The icky green stuff is back – it’s pollen season East Cobbers. To help you through this sniffly season, WellStar’s Grace Chiang, M.D, answers common questions about allergies.
1. What are the most common allergies and what causes them?
Many people have allergies triggered by substances inhaled from the air, such as pet dander, mold, dust mites, and pollen (trees, grasses, weeds).
Food allergies have also become more common over the years, with >90% of food allergies caused by 7 foods: milk, egg, wheat, soy, fish, shellfish, peanut/tree nuts.
The underlying cause of allergies is likely due to a complex interaction between genetics and environmental factors. Many studies are underway to further elucidate the causes of allergies and why the incidence is rising in the U.S. and many other industrialized countries. In general, allergies occur when your immune system overreacts to a substance that is usually not pathogenic or harmful. Risk factors for developing allergies include a positive family history or personal history of allergic conditions including asthma or eczema.
2. Many people think they have a cold when it is actually allergies and vice versa-How do you differentiate between these two conditions?
Symptoms that may occur in both conditions include runny nose, congestion, sneezing and cough. With a cold, these symptoms may be associated with fever and body aches, lasting for approximately 7-10 days. With allergies, itching of the eyes and/or nose is often present. Symptoms usually last for weeks to months at a time, as long as the allergic trigger is present.
3. People tend to think of allergies as causing itchy eyes, runny noses, but can they cause more serious health risks?
Allergies can result in more serious health consequences in individuals with asthma. At least 80% of people with asthma have allergies that trigger their asthma, which can lead to coughing, wheezing, chest tightness and shortness of breath. This may lead to asthma attacks that can result in ER visits or hospitalizations. It is thus important for asthmatics to see an allergist and identify potential allergic triggers. Treating a patient’s allergies is an important part of optimizing asthma care.
4. If you do have allergies, how can you manage them?
A 3 pronged approach is most effective in managing allergies:
- 1. Environmental control measures: strategies to minimize exposure to known allergic triggers, such as keeping a pet out of the bedroom, use of air filters, and dust mite proof encasings
- 2. Medications: help to control symptoms but often need to be taken regularly in order to be effective
- 3. Immunotherapy (“allergy shots”): the only treatment available that alters your body’s immune response to allergens and provides long lasting relief, reducing symptoms and the need for medications
5. How are allergies diagnosed?
Skin testing may be safely performed in children and adults to accurately diagnose allergies, under the supervision of a board certified allergist. Contrary to common belief, there is no age requirement for skin testing. For example, many infants are able to be skin tested for allergy to milk and/or soy, if there is a concern for allergy to their formula. We are able to test for environmental and food allergies as well as stinging insects (bees, wasps, hornets, yellow jacket, fire ant) and penicillin. If skin testing is positive, we expect to see a small, red, itchy bump develop within 15 minutes. I thus have the opportunity to interpret the skin test findings with the patient at the same visit and develop an individualized treatment plan.
6. How are allergies related to other medical conditions, such as asthma and eczema?
Asthma and eczema are other forms of allergic disease. It is thus common for allergies, asthma and eczema to all occur in the same patient or family. Having one of these conditions increases your risk for having the other two, something referred to as the “atopic march,” in which young children may initially have eczema and food allergies, later also developing allergies (hayfever) and asthma.
7. There is a lot of concern about giving children medicine-what is safe and what do you need to avoid?
It can be difficult navigating the many allergy treatments that are now available OTC. It is worthwhile to see an allergist to establish the diagnosis of allergies first. Your allergist can then recommend specific treatments at doses that are safe for children.
8. Is there any truth to the practice of exposing young children to more allergens and germs in order to build up their immune systems?
Some studies have shown that the risk of allergies is reduced for children who are around more bacteria or “germs,” as a result of growing up on a farm or with multiple pets or siblings in the home. The exposure needs to occur very early in life, however, so making these changes later in childhood will not have a protective effect. This is likely an overly simplistic viewpoint however, as the underlying cause of allergies is likely a complex interaction between many variables, both genetic and environmental.
9. What about pet allergies? A lot of people out there really want pets, but their allergies won’t allow them. Are there treatments people can take to help with this?
Allergy shots are the most effective treatment to allow people to live or interact with pets they are allergic to. The allergy shots gradually introduce cat or dog dander to the body’s immune system, helping that individual to develop greater tolerance, or “immunity.” It thus takes time for the allergy shots to result in improvement, but they are the most effective treatment available in providing long term relief.
10. What is an allergist and why should I see one?
An allergist is a doctor that specializes in the diagnosis and treatment of all types of allergic conditions in children and adults, including allergic rhinitis (hayfever), sinus disease, asthma, food allergies, eczema, stinging insect allergy, drug allergy, hives, anaphylaxis, and immune deficiencies. An allergist receives an additional 2-3 years of specialized training after completing their residency. They must also complete a rigorous examination to become board certified in Allergy. All individuals with symptoms or concern for an allergic condition can certainly benefit from seeing an allergist.
Grace Chiang, M.D., has extensive experience in the diagnosis and treatment of asthma and allergic conditions in both children and adults and is in practice with WellStar Medical Group, Allergy and Asthma. She is board certified in allergy/immunology and pediatrics.
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