responses that produce the symptoms of an allergic response.
Your health care provider can identify your allergen sensitivities through allergy testing. Such testing helps guide the type of treatment you need and can identify when to start treatment. For instance, if you have seasonal allergies, you may be able to prevent or minimize symptoms by starting your medication prior to the beginning of the problematic season.
Early Allergy Treatment Options
The first treatment option is trigger avoidance. By avoiding the allergen, you can help prevent allergic reactions. For dust mite allergy, avoidance can include dust mite encasements for bedding, weekly washing of bed linens in hot water, eliminating carpeting, lowering humidity, and other steps. For dander allergies, removing pets from the bedroom to allow for a regular reprieve from dander exposure may be beneficial. Your allergist can advise you on avoidance steps specific to your allergens.
OTC Allergy Medications
The next step is over-the-counter allergy medications. These can help alleviate symptoms such as nasal decongestion, postnasal drainage, runny nose, and itchy eyes. Common over-the-counter medications are:
- Long-acting oral antihistamines
- Antihistamine eye drops
- Intranasal steroids
- Sinus rinsing
The drawbacks of over-the-counter medications are that the medication is not individualized for your specific allergies, they may not provide long-lasting relief or create tolerance, and only treat the symptoms and not the cause of your allergy.
If over-the-counter medications don't help, prescription medications may be needed. Examples of prescription medications include antihistamines, additional intranasal steroid sprays, nasal antihistamine sprays, oral corticosteroids, mast cell stabilizers, leukotriene blockers, and anti-inflammatories. In severe cases, where anaphylaxis is possible, patients may also be prescribed an epinephrine injector.
Allergy Shots and Immunotherapy
Those seeking long-term treatment and relief may be interested in pursuing immunotherapy, an allergy treatment aimed at the cause of the allergy, decreasing or eliminating sensitivity to allergens, and increasing tolerance to the allergen. With three types of immunotherapy available - subcutaneous (allergy shots), sublingual (drops of the allergen under the tongue), and oral tablets, it’s important to understand how immunotherapy differs from traditional allergy treatment.
How Immunotherapy Works
Immunotherapy works similarly to vaccines in that you are exposed to small amounts of the allergen(s) over time. This causes your immune system to build up resistance. Immunotherapy has been used for more than 100 years and can prevent the development of new allergies and the progression of allergic rhinitis (hay fever), asthma, ear infections, and sinus infections.
Immunotherapy should be considered based on:
- Symptom severity
- Length of the allergy season
- Inadequate control of symptoms with current medications
- Inability to avoid triggers
- Time available for treatment
- Personal choice regarding allergy medication use
Once your specific allergens are identified, immunotherapy can begin. Subcutaneous immunotherapy (shots) has two phases: a build-up phase, which involves increasing amounts of injections of allergen subcutaneously (under the skin), and a maintenance phase. The build-up phase may take six to twelve months. The maintenance phase occurs once the effective dose -- the dose at which symptoms are under control -- is reached. Sublingual immunotherapy (drops) can be self-administered at home and is dosed daily throughout the year. Oral tablet immunotherapy may be used for persons with a targeted allergy to grass or weed pollen and is typically taken daily for up to four months prior to and during the season. In general, immunotherapy is usually continued for three to five years.
Initial improvement with immunotherapy may not be noticed immediately. It could take six to twelve months before allergy symptoms improve, but many people notice improvement sooner. Research has shown that about 90 percent of patients on immunotherapy report significant improvements in their symptoms, reductions in the frequency and severity of sinusitis, upper respiratory infections, ear infections, other allergic reactions, and improved quality of life.