What You Need to Know About Allergies

what to do about allergiesWhat To Do About Allergies

Do you have watery, irritated eyes? Is your nose runny or blocked all the time? What about your skin — do you have skin rashes or breakouts at random times? I do. 

People can be allergic to many things, from foods, to animal hairs, to dust and pollen. The common denominator with all of these conditions is misery. Suffering from an allergy can have a truly negative effect on your life. Exposure to your specific allergen can result in skin complaints including breakouts and hives, and breathing problems that leave you feeling drained and unhappy. It can also stop you from going where you want to go, when you want to go there. The first step to defeating an allergy is diagnosing the allergy.

What Are Allergies?

Allergies are the result of an extra sensitive immune system. When the body of a sufferer comes into contact with a particular allergen, their body releases substances, including histamines, as part of a defense reaction. These produce the symptoms commonly associated with allergies. Occasionally these reactions can be very severe, and may need immediate hospital treatment.

Allergic Rhinitis

Allergic rhinitis is one of the most common allergic conditions in the United States, and is commonly known as hay fever. It’s caused by an allergic reaction to pollen and other airborne substances, and sufferers can dread the pollen production hot spots of summer. The most obvious symptom is sneezing, and sore or runny eyes. Some hay fever sufferers may develop a rash, and there is often excessive mucus production, including post nasal drainage that sees mucus drain uncomfortably down the back of the throat. It’s important, however, not to assume that you have hay fever, rather than another allergy, if these symptoms occur.

Diagnosing An Allergy

The first step towards treatment is to diagnose your allergy. Once you contact an otolaryngologist (ear, nose, and throat specialist) they will discuss what you think may be causing the problem, and then carry out a series of allergy tests. These tests can involve the examination of blood samples, or skin-based tests. In the latter tests, the skin is pricked and exposed to tiny amounts of possible allergens. The reaction is then observed. Through these tests, a firm and accurate diagnosis can be obtained.

So What Next?

By finding the root cause of the allergy, preventative steps can be taken that will help the patient avoid the symptoms mentioned above. Two varieties of allergy test are called SET testing and RAST testing. Let’s take a look at how they work, and what can be done if you do have an allergy.

RAST Testing For Allergies

RAST testing is a commonly undertaken test that determines the nature of a patient’s allergies. It stands for radioallergosorbent test, and is also known as in vitro testing. The test procedure involves drawing blood from a patient. The blood is then placed onto small discs made of paper. Each disc has a different allergen attached to it. If the patient has antibodies for the particular allergen, the antibodies will bind to the disc. After this, the allergens are removed through a washing process, so that only the bound antibodies are present. These antibodies are then subjected to radioactive examination. This can help determine which allergens the patient is susceptible to, and can also indicate the dosage of treatment required to combat them.

What Is SET testing?

SET stands for Serial Endpoint Titration. In SET testing, a diluted form of allergen is applied directly onto a patient’s skin (usually the forearm) in the office setting. The nature of the allergens being tested are often based upon historical evidence given by the patient themselves. This information is often combined with a list of common allergens specific to a patient’s specific geography and history.  Results from SET tests are available rapidly – usually in less than an hour – but there are several factors that can have an adverse effect upon SET testing for allergies. Certain medications such as antihistamines may impact the testing results and should be avoided for a time period before the allergy test.

Which Allergy Test Is Best?

Both tests have their advantages and disadvantages. SET testing provides quick results, but the patient is subject to diluted allergens, and so may have discomfort and itching during and for a short time after the procedure. These tests are also subject to external factors that don’t affect RAST testing. RAST testing is not impacted by patient medications, and is favored in certain patients; however, they do involve a blood draw and can be quite costly. The best test for a particular patient is a decision that should be made in consultation with a patient’s testing physician.  

Allergy Treatments

Once an allergy has been discovered, effective management and treatment can begin. This can include avoiding exposure to the allergens through lifestyle or environmental changes, or medical treatment. Medical treatments may be symptomatic treatments such as nasal irrigation, steroid treatments, or antihistamines. Treatments designed to rid a patient of their allergies are also available and include SCIT (allergy shots) and SLIT (sublingual allergy drops). As always, specific medication decisions should be made after discussion with your treating physician.

Dr. Samuel Becker is a board-certified specialist and Director of Rhinology. He practices in New Jersey and Philadelphia.