ALL ABOUT ALLERGIES
An allergy occurs when your immune system reacts to an unknown substance and misinterprets it as a threat. The immune system then produces antibodies in response to this unknown substance. The antibodies travel through the body and release histamines, which cause allergic reactions that can inflame your skin, sinuses, airways, or digestive system.
Nearly one third of adults have some type of seasonal allergy, eczema, or food allergy, making it the most common chronic condition. Allergic reactions can range from mildly uncomfortable to life threatening, such as anaphylaxis.
There is also a genetic component to allergies. If one parent has allergies, children are 50% more likely to also have allergies. If both parents have allergies, that probability jumps to 75%. Allergies can develop at any point, most commonly when exposed to new environments or when changes occur in the immune system.
Many allergies develop in childhood, but adults in their 20s and 30s are also at a higher risk of developing new allergies. Those with existing asthma are also more likely to develop new allergies.
Stages of Allergy Development
While people come into contact with allergens on a regular basis, the reaction to those allergens can be very different. In a Type 1 immune response, there is not a pro-inflammatory response. People with allergies have a Type 2 immune response when confronted with allergens. In a Type 2 immune response, the immune system sends in T helper type 2 cells, which results in the production of immunoglobulin (Ig) E molecules that trigger the production of histamines and other chemicals. Allergic sensitization occurs when the body is first exposed to an allergen and a Type 2 immune response. The body will learn to recognize the allergen and be prepared when met with the allergen again.
Types of Allergies
Dust Mite Allergies
Insect Bite Allergies
Signs & Symptoms of Allergies
Itchy, runny nose
Itchy, watery eyes
Wheezing and coughing
Tightness in the chest
Swollen tongue, eyes, or lips
Shortness of breath
Red, rashy, or cracked skin
Constant throat clearing
Anaphylaxis is a severe, life-threatening allergic reaction that causes the body to go into shock. This type of reaction requires immediate medical attention because your blood pressure can drop suddenly and airways can narrow, impacting breathing.
Swelling in throat and mouth
Blue skin and lips
Fainting or collapsing
Dizziness and confusion
Diagnosing an Allergy
An allergy diagnosis will begin with a visit to a doctor. An ENT, or Ear, Nose, Throat, provider can perform the necessary testing for allergies, as well as create a treatment plan for any diagnosed allergies. The Jackson Clinic is well-equipped to test, diagnose, and treat a variety of allergies for our patients.
Skin Allergy Tests
Skin allergy tests are used to diagnose many common allergies. They are less invasive than blood testing, which may be a better option for children or adults with an aversion to needles. This type of testing is performed in-office and usually has very little discomfort or inconvenience to the patient.
A blood test can detect an allergy by locating antibodies that react to allergens. When the immune system triggers an allergic reaction, it releases Immunoglobulin E (IgE) into the blood. Higher levels of IgE in the blood is used to diagnose a specific allergy.
Intradermal allergy testing involves injecting a small amount of an allergen under the skin using a very thin needle. Each allergen is marked on the body and will be observed for a reaction. An itchy, red bump on the skin indicates that the body has responded to the allergen with an antibody and confirms the allergy.
Common Allergy Treatments
There isn't a cure for allergies, but providers may use a variety of treatments to treat allergy symptoms. Many allergy medications can be purchased over the counter, but stronger medications may require a prescription.
Nasal sprays are sprayed directly into the nose. There are 3 common types of nasal sprays typically used to treat allergies:
Antihistamine sprays: Offers relief from congestion, sneezing, or runny nose. Antihistamine sprays usually make the patient less drowsy than oral antihistamines. Name brand antihistamine sprays include Flonase and Nasacort.
Decongestant sprays: Shrinks swollen blood vessels in the nose that cause you to feel stuffy. These nasal sprays are not for everyday use and can be purchased over the counter. These sprays include Afrin and Zicam.
Steroid sprays: Usually the first type of medication used to treat allergies. Patients typically notice a reduction in allergy symptoms with a week. Some steroid sprays can be purchased over the counter, while others may require a prescription.
Oral corticosteroids are pill or liquid medications that stop severe allergic reactions. These types of medications require close supervision by a medical provider. Oral corticosteroids are typically used for short-term, severe allergies. Commonly prescribed medications include methylprednisolone and prednisone.
Antihistamines are very commonly used to treat indoor or seasonal allergies. They come in pill, liquid, tablet, or spray form and block the release of histamines in the body, which are the chemicals that see allergens as a threat to the body and cause allergy symptoms. Many of this type of medication can be purchased over the counter, such as form of diphenhydramine (or Benadryl®) and desloratadine (or Clarinex®), but they can also be prescribed by your medical provider.
This medication is delivered to the body through a self-injectable device. Epinephrine is used in the event of anaphylaxis in a patient with severe insect, food, or drug allergies.
Corticosteroid Creams or Ointments
This type of medicated treatment is commonly used for skin rashes and will help relieve the pain or itch caused by allergies. Mild corticosteroid creams, such as hydrocortisone, can be purchased over the counter. More powerful creams like betamethasone are available only with a prescription.
Eye drops can be used to relieve allergy symptoms such as tearing, burning, or itchy eyes. Stronger eye drops are available with a prescription, but many can be purchased over the counter.
When receiving immunotherapy treatment, small amounts of an allergen is given to the body so the immune system can build a proper response and not react to the allergen. The Jackson Clinic offer immunotherapy treatments that can be put under the tongue (allergy drops) or given as an injection (allergy shots).
How Immunotherapy Works
During this stage, your provider will work to get you to an effective dose. This stage can last 3-6 months.
This stage may take different amounts of time for different patients and lasts on an ongoing basis until the patient begins to experience relief.
Relief from Symptoms
If immunotherapy is successful, you should begin to see long-term benefits and reduction in symptoms.
Immunotherapy can have side effects, such as allergy symptoms, in some patients. Anaphylaxis can occur in rare cases. There not any known long-term side effects of immunotherapy at this time.
Types of Immunotherapy Treatments
Allergy shots are a common form of immunotherapy. They work similarly to vaccines; they expose the body to a small amount of an allergen to build up an immune response. During the build-up stage, patients may receive allergy shots 1-2 times a week for 3-6 months. These in-office visits are short, but necessary to monitor the patient for any reaction after their shot. Patients may receive shots during the maintenance stage for 3-5 years.
Allergy drops are liquid drops placed under the patient's tongue. The drops work similarly to allergy shots in that they help gradually expose the patient to smalls amounts of the allergen to build the immune response. Allergy drops are a great alternative to those who may not see progress with allergy shots or don't like the thought of weekly injections.