- Allergic Disease of the Eye:
- Allergic Conjunctivitis
- Nose:
- Allergic (Hay Fever) and Nonallergic Rhinitis
- Rhinosinusitis
- Nasal Polyps
- Lung disease:
- Allergic and Nonallergic Asthma
- Occupational or Work-Related Asthma
- COPD
- Allergic Bronchopulmonary Aspergillosis
- Chronic Cough
- Hypersensitivity Pneumonitis
- Skin:
- Atopic Dermatitis or Eczema
- Allergic Contact Dermatitis
- Urticaria (Hives) and Angioedema (Swelling)
- Hereditary Angioedema
- Food Allergy:
- Food Allergy (Immediate Hypersensitivity Reactions)
- Eosinophilic Esophagitis
- Food Intolerance and Sensitivity
- Bee Sting (Hymenoptera) Allergic Reactions
- Drug Allergies
- Other Forms of Anaphylaxis:
- Exercise-Induced Anaphylaxis
- Mastocytosis
- Idiopathic Anaphylaxis
- Immune Deficiency:
- Evaluation of Recurrent Infections
- Management of Humoral Immune Deficiencies
- Genetic Conditions:
- Hereditary Angioedema
- Alpha-1 Anti-Trypsin Deficiency
Hay Fever
What is hay fever?
You may have hay fever if you sneeze often, your nose is runny, congested or stuffy, you have a post nasal drip, your ears pop or are plugged, you get sinus headaches or you are bothered by itching of the nose, eyes, throat or the roof of your mouth.
Is hay fever and allergic rhinitis the same thing?
Yes, but the term allergic rhinitis is more accurate. Hay fever is not always caused by hay and does not cause a fever unless a complication occurs. Spring symptoms are sometimes called rose fever, but are not always caused by roses. Roses and other showy flowers rely on bees and not the wind to carry their heavy pollen and not much of their pollen gets into the air to cause allergies.
How common is allergic rhinitis?
Allergic rhinitis is a very common problem affecting more than 1 in 6 adults and children. Allergic rhinitis is becoming more common because a larger number of people are developing allergies.
Is there more than one type of allergic rhinitis?
Allergic rhinitis takes two different forms - seasonal and year-round. Seasonal allergic rhinitis may occur in the spring, summer and fall and is usually caused by allergies to tree, grass or weed pollen. Year-round allergies may be due to house dust mites, mold spores and animal dander. Some people may experience year-round symptoms that worsen during peak pollen seasons.
Can allergic rhinitis cause other problems?
Yes. Complications of allergic rhinitis may include ear and sinus infections, recurrent sore throats, coughing, headaches, fatigue, irritability, altered sleep patterns and poor school or work performance.
How is allergic rhinitis diagnosed?
Your allergist may begin by taking a detailed history, looking for clues from your lifestyle that will identify the cause of your symptoms. Skin tests are also very helpful and can be done on children and adults. During skin testing small amounts of suspected allergens are introduced into the skin. Skin testing is quick - it only takes several minutes - and it is extremely reliable.
What is the treatment of allergic rhinitis?
There are many ways of treating allergies and each person's treatment plan must be customized based on the frequency, severity and duration of their symptoms. Allergy treatment is aimed at eliminating most, if not all, of the problems and complications of allergic rhinitis by three methods described below.
Avoidance measures:
- Air purifiers with HEPA filters reduce exposure to indoor allergens.
- Keep car and house windows closed and use air-conditioning in the summer, if possible.
- Do not hang clothing outdoors to dry because pollen may cling to towels and sheets.
- Pollen counts are highest between 5 and 10 am so limit early morning outdoor activity.
- Dry wet laundry immediately so mold does not grow on wet clothes.
Medications
- Antihistamines are available as once a day pills or liquids. Some antihistamines do not cause drowsiness. Other antihistamines may cause drowsiness and should not be taken before driving or using machinery.
- Decongestants pills may help unclog the nose but may raise blood pressure and should be used carefully.
