What you need to know about Allergies?

Infections & Diseases

Table of Contents: Definition of Allergy / Where are Allergens? (In the Air we Breathe) / Types of Allergies and What Cause Allergies? (Food Allergy, Medication Allergy, Insect Allergy, Latex Allergy, Allergic Conjunctivitis and Allergic Rhinitis, Hay Fever, Anaphylaxis, Exercise Induced Anaphylaxis, Toxins Interacting with Proteins, Genetics, Hygiene, Stress, Other Environmental Factors) / Who is at Risk for Allergies and Why? / Signs and Symptoms of Allergies / Pathophysiology (Acute response, Late-phase response, Allergic contact dermatitis) / Epidemiology / Allergies Testing and Diagnosis (Skin Prick Testing, Patch Testing, Blood Testing, Challenge Testing, Elimination/Challenge Tests, Unreliable Tests, Is Allergy Testing Safe?, Diagnosis) / Prevention, Treatment and Management of Allergy (Prognosis and Complications, Nutrition and Diet for Allergies) / Conventional Medicine for Allergy (Medication, Immunotherapy, Allergy Shots, Allergy Drops, Antihistamines, Homeopathic Medicine, Allium cepa (raw onion), Euphrasia (eyebright), Nux vomica (poison nut), Arsenicum album (trioxide of arsenic), Vitamins and Minerals) / Alternative Medicine for Allergy (Herbal Medicine, Herbal Tea Bath, Chinese Medicine) / Home Remedy for Allergy

What are allergies? Allergies, also known as allergic diseases, are a number of conditions caused by hypersensitivity of the immune system to typically harmless substances in the environment. Allergens may cause an allergic reaction when they come in contact with skin or the eye, when they are inhaled, eaten, or are injected. An allergic reaction can occur as part of a seasonal allergy. Or an allergic reaction can be triggered by taking a drug, eating certain foods, or breathing in dust or animal dander. These diseases include hay fever, food allergies, atopic dermatitis, allergic asthma, and anaphylaxis. Symptoms may include red eyes, an itchy rash, sneezing, a runny nose, shortness of breath, or swelling. Food intolerances and food poisoning are separate conditions.

The immune system is responsible for the identification and destruction of foreign substances that enters the body. Normally the immune system acts as the body's defense against disease-causing microorganisms and substances. However for some people, the immune system mistakes perfectly harmless substances for germs and in response, it releases certain compounds to destroy the perceived "enemy". This results to allergic reaction. Some people may show allergic reaction to one substance, but others may manifest allergic reaction to many substances which we call allergens.

Early exposure to potential allergens may be protective. Treatments for allergies include the avoidance of known allergens and the use of medications such as steroids and antihistamines. In severe reactions injectable adrenaline (epinephrine) is recommended. Allergen immunotherapy, which gradually exposes people to larger and larger amounts of allergen, is useful for some types of allergies such as hay fever and reactions to insect bites. Its use in food allergies is unclear.

Allergies are common: In the developed world, about 20% of people are affected by allergic rhinitis, about 6% of people have at least one food allergy, and about 20% have atopic dermatitis at some point in time. Depending on the country about 1–18% of people have asthma. Anaphylaxis occurs in between 0.05–2% of people. Rates of many allergic diseases appear to be increasing.

Allergens may be inhaled, ingested (eaten or swallowed), applied to the skin, or injected into the body either as a medication or inadvertently by an insect sting. The symptoms and conditions that result depend largely on the route of entry and the type of allergen. The chemical structure of allergens affects the route of exposure. Airborne pollens, for example, tend to have little effect on the skin. They are easily inhaled and will thus cause more nasal and respiratory symptoms with limited skin symptoms. When allergens are swallowed or injected, they may travel to other parts of the body and provoke symptoms that are remote from their point of entry. For example, allergens in foods may prompt the release of mediators in the skin and cause hives.

The specific protein structure is what determines the allergen's characteristics. Cat protein, Fel d 1, from the Felis domesticus (the domesticated cat), is the predominant cat allergen. Each allergen has a unique protein structure leading to its allergic characteristics.

