What are Environmental Allergies?
Environmental allergies, or hayfever, affect over 50 million children and adults in the United States. Individuals with environmental allergies react to a variety of airborne allergens including dust mites, pollen, animal dander, and molds. Environmental allergies occur when our immune system mistakes a normally harmless substance (allergen) as something foreign or dangerous.
Our immune system's normal function is to protect us from infections that can be caused by bacteria, viruses, and fungi. When our immune system misidentifies an allergen as "dangerous," the body mounts an inflammatory reaction against that substance. The immune system reacts to the allergen by producing Immunoglobulin E (IgE) antibodies. Exposure of an allergic individual to an allergen results in the release of inflammatory chemicals which causes the symptoms of environmental allergies.
What are the Common Symptoms of Environmental Allergies?
The most common symptoms of environmental allergies are itchy eyes, runny nose, nasal congestion, and post-nasal drip. Individuals with more severe allergies can experience the above symptoms with intense fatigue. Children and adults with environmental allergies often experience recurrent upper respiratory infections (ear and sinus infections, bronchitis, pneumonia) at a higher frequency than individuals who do not have allergies.
People with more severe environmental allergies commonly develop asthma which can flare when they are exposed to things in the environment to which they are allergic. Some individuals with a severe pollen allergy develop a sensitivity to fresh fruits and vegetables which resemble, on the microscopic level, the allergen they are allergic to.
How is a Person Tested for Environmental Allergies?
Allergy testing can be done at any age. Skin testing is the most accurate and least expensive test for allergies and involves the placement of a small droplet of purified allergen on the skin. This droplet is then pricked or scratched with a small plastic device. If a patient is allergic they break out in a small bump at the site where they were scratched. Blood tests can also be done to identify environmental allergies however these tests are more invasive and less accurate than skin testing. Blood tests are typically reserved for individuals who cannot be skin tested because of skin disease or the inability to stop their allergy medications.
How are Allergies Treated?
There are many important measures that can be taken to help control environmental allergies. Environmental control measures to decrease allergen exposure include keeping windows closed during pollen season, limiting outdoor activity in the mornings when pollen and mold counts are often higher, and avoiding hanging clothing outdoors. Individuals with dust mites can help decrease exposure by using specialized covers for their mattresses and pillows and minimizing the amount of stuffed animals and other "dust collecting" items in the bedroom. Air filters help decrease the amount of circulating allergen in the air, as does keeping pets outdoors. Allergy medications are often employed to treat allergies. Common allergy medications include antihistamines, nasal steroid sprays, and eye drops.
What are Allergy Shots?
Allergy shots are an underutilized treatment for the control and prevention of allergies and asthma. Allergy shots involve the formulation of a vaccine that is composed of the allergens that a person is allergic to. The individual is then injected with increasing amounts of the vaccine to build tolerance. Individuals treated with immunotherapy are often able to discontinue their allergy medications with time. Immunotherapy is an excellent treatment alternative for individuals in whom allergy avoidance and medications no longer control symptoms or in those individuals wanting to minimize the amount of medications they take.
Jonathan Mozena MD
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