- There are different types of nasal sprays that can be used. Nasal sprays containing steroids are effective and have few side effects. Decongestant sprays should not be used for more than two days because they may cause side effects. Salt-water sprays can be used several times a day. Stop any spray if nasal bleeding occurs.
Allergy shots
- Allergy shots are also called desensitization or immunotherapy.
- Allergy shots are very effective in reducing symptoms by building up the immune system.
- Allergy shots start out weekly and then build up to a monthly schedule.
- Injections contain small, purified doses of the allergens that cause symptoms.
Asthma
What is asthma?
Asthma is a chronic but reversible narrowing or obstruction of the airways of the lung. Obstruction is caused by inflammation and swelling of the membranes lining the airways, spasm of the muscles surrounding the airways, and plugging of the air tubes by mucus. Swelling, spasm and plugging all cause airway narrowing which makes breathing very hard work for the asthmatic.
What are the signs of asthma?
Asthma causes repeated attacks of difficulty breathing, wheezing, coughing, shortness of breath or chest tightness. Other signs of asthma include coughing after exercise or after a lot of laughter, a cough that worsens at night or a persistent cough.
What causes asthma?
Asthma can be caused by allergies to dust mites, grass, tree or ragweed pollen, mold spores, animal dander and even food. Other causes include colds or infections, air pollution and fumes from car exhaust, perfumes, and tobacco smoke. Emotional stress, changes in the weather, vigorous exercise and inhaling cold air can cause asthma.
At what age does asthma appear?
Asthma may appear at any age. A small baby may show the typical wheezing and coughing of asthma. An 80 year-old who never was allergic may develop asthma. Asthma caused by allergic reactions is more likely to appear before the age of thirty. Asthma caused by other triggers is more likely to appear later in life.
How is asthma diagnosed?
Asthma is diagnosed by a careful physical examination and medical history. Skin testing may be necessary to identify an allergic cause. Skin testing is quick - it only takes several minutes - and it is extremely reliable. Breathing tests may also be helpful to diagnose asthma or follow the progress of treatment.
How is asthma treated?
Asthma is treated by identifying the causes and then by avoiding them if possible. Each person's treatment plan must be customized based on the frequency and severity of their symptoms in addition to how they respond to various medicines. Treatment is aimed at eliminating most, if not all, of the symptoms by using the medicines described below.
Bronchodilators - also called "quick relievers"
- They quickly reduce symptoms by opening up or dilating the airways of the lung in minutes.
- They are commonly used as inhalers but are also available as pills and liquids.
- The goal is to use quick relievers two times each week or less.
- Quick relievers provide short-term relief and may need to be used several times a day.
Long-term controllers
- They must be used once or twice daily every day. They reduce symptoms gradually.
- They are added if quick relievers are used too frequently.
- One example is inhaled steroids that are extremely effective and safe if used properly. Remember to rinse and spit the rinse out after using inhaled steroids.
Allergy Shots - also called immunotherapy
- Allergy shots start out weekly and then build up to a monthly schedule.
- A newer series of shots is available every 2 - 4 weeks for severe patients.
- Injections are very effective in reducing symptoms by building up the immune system.
Can asthma be cured?
Asthma is not usually cured. Some patients may seem to outgrow their asthma but may have a recurrence later in life, especially with colds or respiratory infections. Almost every asthmatic can obtain relief and lead an active life with the proper care of a physician skilled in the practice of allergy.
Bee Sting Allergies
What is a severe reaction?
A severe allergic reaction (also called anaphylaxis) may occur from an insect sting. Symptoms of such a reaction may include itching, swelling and hives all over the body, problems breathing, throat discomfort, dizziness and loss of consciousness. Death may even result from a severe allergic reaction if proper therapy is not immediately available. These symptoms may occur within minutes of a sting.
Which insects can cause allergic reactions?
Yellow jackets, wasps, hornets and bees may cause severe allergic reactions. Fire ants, which are found in the southern United States, may also cause these types of reactions. It may be difficult to determine which insect is responsible unless skin testing is performed by an Allergist. Blood testing may also be necessary, but is not as reliable as skin testing.
