Allergy treatments are determined by the type of allergy identified during your allergy testing. Because many allergy symptoms are simply annoying — runny nose, stuffy nose, sneezing — certain allergy treatments will focus on relieving those symptoms, removing allergens from your immediate environment and helping your body learn to fight off allergens on its own. Depending on the results of your allergy testing, your allergies may also be treated in one of the ways detailed below.

How to Treat Allergies

At the Ohio State Wexner Medical Center, our allergists are focused on relieving allergy symptoms to help you live a normal life. Allergy testing is the first step. Once your specific allergy type has been identified, your allergist can determine the best course of treatment for your care.

Allergy Immunotherapy Treatment

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.

Allergy immunotherapy 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.

Allergy immunotherapy 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.

Treating allergies with medication

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

Oral antihistamines

Oral antihistamines are a common and effective treatment option, but they have some negative side effects such as drowsiness. Some common over-the-counter antihistamines are Claritin, Zyrtec and Benadryl, which come in pill form. There are nasal spray varieties as well.

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 at decreasing the redness of the eye. Talk to your doctor about the 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. These medications usually require a prescription.

Nasal steroid sprays

Nasal steroids are one of the cornerstones of allergy treatment. Because nasal sprays are 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 headaches.

Decongestants

Decongestants, available as oral or topical medications, help with a stuffy nose, but also have some restrictions on their use. 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 for 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. Reading food labels is an important part of minimizing the risk of accidental exposure to an allergen. Accidental exposure can also be a risk when eating food prepared by other people as there are no labels to check. Also, other people will not be as aware of your allergy as you are, so it is always a good idea to ask about ingredients when you’re eating food you did not prepare yourself.

Treatment for more serious food allergies

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.

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