In the Air we Breathe:

Aside from oxygen, the air contains a wide variety of particles, including allergens. The usual diseases that result from airborne allergens are hay fever, asthma, and conjunctivitis. The following allergens can trigger allergic reactions when inhaled by sensitized individuals.

  • Pollens from trees, grasses, and/or weeds.
  • Dust mites.
  • Animal proteins, including dander, skin, and/or urine.
  • Mold spores.
  • Insect parts, especially from cockroaches.

Risk factors for allergy can be placed in two general categories, namely host and environmental factors. Host factors include heredity, sex, race, and age, with heredity being by far the most significant. However, there have been recent increases in the incidence of allergic disorders that cannot be explained by genetic factors alone. Four major environmental candidates are alterations in exposure to infectious diseases during early childhood, environmental pollution, allergen levels, and dietary changes.

Food Allergy:

A wide variety of foods can cause allergic reactions, but 90% of allergic responses to foods are caused by: cow's milk, soy, eggs, wheat, peanuts, tree nuts, fish, and shellfish. Other food allergies, affecting less than 1 person per 10,000 population, may be considered "rare". The use of hydrolyzed milk baby formula versus standard milk baby formula does not appear to change the risk. Although peanut allergies are notorious for their severity, peanut allergies are not the most common food allergy in adults or children. Severe or life-threatening reactions may be triggered by other allergens, and are more common when combined with asthma.

Peanut allergies are not the most common food allergy in adults or children. Severe or life-threatening reactions may be triggered by other allergens, and are more common when combined with asthma. Peanut allergies can sometimes be outgrown by children. Egg allergies affect one to two percent of children but are outgrown by about two-thirds of children by the age of 5. The sensitivity is usually to proteins in the white, rather than the yolk. Milk-protein allergies are most common in children. Approximately 60% of milk-protein reactions are immunoglobulin E-mediated, with the remaining usually attributable to inflammation of the colon. Some people are unable to tolerate milk from goats or sheep as well as from cows, and many are also unable to tolerate dairy products such as cheese. Roughly 10% of children with a milk allergy will have a reaction to beef. Beef contains small amounts of proteins that are present in greater abundance in cow's milk. Lactose intolerance, a common reaction to milk, is not a form of allergy at all, but rather due to the absence of an enzyme in the digestive tract.

Allergens can be transferred from one food to another through genetic engineering, however genetic modification can also remove allergens. Little research has been done on the natural variation of allergen concentrations in unmodified crops.

Medication Allergy:

About 10% of people report that they are allergic to medications; however, 90% turn out not to be. Serious allergies only occur in about 0.03%. That include: penicillin, allopurinol, sulfa antibiotics, no steroidal anti-inflammatory drugs (NSAIDS, such as aspirin and ibuprofen), muscle relaxants.

Insect Allergy:

Allergy caused by insect bites that belongs to the hymenoptera order of insects. Typically, insects which generate allergic responses are either stinging insects (wasps, bees, hornets and ants) or biting insects (mosquitoes, ticks). Stinging insects inject venom into their victims, whilst biting insects normally introduce anti-coagulants.

Latex Allergy:

Allergy caused by contact to latex materials. Common latex materials that cause allergic reaction are: rubber bands, carpet backing, hospital and dental equipment, rubber gloves, balloons, condoms. Latex can trigger an IgE-mediated cutaneous, respiratory, and systemic reaction. The prevalence of latex allergy in the general population is believed to be less than one percent. In a hospital study, 1 in 800 surgical patients (0.125 %) reported latex sensitivity, although the sensitivity among healthcare workers is higher, between seven and ten percent. Researchers attribute this higher level to the exposure of healthcare workers to areas with significant airborne latex allergens, such as operating rooms, intensive-care units, and dental suites. These latex-rich environments may sensitize healthcare workers who regularly inhale allergenic proteins.