Treatment of reactions to insect stings
An Epi-Pen is a portable injection of adrenaline or epinephrine that can be administered at the first sign of a life threatening reaction. An Epi-Pen may not clear a reaction completely but usually would buy time for paramedics to arrive on the scene for further treatment or to buy time to get to a hospital emergency room. The effects of an Epi-Pen usually last only several minutes. Benadryl is also a first aid remedy.
Prevention
Prevention of a severe allergic reaction is the desired goal of treatment. Desensitization shots can prevent a life threatening reaction. Desensitization shots begin on a weekly schedule and then quickly change to monthly injections. Desensitization shots begin by administering very small amounts of the insect venom. The concentration of the venom is increased until the patient tolerates the equivalent of two stings. The risk of a life threatening reaction to a sting is greatly reduced by desensitization shots.
Other Precautions
- Avoid wearing sandals or walking barefoot in the grass.
- Be careful when drinking soda outdoors as stinging insects are attracted to sweet beverages and may crawl inside cans.
- When outdoors, stay clear of garbage cans that also attract stinging insects.
- Avoid wearing perfumes and colognes outdoors.
- Don't wear clothes with floral designs.
Drug Allergies
Drugs may cause allergic reactions such as rashes, hives, swelling, shortness of breath and even life threatening decreases in blood pressure and severe asthma. An allergic reaction may occur to a cream or lotion applied to the skin, an oral pill, nasal spray, inhaler or an injection. A drug reaction can occur within minutes, hours or even after days of using a medicine and a reaction can last for weeks and months. Some drugs are more likely to cause problems than others but all drugs have the potential to cause allergic reactions. If many drugs are used on a daily basis and a drug allergy is present it may be necessary to stop more than one suspicious drug to determine which drug is the culprit. Close medical follow up is essential. Usually an alternative choice is available to replace the drug responsible for the allergic reaction.
How can drug allergies be diagnosed?
Skin testing can be performed on only a small number of drugs. Patch testing is possible with creams, lotions and ointments that are suspected of causing allergies. Patch testing involves applying the suspected drug onto the skin and then covering it with a patch. The patch is then removed after 48 hours to check for abnormal signs of redness and swelling. Blood testing may also be possible to diagnose a drug allergy.
Allergy to antibiotics
Allergies to antibiotics may not last forever. Penicillin allergy, for example, may decrease as you get older. If skin testing with penicillin is negative then a challenge with a test dose of penicillin in the doctor's office may be the next step to determine if penicillin can be prescribed in the future. If penicillin must be avoided then many alternatives can be considered.
How are drug allergies treated?
Avoidance is the best form of treatment. If exposure to a harmful drug has occurred the treatment of an allergic reaction may include antihistamines, steroid creams and pills, and possibly inhalers, oxygen and epinephrine if the reaction is severe. To prevent a reaction, desensitization in a hospital may be required if an antibiotic is absolutely necessary and there are no other alternatives. Initially many small doses of a drug are administered during a desensitization procedure. If these small doses are tolerated then larger doses are given and eventually the top dose is tolerated. Desensitization procedures are complex, require several hours to perform and have a certain risk associated with them.
Dust Mite Allergy
Dust mites are microscopic spider-like insects found in house dust, mattresses, cushions, and carpets. They can also be found on our skin. They require warmth and humidity and feed on organic debris. We are exposed to them during the entire year but especially in the winter when we spend more time indoors. They can cause allergic reactions such as sneezing, runny or stuffy nose symptoms, watery and itchy eyes or asthma complaints including wheezing, coughing and shortness of breath. Dust mite allergy can even aggravate skin allergies such as eczema and hives. Reactions can occur when allergic individuals inhale proteins shed from the bodies of dust mites. Higher exposure to dust mites occurs when we sit or lie on our beds, couches and floors because these airborne dust proteins settle quickly. Dust mites do not bite and are not related to cat or dog mites.
