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Allergic reactions
Allergic reactions
Allergy symptoms
Allergy symptoms
Histamine is released
Histamine is released
Introduction to allergy treatment
Introduction to allergy treatment
Hives (urticaria) on the arm
Hives (urticaria) on the arm
Hives (urticaria) on the chest
Hives (urticaria) on the chest
Hives (urticaria) - close-up
Hives (urticaria) - close-up
Hives (urticaria) on the trunk
Hives (urticaria) on the trunk
Allergies
Allergies
Antibodies
Antibodies


Allergies

Treatment:

The goal is to reduce the symptoms caused by inflammation of the affected tissues.

Of course, the best "treatment" is to avoid what causes your allergies in the first place. It may be impossible to completely avoid everything you are allergic to, but you can often take steps to reduce your exposure. This is especially important for food and drug allergies.

Medications that can be used to treat allergies include the following:

  • Short-acting antihistamines, which are generally non-prescription, often relieve mild to moderate symptoms but can cause drowsiness. In addition, these antihistamines can blunt learning in children (even in the absence of drowsiness). An example is diphenhydramine. One formerly prescription medication, loratadine (Claritin), is now available over the counter. It does NOT tend to cause drowsiness or affect learning in children.
  • Longer-acting antihistamines cause less drowsiness and can be equally effective, and usually do not interfere with learning. These medications, which require a prescription, include fexofenadine (Allegra) and cetirizine (Zyrtec).
  • Nasal corticosteroid sprays are very effective and safe for people with symptoms not relieved by antihistamines alone. These prescription medications include fluticasone (Flonase), mometasone (Nasonex), and triamcinolone (Nasacort AQ).
  • Decongestants may also be helpful in reducing symptoms such as nasal congestion. Nasal spray decongestants should not be used for more than several days, because they can cause a "rebound" effect and make the congestion worse. Decongestants in pill form do not cause this effect.
  • Cromolyn sodium is available as a nasal spray (Nasalcrom) for treating hay fever. Eye drop versions of cromolyn sodium and antihistamines are available for itchy, bloodshot eyes.
  • Leukotriene inhibitors -- montelukast (Singulair) is a prescription medicine approved to help control asthma and to help relieve the symptoms of seasonal allergies.

The most appropriate medication depends on the type and severity of symptoms. Specific illnesses that are caused by allergies (such as asthma, hay fever, and eczema) may require other treatments.

Allergy shots (immunotherapy) are occasionally recommended if the allergen cannot be avoided and symptoms are hard to control. Regular injections of the allergen are given, with each dose slightly larger than the previous dose. Allergy shots keep your body from over-reacting to the allergen. They do not work for everybody and require frequent doctor's visits.

Severe reactions (anaphylaxis) require epinephrine, which can be life saving when administered soon after exposure by patients themselves.



Support Groups:

General and up-to-date information for food allergy sufferers can be obtained online through the Food Allergy and Anaphylaxis Network. See asthma and allergy support group.



Expectations (prognosis):

Most allergies can be easily treated with medication. However, medication only helps relieve the symptoms from that exposure, they do not prevent future allergic reactions.

Some children may outgrow an allergy as the immune system becomes less sensitive to the allergen. This is particularly true of food allergies. However, as a general rule, once substances have provoked allergic reactions, they continue to affect the person.

Allergy shots may cause uncomfortable side effects (such as hives and rash) and may have dangerous outcomes (such as anaphylaxis). Allergy shots are most effective in allergens that cause hay fever symptoms and individuals with severe insect sting allergies, but not food allergies. While it may require years of treatment, it is effective in about two-thirds of cases.



Complications:
  • discomfort during the allergic reaction
  • disruption of lifestyle
  • drowsiness and other side effects of antihistamines
  • side effects of other medications (see the specific medication)
  • anaphylaxis (life-threatening allergic reaction)


Calling your health care provider:

Call for an appointment with your health care provider if severe symptoms of allergy occur, if previously successful treatment has become ineffective, or if symptoms appear severe or do not respond to treatment.



References:

Christodoulopoulos P, Tulic MK, Kontolemos M, Hamid Q. Immunopathology of Allergic Airway Inflammation.In: Middleton's Allergy: Principles and Practice.  6th ed.Mosby, Inc., 2003; 501-511.

American Academy of Allergy, Asthma and Immunology. The Allergy Report page. Available at: http://www.theallergyreport.org/. Accessed March 23, 2005.

 




Review Date: 3/29/2005
Reviewed By: Thomas A. Owens, M.D., Departments of Internal Medicine and Pediatrics, Duke University Medical Center, Durham, NC. Review provided by VeriMed Healthcare Network.

The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. Copyright 2004 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.

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