If you’ve learned to live with your allergies for years — we’re here to offer a different path. Allergies are so common it would seem logical that any doctor’s office can provide accurate testing and effective therapies. However, board certified allergists, such as our team at Ohio State, have been studying allergies for years with specialized training to provide you the customized care you deserve.

Your road to improving your allergy symptoms may include the following allergy tests or treatments:

  • Inhalant testing
  • Skin contact testing
  • Medications to treat your symptoms
  • Immunology to train your immune system against allergies

What is inhalant allergy testing?

Inhalant allergies are reactions to things you breathe in, such as pollens, molds, dust and animal dander. Despite the name, testing is performed using either skin prick or, in some cases, blood tests. A skin prick test is more accurate and the preferred method to test for inhalant allergy testing.

What to expect during inhalant allergy testing?

Allergy skin tests aren’t painful. The skin prick testing device has small plastic prongs that penetrate the superficial layers of your skin. Children as young as 5 years old can easily tolerate this type of testing. Reactions to an inhalant allergy skin test should occur within about 20 minutes of being exposed. For most people, this test provides a clear diagnosis of their allergy triggers. Occasionally, if these tests aren’t definitive, your allergy doctor will proceed with intradermal skin testing. This test places a small amount of allergen slightly deeper into the skin.

There are some medications that interfere with the results of skin testing or make skin testing less safe. Your doctor may have you stop taking certain medications five to seven days before testing.

For blood testing, the physician decides which allergens to test you for based on your medical history. You’ll have several small tubes of blood drawn in the lab. The blood will then be tested against each of the potential allergens determined by the physician. Blood testing is a good choice for people with asthma that is not well-controlled, those who are pregnant, who have rare skin conditions that don’t allow them to stop taking antihistamine medication for five days prior to skin testing, or who are taking a high blood pressure medication, or certain types of eye drops.

What is skin contact allergy testing?

Skin contact allergy testing, or patch testing, is a way of diagnosing whether there are substances in your environment that react with your skin to cause allergy symptoms ranging from a rash or hives to chest tightness or difficulty breathing.

Possible allergens include virtually anything your skin comes into contact with:

  • Hair and skin care products
  • Cleaning and laundry products
  • Jewelry
  • Clothing
  • Glues
  • Topical medications

While the process to inhalant skin testing is similar, skin contact allergy testing can return a reaction over a much longer period of time. With inhalant testing, the test substances are placed on the skin, and a reaction occurs or doesn’t occur within 20 minutes. The allergens in patch testing can cause a reaction over a 12- to 24-hour period or more, so the test substances have to be in contact with the skin longer.

What to expect during a patch allergy test?

  • Test panels of common allergens are attached to medical adhesive paper, with several in each group.
  • The panels are placed on your back, between the shoulder blades. They are flat and comfortable to sleep on.
  • After 2-3 days the test panels are removed.
  • This process will be repeated to rule out an allergy to the adhesive paper itself or otherwise confirm the test results.

Treating allergies with medication

Allergy medications are often the first defense against allergic symptoms that cause you problems.

Oral antihistamines

Oral antihistamines are very effective but can have the downside of making many people very drowsy. Some examples include Claritin, Zyrtec and Benadryl, which are available over-the-counter. Antihistamines are also available in a nasal spray.

Eye drops

There are two basic types of over-the-counter allergy eye drops. The first is a combination of antihistamine and decongestant, while the other is only an antihistamine. The antihistamine component is effective at managing itching. The decongestant is effective in decreasing redness of the eye. Talk to your doctor about potential side effects of long-term eye drop use.

Leukotriene modifiers

Leukotriene modifiers help prevent breathing problems associated with allergies, asthma and chronic obstructive pulmonary disease. A common example is Singulair, and these medications often require a prescription.

Nasal steroid sprays

Nasal steroids are one of the cornerstones of allergy treatment. The nice thing about the sprays is that since they’re used in the nose, there is minimal absorption by or effect on the rest of the body. The most common side effect of nasal steroids is nasal passage irritation or mild nose bleeding. Other common side effects of using steroid nasal sprays are dryness inside the nose or headache.