The most prevalent response to latex is an allergic contact dermatitis, a delayed hypersensitive reaction appearing as dry, crusted lesions. This reaction usually lasts 48–96 hours. Sweating or rubbing the area under the glove aggravates the lesions, possibly leading to ulcerations. Anaphylactic reactions occur most often in sensitive patients who have been exposed to a surgeon's latex gloves during abdominal surgery, but other mucosal exposures, such as dental procedures, can also produce systemic reactions.

Latex and banana sensitivity may cross-react. Furthermore, those with latex allergy may also have sensitivities to avocado, kiwifruit, and chestnut. These people often have perioral itching and local urticarial. Only occasionally have these food-induced allergies induced systemic responses. Researchers suspect that the cross-reactivity of latex with banana, avocado, kiwifruit, and chestnut occurs because latex proteins are structurally homologous with some other plant proteins.

Allergic Conjunctivitis and Allergic Rhinitis:

Allergic reaction is caused by exposure to pollen, house-dust mite, but there are others, including allergens from animals dander such as cats, dogs, and horses. Certain foods, drugs and chemicals can also trigger allergic reaction.

Hay Fever:

Fever, asthma and eczema are all related allergy conditions and the tendency to develop them runs in families. Most people with hay fever have allergic reaction to grass and oilseed rape pollens, which appear from April to August each year. People who are sensitive to pollen from hazel, yew, elm and alder may develop allergy symptoms from January to April, and people allergic to nettles and other weeds can be affected from April to mid-September.

Many individuals have a combination of both seasonal and perennial allergies. Symptoms result from the inflammation of the tissues that line the inside of the nose after exposure to allergens. The ears, sinuses, and throat can also be involved. The most common symptoms include the following: runny or stuffy nose, sneezing, itchy nose, ears, and throat or postnasal drip (throat clearing). In 1819, an English physician, John Bostock, first described hay fever by detailing his own seasonal nasal symptoms, which he called "summer catarrh". The condition was called hay fever because it was thought to be caused by "new hay".


Anaphylactic shock is a potentially life-threatening allergic reaction that can affect a number of organs at the same time. Allergens that typically lead to anaphylaxis are foods, medications, and venom (bee stings). Environmental allergens rarely lead to anaphylaxis, except anaphylaxis can result from allergy shots (subcutaneous immunotherapy). Some or all of the following symptoms may occur:

  • Hives itching or flushing present in 80%-90% of cases
  • Nasal congestion, runny nose, itchy eyes
  • Swelling of the tongue and/or throat
  • Abdominal discomfort, nausea, vomiting, diarrhea
  • Shortness of breath, wheezing, coughing
  • Low blood pressure, leading to lightheadedness, passing out, or shock.

Anaphylactic shock is an emergent, life-threatening condition that occurs when blood vessels dilate excessively due to an allergic reaction, which causes a significant drop in blood pressure. This can result in inadequate blood flow to the organs in the body.

Exercise Induced Anaphylaxis:

Allergy due to exercise-induced anaphylaxis develops allergic reaction after doing some strenuous exercise.

Toxins Interacting with Proteins:

A non-food protein reaction, urushiol-induced contact dermatitis, originates after contact with poison ivy, eastern poison oak, western poison oak, or poison sumac. Urushiol, which is not itself a protein, acts as a hapten and chemically reacts with, binds to, and changes the shape of integral membrane proteins on exposed skin cells. The immune system does not recognize the affected cells as normal parts of the body, causing a T-cell-mediated immune response. Of these poisonous plants, sumac is the most virulent. The resulting dermatological response to the reaction between urushiol and membrane proteins includes redness, swelling, papules, vesicles, blisters, and streaking.


Allergic diseases are strongly familial: identical twins are likely to have the same allergic diseases about 70% of the time; the same allergy occurs about 40% of the time in non-identical twins. Allergic parents are more likely to have allergic children and those children's allergies are likely to be more severe than those in children of non-allergic parents. Some allergies, however, are not consistent along genealogies, parents who are allergic to peanuts may have children who are allergic to ragweed. It seems that the likelihood of developing allergies is inherited and related to an irregularity in the immune system, but the specific allergen is not.