TREATMENT PLANS
- Avoiding exposure may be easier said than done. Anti-dust programs should start in the bedroom.
- Medications that treat the symptoms.
- Allergy injections decrease the underlying allergy and build up the immune system.
AVOIDANCE MEASURES
- Encase mattresses and pillows in dust mite proof covers that can be purchased at home center stores or on line. These covers should encase the mattress and pillow on the top and bottom and zip around the side. Fabric encasements with a micro-weave are the most effective. Lower cost, felt-like compressed fabrics do not work as well because they allow dust mites to live within the encasement.
- Wash bed sheets at least once a week to remove dust mite proteins.
- Use cotton/polyester blankets and wash them at least twice a month. Do not use wool or down comforters.
- Remove as many stuffed animals from the bedroom as possible. If a favorite stuffed animal must remain in the bedroom then it should be washed regularly with the blankets. Placing the stuffed animal in a plastic bag in the freezer overnight will kill the dust mites.
- If possible, throughout the house but especially in the bedroom and family/TV room remove the carpeting and install a wood, tile or linoleum floor that can be easily cleaned several times a week.
- If carpeting cannot be removed then vacuum the carpets two to three times a week. Dust allergic individuals should wear a filter mask while they vacuum or, if someone else vacuums, stay out of house and wait 30 minutes for the dust to settle before returning.
- Keep the indoor relative humidity between 35 - 45%. Dust mites thrive at higher humidity levels. Humidifiers and vaporizers are not recommended for this reason unless the indoor humidity drops below 35%.
- Things to avoid in the bedroom: flowers, plants, pets, perfumes, wall hangings, bookcases, bed skirts and bunk beds. Washable cotton or synthetic shades are preferred instead of curtains, drapes and Venetian blinds.
Eczema
What is eczema?
Eczema, also known as atopic dermatitis, is a chronic inflammation of the skin that causes a dry itchy, irritated rash that can require daily care. Most people (90%) develop atopic dermatitis before age 5 but an older adult who was never allergic may also suddenly develop eczema.
Where does eczema occur?
Eczema usually starts behind the knees and on the elbows but may occur anywhere on the body. It commonly occurs on the left and right sides of the body rather than just on one side of the body. In severe case more than half of the body may be involved.
What causes eczema?
Allergic and non-allergic triggers may aggravate eczema. Common allergic triggers of eczema include foods and inhaled allergens such as dust mites, molds, and seasonal pollens. Skin testing may be helpful to determine if allergies are aggravating your eczema. Non-allergic, or irritant triggers include emotional stress, dry air, chemicals, perfumes, tobacco smoke, and some soaps and detergents.
How is eczema treated?
The goals of treating eczema include proper skin care, avoiding the triggers, stopping the itch and reducing the inflammation. Itching leads to scratching which leads to more itching and scratching. It is important to stop the itch/scratch cycle.
Prevent drying of the skin
It is important to manage eczema appropriately because improper care can cause flare-ups that may be itchy or painful. On the other hand, using the correct routines, soaps, moisturizers, and medications can soothe inflamed skin and prevent flare-ups. Keep in mind the following key points:
- Take short, lukewarm showers. Baths are worse than showers because your skin is constantly exposed to water in a bath. If baths are desired, especially in young children who cannot take showers, then use a small amount of water in the tub and turn it into a sponge bath. Bubble baths should be avoided. The ideal number of showers per week should be customized to each patient's medical needs and can be discussed with your allergist.
- Use mild, non-irritating, fragrance-free soaps such as Cetaphil or Dove. Avoid common irritants such as scented detergents or moisturizers.
- Pat dry after showering - do not rub vigorously. Long, hot showers and rubbing removes the skin's natural oils and can lead to dry skin.
- Apply a fragrance-free moisturizing ointment after patting dry. Moisturizing ointments and creams work better than lotions that tend to evaporate more quickly. Moisturize as frequently as you can - the more you moisturize, the better your skin will feel.
Stop the itch.