Decongestants

Decongestants, available as oral or topical medications, help with a stuffy nose. Decongestants may not be right for you if you have high blood pressure, prostate enlargement, glaucoma, rapid heartbeat or sleep problems. Be sure to ask your doctor if decongestants are safe for you to take.

Food allergy treatment

A mild food allergy reaction can be treated with an over-the-counter oral antihistamine. Liquid antihistamines get into the bloodstream faster than pills or capsules.

The only treatment of immediate-type food allergies is lifelong avoidance. Avoiding obvious forms of the food is pretty easy. But hidden forms of the allergic substances are often hard to avoid. For example, if you’re allergic to milk you won’t drink it, or eat ice cream or cheese. But whey is a milk protein and is found in many prepared foods, such as bread.

Another concern is the risk of accidental exposure such as the classmate who brings cookies to your child's classroom, forgetting the treats contain peanuts.

In some cases, difficulty swallowing could be a sign of a condition known as eosinophilic esophagitis. This allergic reaction is triggered by food and environmental allergens and causes white blood cells in the throat to become inflamed. Treatment of eosinophilic esophagitis varies depending on the source of the allergic reaction. Your doctor may eliminate specific foods from your diet or prescribe glucocorticosteroids to control inflammation.

For more serious food allergy reactions, such as chest tightness or trouble breathing, feeling like your throat is closing, lip and tongue swelling, or severe generalized hives, you should carry self-injectable epinephrine that you or a friend or family member can inject into your thigh. Keep in mind that using self-injectable epinephrine is just a temporary measure and the symptoms will return.

If you use an EpiPen, always call 911 or head to the nearest emergency room immediately for complete treatment.

Immunotherapy allergy treatment

How does immunotherapy work?

The theory behind allergy immunotherapy is helping the body’s immune system build a tolerance to the allergens it currently reacts to. This is done by starting with very small amounts of these allergens taken as shots or drops, and gradually building up to a target dose we know is effective. This takes between one to five months to get to the target dose, depending on the form of immunotherapy you are using, and how your body tolerates it.

Once you reach the target dose, you continue at that dose for three to five years, with important changes taking place in your immune system over that entire time. When you finish with immunotherapy, most people have three or more years of sustained relief.

Why use immunotherapy?

The other mainstays of allergy treatment — avoiding allergens or using medicines to control symptoms — only make temporary changes. Immunotherapy makes permanent changes in your immune system, helping you develop tolerance to the allergens that cause reactions. Additionally, immunotherapy can decrease the rate at which you develop future allergic sensitivities and can improve or prevent asthma in allergic children.

Immunotherapy can be delivered as weekly allergy shorts or daily under-the-tongue treatments.

Immunotherapy allergy shots

Also known as subcutaneous immunotherapy (or SCIT), allergy shots are specifically formulated for your allergies. No one else has an allergy vaccine exactly the same as yours.

Allergy shots are given once a week. While climbing to the target dose, these shots must be delivered in your doctor’s office. This is because there’s a greater, though still small, chance of an allergic reaction.

After you reach your target dose, you or a family member can administer the shots at home. You must agree to stringent safety measures if you choose this option: you must always have auto-injectable epinephrine and liquid antihistamine with you, always have another adult with you for 20 minutes after the shot and always have nearby access to a phone capable of reaching emergency responders.

Most reactions are just small red areas on the arm. If the redness is any greater than the size of a dime after an injection, or if you have any general symptoms like hives, chest tightness or shortness of breath, call your physician or 911 immediately.

Immunotherapy allergy drops

Also known as sublingual immunotherapy, allergy drops can be used instead of shots. Sublingual (under-the-tongue) immunotherapy (SLIT) has been used extensively in Europe, Asia and Australia for the last 30 years, but only recently in the United States. It’s been shown to be highly effective in treating allergies.

As with allergy shots, your SLIT vaccine is mixed specifically for you, with only the allergens to which you are sensitive. You would receive your very first dose at the office, and thereafter take your daily drops at home. This is because SLIT is even safer than allergy shots. When you are at your target dose, you’ll be using your allergy drop vial to deliver three squirts under the tongue. You’ll hold the liquid there for 2 minutes, then swallow the dose.

Some people experience mild tingling or itching in the mouth with SLIT. The chances of a serious reaction are very small.

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