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 to help your immune system develop a tolerance for the specific substances or allergens that trigger your symptoms. This is done by intentionally exposing your body to just enough allergens to stimulate your immune system without causing a full allergic reaction.
The ultimate goal of immunotherapy is to reduce or eliminate your allergy symptoms and decrease the amount of medication you need to control any bothersome symptoms that remain.
Ohio State offers several immunotherapy treatment options. Each is effective, but one may be more appropriate for your own allergy profile. You may also prefer one over the others depending on treatment method, timing and cost.
Benefits of immunotherapy
While avoiding allergens or using medications to temporarily control allergy symptoms can provide temporary relief, immunotherapy offers a more lasting solution.
- Because it creates permanent changes in your immune system, most people have three or more years of sustained allergy symptom relief after completing a course of immunotherapy.
- Immunotherapy can also decrease the rate at which you develop future allergic sensitivities and may improve or prevent asthma in allergic children.
Types of Immunotherapy
Immunotherapy can be administered in different ways:
- Using shots that are injected under your skin, usually in the upper arm
- By nearly painless injection directly into a lymph node in your groin
- Via drops placed under your tongue
You’ll begin by receiving a very small amount of your symptom-triggering allergens, gradually increasing the concentration over time. This is the buildup phase.
Depending on the immunotherapy method used and how your body tolerates it, this initial treatment can take from one to five months. With some immunotherapy, you’ll also require a maintenance phase with doses given at gradually longer intervals over a number of years.
Immunotherapy can improve symptoms caused by seasonal/outdoor allergens, indoor allergens or insect stings. It cannot be used for food allergies or for chronic hives, also known as urticaria.
Your doctor can recommend which options might be right for you based on your type of allergies, lifestyle, insurance and other health factors.
Subcutaneous immunotherapy or allergy immunotherapy shots
Commonly referred to as allergy shots, subcutaneous immunotherapy (SCIT) uses a liquid injection specifically formulated for your list of allergies. No one else has an allergy formulation exactly the same as yours.
- Allergy shots are given once a week through the buildup phase, then slowly spaced out to once a month and longer, usually over a three-to-five-year period.
- Allergy shots must be given in your doctor’s office. This is because there’s a small chance of allergic reaction.
- 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 later have any general symptoms like hives, chest tightness or shortness of breath, call your physician or 911 immediately.
Sublingual immunotherapy or allergy immunotherapy drops
This highly effective treatment gives you an alternative to shots.
Although only recently available in the United States, sublingual (under the tongue) immunotherapy (SLIT) has been used extensively in Europe, Asia and Australia for the last 30 years. Because of its relatively new use in America, SLIT doesn’t yet have U.S. Food & Drug Administration (FDA) approval like allergy shots. However, many years of data confirm its safety and effectiveness.
- As with allergy shots, your SLIT formula is mixed specifically for you, with only the allergens you’re sensitive to.
- Your very first dose is given at your doctor’s office. You’ll then use your allergy drop vial at home to squirt daily drops under your tongue.
- This is because SLIT is even safer than allergy shots, with a smaller chance of serious reaction.
- Some people do experience mild tingling or itching in the mouth with SLIT.
- Once you reach your target dose, you’ll place three drops under your tongue. You’ll hold the liquid there for 2 minutes, then swallow the dose.
- For most effective results, you’ll likely take the liquid allergen drops every day for several years, typically three to five.
Intralymphatic immunotherapy
Representing a major advancement in allergy treatment, ultrasound-guided intralymphatic immunology (ILIT, which is pronounced “eye-let”) requires just three injections over a two-month period for lasting symptom relief.
The Ohio State Wexner Medical Center is one of the very first academic health care centers in the nation to offer ILIT.
- For ILIT, a small concentration of allergens — even smaller than what’s used with shots or sublingual drops — is injected directly into one of your inguinal lymph nodes in your groin.
- This lymph node is used because it’s easy to access, lies just below the skin and is the safest and most painless area for this type of injection.
- An ultrasound is used to help with precise placement.
- Each ILIT injection is done in your doctor’s office and only takes a few minutes.
- Injections are spaced one month apart, so total treatment takes just two months.
- Like allergy shots and sublingual drops, ILIT reduces your reaction to outdoor allergens, indoor allergens and insect stings. However, ILIT injections can only contain a limited number of allergens at a time.
- If you have a large number of triggers, you may need more than one series of ILIT treatment. As an example, one series for your indoor allergies and the second series for your outdoor allergies.
- We can prioritize which allergens we target first based on which cause the worst symptoms.
- An additional ILIT series for a different group of allergens can usually begin soon after finishing the first ILIT series.
- Like sublingual drops, ILIT is not yet FDA-approved, but it does deliver results similar to shots and drops in a much shorter period of time. In addition, current data shows ILIT is even safer than traditional allergy shots.
Although you’ll need to pay for ILIT out-of-pocket, it may still be cheaper in the long run compared to years of traditional allergy treatment, especially if you have a high-deductible insurance plan. ILIT may not be appropriate for all allergy sufferers, but it can provide significant relief from allergy symptoms in just a matter of weeks.
What’s the right immunotherapy treatment for your allergies?
The best immunotherapy for you depends on your symptoms, goals and the allergens that trigger your symptoms. All three methods offered at Ohio State work in the same general way, but your preference may depend on how much time your schedule allows for appointments, how quickly you want relief and the required out-of-pocket costs.
You can schedule an appointment with an Ohio State allergist yourself. You can also get a referral from your regular doctor, but it isn’t required.
For any immunotherapy, allergy testing is needed to confirm what causes your reactions so we can create a personal treatment plan.
- Your allergy test can be performed with an allergist outside of Ohio State, but if your symptoms have changed recently or you haven’t received an allergy test within the last year or two, you might need an additional allergy test.
- Allergy tests can be a skin test or blood test.
Once we identify the appropriate immunotherapy options for you and discuss the benefits, timing and costs of each, we can create a treatment plan going forward.
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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