Antihistamines taken by mouth are very helpful to stop the itch. Do not use antihistamines directly on the skin because this may cause an allergy to the antihistamine applied to the skin. Oral, once-a-day antihistamines are available which do not cause drowsiness.
Reduce the inflammation.
Steroid creams, lotions and ointments are sometimes prescribed to decrease skin inflammation. A good time to apply these creams is right after a shower before a moisturizer is placed on the skin. Some creams may need to be applied twice daily. Steroids should be used carefully, especially on the face and on skin folds such as the inside of the elbows. Other anti-inflammatory creams that are not steroids are also available by prescription for certain patients. For severe cases or flare-ups, oral steroids may be needed.
Allergy Injections
Allergy shots are also an option if an allergic trigger is present. Allergy shots start out weekly and then build up to a monthly schedule. Injections are effective in reducing symptoms by building up the immune system.
Food Allergy
Any food can cause an allergic reaction at any age. Some foods are more likely to cause reactions at certain ages. For example, children are more likely to experience reactions to eggs and milk and adults are more likely to experience reactions to shellfish such as shrimp and lobster. A child is more likely to grow out of a food allergy than an adult. A food allergy may cause itching and swelling in or around the mouth, rashes, nasal congestion, shortness of breath, and intestinal symptoms such as vomiting and diarrhea. In extreme situations, food allergies may cause fatal reactions.
Reports of food allergy are on the rise for a variety of possible reasons. Some foods, like peanut butter, are eaten more commonly than they were many years ago resulting in a greater chance of setting off an allergic reaction.
The treatment of food allergies is to avoid the troublesome food. If the troublesome food is accidentally eaten then emergency allergy treatment including antihistamines, inhalers and even steroids and epinephrine may be required. A patient with a history of a severe life threatening food allergy should carry an Epi-Pen in case an emergency arises.
Food families are groups of foods that are closely related. Foods within the same group could cause cross-reactions because they are similar. If someone is allergic to a specific food such as shrimp then extreme caution should be applied when eating another food that is closely related such as lobster. The food family list below outlines which foods are related to each other. There are no allergy shots presently available to treat food allergies.
Food Families
| Almond | Apricot, Cherry, Nectarine, Peach, Plum, Prune |
| Apple | Crabapple, Pear, Quince |
| Beef | Gelatin, Goat, Lamb, Veal |
| Cashew | Mango, Pistachio |
| Chicken | Cornish hen, Duck, Goose, Pheasant, Quail, Turkey |
| Chocolate | Cocoa, Cola |
| Cucumber | Cantaloupe, Casaba, Honeydew, Pumpkin, Squash, Watermelon |
| Grape | Champagne, Raisin, Wine, Wine Vinegar |
| Lettuce | Artichoke, Chamomile, Endive, Safflower, Sunflower, Tarragon |
| Milk | Butter, Buttermilk, Cheese, Cream, Yogurt, Ice cream |
| Mushroom | Truffle, Yeast |
| Mustard | Broccoli, Brussel sprouts, Cabbage, Cauliflower, Horseradish, Turnip |
| Orange | Citron, Grapefruit, Kumquat, Lemon, Lime, Tangelo, Tangerine |
| Peanut/Soy | Alfalfa, Peas, Carob, Beans, Licorice, Mesquite, Soybean, Tamarind |
| Pork | Bacon, Ham, Sausage, Scrapple |
| Shellfish | Crustaceans: Crab, Lobster, Prawns, Shrimp Mollusks: Clams, Mussels, Oysters, Scallops |
| Spinach | Beet |
| Strawberry | Blackberry, Boysenberry, Raspberry |
| Tomato | Cayenne pepper, Eggplant, Potato, Red pepper |
| Walnut | Hickory Nut, Pecan |
Hives
What are hives?
Hives, also called urticaria, is a skin rash that consists of itchy welts of many sizes. Welts can be red and slightly swollen. Small welts may group together to form bigger welts covering large areas of the body. When the swellings go deep into the skin the term angioedema is used.
Where do hives occur?