The risk of allergic sensitization and the development of allergies varies with age, with young children most at risk. Several studies have shown that IgE levels are highest in childhood and fall rapidly between the ages of 10 and 30 years. The peak prevalence of hay fever is highest in children and young adults and the incidence of asthma is highest in children under 10.


Allergic diseases are caused by inappropriate immunological responses to harmless antigens driven by a TH2-mediated immune response. Many bacteria and viruses elicit a TH1-mediated immune response, which down-regulates TH2 responses. The first proposed mechanism of action of the hygiene hypothesis was that insufficient stimulation of the TH1 arm of the immune system leads to an overactive TH2 arm, which in turn leads to allergic disease. In other words, individuals living in too sterile an environment are not exposed to enough pathogens to keep the immune system busy. Since our bodies evolved to deal with a certain level of such pathogens, when they are not exposed to this level, the immune system will attack harmless antigens and thus normally benign microbial objects, like pollen, will trigger an immune response.

The hygiene hypothesis was developed to explain the observation that hay fever and eczema, both allergic diseases, were less common in children from larger families, which were, it is presumed, exposed to more infectious agents through their siblings, than in children from families with only one child. The hygiene hypothesis has been extensively investigated by immunologists and epidemiologists and has become an important theoretical framework for the study of allergic disorders. It is used to explain the increase in allergic diseases that have been seen since industrialization, and the higher incidence of allergic diseases in more developed countries. The hygiene hypothesis has now expanded to include exposure to symbiotic bacteria and parasites as important modulators of immune system development, along with infectious agents.

Epidemiological data support the hygiene hypothesis. Studies have shown that various immunological and autoimmune diseases are much less common in the developing world than the industrialized world and that immigrants to the industrialized world from the developing world increasingly develop immunological disorders in relation to the length of time since arrival in the industrialized world. Longitudinal studies in the third world demonstrate an increase in immunological disorders as a country grows more affluent and, it is presumed, cleaner. The use of antibiotics in the first year of life has been linked to asthma and other allergic diseases. The use of antibacterial cleaning products has also been associated with higher incidence of asthma, as has birth by caesarean section rather than vaginal birth.


Chronic stress can aggravate allergic conditions. This has been attributed to a T helper 2 (TH2)-predominant response driven by suppression of interleukin 12 by both the autonomic nervous system and the hypothalamic–pituitary–adrenal axis. Stress management in highly susceptible individuals may improve symptoms.

Other Environmental Factors:

There are differences between countries in the number of individuals within a population having allergies. Allergic diseases are more common in industrialized countries than in countries that are more traditional or agricultural, and there is a higher rate of allergic disease in urban populations versus rural populations, although these differences are becoming less defined. Historically, the trees planted in urban areas were predominantly male to prevent litter from seeds and fruits, but the high ratio of male trees causes high pollen counts.

Alterations in exposure to microorganisms is another plausible explanation, at present, for the increase in atopic allergy. Endotoxin exposure reduces release of inflammatory cytokines such as TNF-α, IFNγ, interleukin-10, and interleukin-12 from white blood cells (leukocytes) that circulate in the blood. Certain microbe-sensing proteins, known as Toll-like receptors, found on the surface of cells in the body are also thought to be involved in these processes.

Gut worms and similar parasites are present in untreated drinking water in developing countries, and were present in the water of developed countries until the routine chlorination and purification of drinking water supplies. Recent research has shown that some common parasites, such as intestinal worms (e.g., hookworms), secrete chemicals into the gut wall (and, hence, the bloodstream) that suppress the immune system and prevent the body from attacking the parasite. This gives rise to a new slant on the hygiene hypothesis theory, that co-evolution of humans and parasites has led to an immune system that functions correctly only in the presence of the parasites. Without them, the immune system becomes unbalanced and oversensitive. In particular, research suggests that allergies may coincide with the delayed establishment of gut flora in infants. However, the research to support this theory is conflicting, with some studies performed in China and Ethiopia showing an increase in allergy in people infected with intestinal worms. Clinical trials have been initiated to test the effectiveness of certain worms in treating some allergies.

