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Living with Allergies

When people hear the word “allergies,” many think of hay fever or peanuts; however, there are several different types of allergies, and the reactions are different for each. Treatments will also vary. Learn more about allergy types and treatments.


Allergy types and reactions

Rhinitis is an inflammation of the mucous membranes of the nose. Symptoms include:

  • Sneezing
  • Itchy nose, roof of the mouth, throat, eyes and ears
  • Runny nose
  • Congestion
  • Watery eyes

Seasonal allergic rhinitis (or hay fever) is caused by allergens like mold and pollen. Some people have symptoms of rhinitis no matter what the season. This is called perennial allergic rhinitis. It can be caused by allergens such as animal dander, indoor mold, dust mites and cockroaches.

Sinusitis is a painful, long-lasting inflammation of the sinuses. Sinuses are the hollow cavities behind the cheek bones, around the eyes and behind the nose. Symptoms of sinusitis include:

  • Congestion
  • Green or gray nasal discharge
  • Postnasal drip
  • Pressure in the face
  • Headache
  • Fever
  • A cough that won’t go away

Sinusitis is common in the winter. It may last for months or years if it is not properly treated. Colds are the most common cause of acute sinusitis, but people with allergies are much more likely to develop sinusitis than people who do not have allergies.

Skin allergies can lead to red, bumpy, scaly, itchy or swollen skin. The most common allergic skin conditions are:

  • Eczema
  • Hives and angioedema
  • Allergic contact dermatitis

Symptoms of a skin allergy include:

  • A strange rash
  • Red, scaly or itchy skin
  • A swelling of the deeper layers of the skin, such as the eyelids, mouth or genitals
  • Dry, flaking skin
  • Inflamed or blistered skin

Skin allergies are painful and unpleasant, but there are things you can do to treat and prevent an allergic skin reaction.

Food allergies happen when a person’s immune system overreacts to the proteins in a certain food. Twelve million people in the United States have food allergies.

Eight kinds of food cause most food allergies:

  • Cow’s milk
  • Eggs
  • Peanuts
  • Wheat
  • Soy
  • Fish
  • Shellfish
  • Any nuts from trees, such as almonds, cashews, chestnuts, pecans, walnuts, etc.

Signs of a food allergy include:

  • A rash, or red, itchy skin
  • Stuffy or itchy nose, sneezing, or itchy and teary eyes
  • Vomiting, stomach cramps or diarrhea
  • Angioedema or swelling

Some people with food allergies can have a serious reaction called anaphylaxis. Signs of this kind of reaction include:

  • Hoarseness, throat tightness or a lump in the throat
  • Wheezing, chest tightness or trouble breathing
  • Tingling in the hands or feet, lips, or scalp

Insect sting allergies occur when your immune system overreacts to the insect’s venom. Some people may have trouble breathing or itch and have hives all over their body after being stung.

Most allergic insect sting reactions are caused by five kinds of insects:

  • Yellow jackets
  • Honeybees
  • Paper wasps
  • Hornets
  • Fire ants

For people who are very allergic to an insect’s venom, a sting may cause a dangerous allergic reaction called anaphylaxis. Signs of anaphylaxis include:

  • Itching and hives over a large part of the body
  • Swollen throat or tongue
  • Trouble breathing
  • Dizziness
  • Stomach cramps
  • Nausea or upset stomach
  • Diarrhea

If you are allergic to insect stings, you can reduce your risk of having an allergic reaction by staying indoors during insect season and always carrying autoinjectable epinephrine.

Source: American Academy of Allergy Asthma & Immunology


Treatment options

You don’t have to suffer through allergy season without relief. Here are some short-term and long-term options if you have allergies.

Medication. Allergic rhinitis (hay fever), allergic conjunctivitis and urticaria (hives) are common problems for older adults and often require the use of antihistamines. Antihistamines are divided into two classes: first generation and second generation.

First-generation antihistamines, while very effective at controlling symptoms, are often associated with symptoms in older adults such as anxiety, confusion, sedation, blurred vision, reduced mental alertness, urinary retention and constipation. These side effects are even more common if you are being treated with certain antidepressant medications. The second generation antihistamines cause fewer side effects.

If you have allergies that require an antihistamine, discuss the use of second-generation antihistamines in place of a first-generation antihistamine with your physician. Physician and allergist-prescribed antihistamines currently in use are generally from the second- or third-generation drugs that have an extremely favorable safety profile for users.

Immunotherapy, also known as allergy shots, is an effective vaccination program that increases immunity to substances called allergens that trigger allergy symptoms. Allergen immunotherapy involves administering gradually increasing amounts of an allergen to a patient over several months. The injections are first given on a weekly or bi-weekly basis, and when the maintenance level is reached, eventually on a monthly basis. This process reduces symptoms that are otherwise triggered by allergen exposure. This form is of treatment is the closest thing to a “cure” for allergic symptoms.

Sublingual immunotherapy (SLIT), also known as allergy drops, is currently being investigated in clinical research settings for use in the United States. SLIT involves a dosing schedule of increasing amounts of allergen, much like the shots. But instead of shots, the allergens are administered in a liquid or tablet form under the tongue. Drops may sound like a good alternative to shots, but this therapy is not FDA-approved. Several questions need to be answered before SLIT can be used outside of the research domain. The optimal starting dose and dosing frequency for maintenance have not been established.

For food allergies, the best therapy is vigilance. Allergists can diagnose food allergy by skin tests, blood tests and food challenges. Once food allergy has been diagnosed, an allergist will provide education about food avoidance, use of emergency measures in case of exposure and the likelihood of outgrowing the food allergy. They will also provide ongoing care and guidance in dealing with food allergies over time.

When to see an allergist:

  • For any allergic reaction that has an unclear cause.
  • To confirm a suspected allergy.
  • If you have limited your diet based on possible allergy to foods or additives.
  • For advice on the best treatment and avoidance measures for food allergy.
  • For advice on ways to potentially prevent food allergy.

Source: American Academy of Allergy Asthma & Immunology

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