Hives or deep swellings can develop anywhere on the body, including the face, lips, tongue, eyes, and ears. They can develop inside the body. When they develop on the head they can be disfiguring. When they develop inside the body they can cause problems breathing, swallowing and even belly pain.
How long do hives last?
Many people experience episodes of hives that last for several hours or days and then never recur. Some people experience hives time and time again over periods lasting several years. These people can have hives as frequently as every day or as infrequently as once a month.
At what age do hives appear?
Hives may appear at any age. A small child may show the typical signs of hives. An older adult who was never allergic may suddenly develop hives.
What causes hives?
Hives can be caused by many things. Hives lasting a short period of time may be due to a viral infection, drug reaction, insect bite or sting, and food allergy. Allergy to inhaled pollen, mold or dust mites may be the sole cause of hives or aggravate hives due to other causes. Hives lasting a long period of time may be due to common illnesses such as thyroid disorders, infections or even uncommon congenital diseases.
The evaluation of hives may uncover a medical illness that causes hives. When a medical illness is discovered and then treated, the hives usually disappear.
What happens if all the tests are normal?
Usually, extensive evaluations of people with hives will be normal. This means that a complete medical history, physical examination, and blood tests will usually be normal. A normal evaluation occurs very often and is reassuring that an important illness causing hives is not present. In other words, when an exact cause of hives cannot be found, patients are often relieved to know that something else isn't brewing.
How are hives treated?
The treatment of hives varies from patient to patient. Occasionally, antihistamines taken by mouth may be the only medication necessary to eliminate hives. In some patients many different medicines may be needed. Oral, once-a-day antihistamines are available which do not cause drowsiness. Other antihistamines are available that may cause drowsiness. Do not use antihistamines directly on the skin because this may cause an allergy to the antihistamine applied to the skin.
It may be necessary to use two different antihistamines in one day - one in the morning and one at night. If an antihistamine that may cause drowsiness is necessary then using it at bedtime would be preferred. Such an antihistamine may need to be stopped if drowsiness occurs the following morning. Be careful driving and operating machinery after taking new medicines for this reason.
Are steroids used to treat hives?
In addition to antihistamines and other medicines, steroid pills may be needed to treat patients with severe hives. Steroid pills should be used carefully because they may cause many side effects if they are used for a long time.
Steroid creams are reserved for small isolated trouble spots and should not be used over large areas of the body.
Allergy shots are not helpful in the treatment of hives. Allergy shots are reserved for hay fever and asthma.
Mold Allergy
Mold (also called fungi) produce reproductive particles called spores that cannot be seen by the naked eye. Inhaled spores may cause allergic reactions such as sneezing, runny or stuffy nose symptoms, watery and itchy eyes or asthma complaints including wheezing, coughing and shortness of breath. Mold allergy can even aggravate skin allergies such as eczema and hives. If someone is allergic to inhaled mold it does not mean they are allergic to eating foods that contain mold such as cheese.
People allergic to molds usually have symptoms from spring to fall but symptoms can also be year-round. Molds grow almost anywhere, especially wherever there is moisture. Mold can be found outdoors on fallen leaves and moist shady areas such as planting beds. They are found on compost piles and grow on grasses, trees and shrubbery. People who are allergic to cut grass may be allergic to molds because molds are blown into the air when grass is cut. People who react to indoor live Christmas trees may be allergic to mold growing on the bark or needles of the tree. Molds are found indoors in damp basements and closets, bathrooms (especially shower stalls), refrigerator drip trays, air conditioners, humidifiers and wherever humid conditions exist. Molds may grow behind walls and ceilings if those areas were exposed to water damage from leaky roofs or pipes. Molds can also grow on padding under carpets that may have gotten wet. The proper indoor humidity level should be 35 - 45%.
Treatment Plans
There are three treatment options:
- Avoiding exposure to molds is easier said than done.
- Medications treat only the symptoms of mold allergy.
- Allergy injections decrease the underlying allergy and build up the immune system.
Avoidance Measures
| Air Conditioners | maintain the filter by cleaning it and then drying it thoroughly or replace it |
| Bathrooms | wash tile and grout frequently; check hard to reach corners |
| Cellar or Basement | use a dehumidifier to reduce mold growth mold-inhibiting paint may be helpful french drains may be needed to prevent indoor flooding |
| Clothes | do not leave them damp - dry immediately after washing |
| Dehumidifiers | may breed mold and should be cleaned thoroughly |
| Humidifiers | may breed mold and should be cleaned thoroughly |
| Indoor Plants | breed mold in potting soil |
| Yards | molds grow on fallen leaves, mulch beds and in shady areas |
Pet Allergy
What causes pet allergy?
Cat and dog dander are very common causes of pet allergy. Dander is similar to dandruff and contains dried skin that is shed from the body of the animal. The dried skin of animals contains proteins that can be breathed in and cause an allergic reaction. Even hairless dogs shed dander and can cause allergy problems. The saliva and urine of pets also contain proteins that can cause allergic reactions. Many other types of pets can cause allergies such as rabbits, hamsters, guinea pigs, birds and even mice.
What are the symptoms of pet allergy?
Symptoms of pet allergy are similar to symptoms of allergies caused by other items like dust mites, mold and pollens. Sneezing, nasal congestion, wheezing, and coughing are all possible symptoms. Allergic patients who accidentally touch their eyes after they touch their pets often report symptoms of the eye such as redness, itching and excessive tearing. Patients may also develop welts if their pets scratch them. Some patients have reported local redness and swelling if their pets lick them near small nicks or cuts on their skin.
How is pet allergy treated?
The treatment of pet allergy is similar to the treatment of other allergies. Avoidance measures are very important, but are easier said than done. The goal is to reduce the amount of dander that can build up indoors. Keeping a pet out of one's bedroom is helpful but dander still finds its way in through ducts or even indoor wind currents. Here are a few tips:
- Keep your pet outside of your house as much as possible.
- Keep your pet outside of your bedroom as much as possible.
- Frequently wash your bed sheets and covers in hot water and dry them on a high heat cycle.
- Don't groom your pet. Have someone else do the grooming outside your house.
- Use a HEPA room air purifier in your bedroom and wherever the pet likes to sleep. A HEPA air filter will reduce the dander from the air inside your house.
- Frequently vacuum your carpeting. Tile, wood, or linoleum flooring will hide less dander and can be cleaned more effectively.
- If there is a favorite upholstered chair or sofa that your pet likes to lay on then cover it with a towel or sheet that can be washed frequently.
- If your pet rides in the car with you then cover the car seat with a towel or sheet that can be washed frequently.
Do medicines help?
Medicines that are used for hay fever are helpful in treating pet allergy. Antihistamine pills and prescription nasal sprays can be very effective and may have to be used on a daily basis. Non-drowsy antihistamines are available as once-a-day pills or liquids. Decongestant pills may help open up the nose but may raise blood pressure and should be used carefully. If you are going to visit a house with a pet that you are allergic to then treatment with these medicines prior to your visit may also be very helpful. Sometimes treatment is necessary the night before and the day of your planned visit to a house with a pet that causes allergies.
Do allergy shots help?
If avoidance measures and medicines are not enough then allergy shots may also be necessary. Allergy shots contain small amounts of purified proteins that are also called allergens. Allergy shots strengthen the immune system and decrease the body's sensitivity to these allergens. Allergy shots start out weekly and then build up to a monthly schedule. Allergy symptoms usually start to decrease in a few months after starting shots.
Summary
There are three ways to treat pet allergy: avoidance measures, medicines and allergy shots. Usually a combination of these approaches is necessary. In our practice we try to keep the pet and pet owner together and only recommend removing the pet from the patient's house as a last resort.
Poison Ivy
What is poison ivy?
Poison ivy is a plant that usually grows close to the ground, but may grow as a vine and wrap around bushes and trees. Poison ivy is related to poison oak and poison sumac. Four out of five people are allergic to these plants that produce an oily resin.
What is a poison ivy rash like?
A red, swollen and blistering skin rash may develop one to two days after contact with very small amounts of the poison ivy resin. Rashes may be extremely itchy, appear in streaky lines, and last up to two weeks if they are not treated. Indirect exposure may also cause rashes when an allergic individual pets a dog, or touches a garden tool that brushed against poison ivy, for example. The smoke from burning poison ivy plants may cause allergic respiratory symptoms including coughing and severe shortness of breath.
Is poison ivy contagious?
You cannot get a poison ivy rash by touching another person's poison ivy rash. It is important to know that infectious diseases of the blood that are unrelated to poison ivy, such as hepatitis and other viruses, can be spread from the fluid oozing from a poison ivy rash.
How is poison ivy treated?
The best way to prevent allergic rashes from poison ivy is to avoid exposure to the poison ivy plant and resin. The leaves of poison ivy are grouped in threes. The familiar saying is "leaves of three, leave them be." If it is applied correctly, an over-the-counter product called Ivy Block can help prevent a poison ivy rash. Allergy shots are not effective in preventing poison ivy reactions. If you have been in contact with poison ivy, immediately washing exposed skin with soap and water will help to prevent a rash. Do not delay medical treatment if exposure has occurred because early treatment will provide more relief than treatment started at a later time. Prescription treatment includes steroid creams, antihistamines to reduce itching, and oral steroid pills that reduce inflammation. Oral steroids are used for severe rashes and when rashes occur in sensitive areas such as the face or groin.
Sinusitis
Sinusitis is a term used to describe an infection of the sinus cavities that surround the nose. The sinuses are found in the cheek bones, the forehead and behind the nose. The sinuses normally drain into the nose through narrow openings. If allergies cause the sinuses to fill with mucus then these narrow openings may become blocked resulting in sinus congestion, pressure and headaches. Persistent sinus congestion could lead to infections requiring antibiotic therapy. Viral infections, like the common cold, could also cause the sinuses to fill with mucus and cause similar symptoms of pressure and headaches. Head colds usually clear after a few days and do not require antibiotics.
Is it an allergy, a head cold or a sinus infection?
Patients often have difficulty sorting out whether their sinus symptoms are caused by allergy problems or head colds. Some important factors to consider include the following items:
- Duration of symptoms - If symptoms persist beyond one week then allergies or a chronic sinus infection is more likely than a head cold. Head colds usually last for only several days and do not require antibiotics.
- Fever - Allergies don't cause fever but chronic allergies can lead to sinus infections that do cause fever.
- Discolored mucus lasting throughout the day is usually a sign of infection and not allergies. Allergies can cause discolored mucus occurring first thing in the morning but then the color of the mucus should clear as the day progresses.
- Bad breath or an unpleasant nasal mucus odor usually indicates a sinus infection but chronic allergies can also cause these changes.
- Chronic coughing could be a sign of both sinusitis and allergies. Clogged, drippy sinuses either due to an infection or allergies can also cause asthma to worsen.
What s the treatment of sinusitis?
- Prevention is very important. Reducing allergy problems reduces the chance of developing infections. For further information regarding the treatment of allergies please see Hay Fever.
- Thin the nasal mucus by keeping up with your fluid intake and don't get dehydrated.
- Be careful of antihistamines that may dry up the mucus and thicken nasal secretions.
- Certain over the counter and prescription medicines can be used to increase the drainage of nasal mucus. Saline or salt water sprays work well to thin nasal mucus too.
- Reduce nasal swelling with nasal steroid sprays.
- Don't use over the counter nasal decongestants for more than two days because these sprays may backfire and cause more harm than good.
- Antibiotics are required if the above steps are not enough.
Disclaimer
The information presented on this web site is intended to be general and not specific to any individual patient. Please consult with Dr. Klein, Dr. Simpson or your health care provider for specific medical advice before following any recommendations presented on this web site. Please do not attempt to self-diagnose or self-treat your allergies or asthma.