Allergies can develop at any age, but most food allergies begin at a young age, and many are outgrown. Environmental allergies can develop at any time. The initial exposure or sensitization period may even begin before birth. Individuals can also outgrow allergies over time. It is not fully understood why one person develops allergies and another does not, but there are several risk factors for allergic conditions. Family history, or genetics, plays a large role, with a higher risk for allergies if parents or siblings have allergies. There are numerous other risk factors for developing allergic conditions. Children born via Cesarean section have a higher risk of allergy as compared to children who are delivered vaginally. Exposure to tobacco smoke and air pollution increases the risk of allergy. Boys are more likely to be allergic than girls. Allergies are more common in westernized countries, and less common in those with a farming lifestyle. Timing of exposures to antigens, use of antibiotics, and numerous other factors, some of which are not yet known, also contribute to the development of allergies. This complicated process continues to be an area of medical research.

The parts of the body that are prone to allergic symptoms include the eyes, nose, lungs, skin, and gastrointestinal tract. Although the various allergic diseases may appear different, they all result from an exaggerated immune response to foreign substances in sensitive individuals.

Many allergens such as dust or pollen are airborne particles. In these cases, symptoms arise in areas in contact with air, such as eyes, nose, and lungs. For instance, allergic rhinitis, also known as hay fever, causes irritation of the nose, sneezing, itching, and redness of the eyes. Inhaled allergens can also lead to increased production of mucus in the lungs, shortness of breath, coughing, and wheezing.

Aside from these ambient allergens, allergic reactions can result from foods, insect stings, and reactions to medications like aspirin and antibiotics such as penicillin. Symptoms of food allergy include abdominal pain, bloating, vomiting, diarrhea, itchy skin, and swelling of the skin during hives (urticaria). Food allergies rarely cause respiratory (asthmatic) reactions, or rhinitis. Insect stings, food, antibiotics, and certain medicines may produce a systemic allergic response that is also called anaphylaxis; multiple organ systems can be affected, including the digestive system, the respiratory system, and the circulatory system. Depending on the rate of severity, anaphylaxis can include skin reactions, bronchoconstriction, swelling, low blood pressure, coma, and death. This type of reaction can be triggered suddenly, or the onset can be delayed. The nature of anaphylaxis is such that the reaction can seem to be subsiding, but may recur throughout a period of time.

Substances that come into contact with the skin, such as latex, are also common causes of allergic reactions, known as contact dermatitis or eczema. Skin allergies frequently cause rashes, or swelling and inflammation within the skin, in what is known as a "weal and flare" reaction characteristic of hives and angioedema.

With insect stings a large local reaction may occur (an area of skin redness greater than 10 cm in size). It can last one to two days. This reaction may also occur after immunotherapy.


Affected organCommon signs and symptoms
NoseSwelling of the nasal mucosa (allergic rhinitis), runny or stuffy nose, sneezing (hay fever, rhinitis), nasal congestion.
SinusesAllergic sinusitis.
EyesRedness and itching of the conjunctiva (allergic conjunctivitis, watery), redness under the lids and of the eye overall, swelling of the membranes.
Mouth and throatSwelling around the mouth and throat, postnasal drip (throat clearing).
AirwaysSneezing, coughing, bronchoconstriction, wheezing and dyspnea, shortness of breath, chest tightness, sometimes outright attacks of asthma, in severe cases the airway constricts due to swelling known as laryngeal edema.
EarsFeeling of fullness, itchy ears, possibly pain, and impaired hearing due to the lack of eustachian tube drainage.
SkinRashes, such as eczema and hives (urticaria), itchy and swelling skin, dry skin associated with significant itching, involvement of the face, the front of elbows, and behind knees, though the rash can occur anywhere, intense itching (typically not painful), raised, red, welts that resolve over hours to a day, swelling (particularly of the lips, face, hands, and feet).
Gastrointestinal tractAbdominal pain, nausea, bloating, vomiting, diarrhea.
All bodyLowering of blood pressure, light headedness, weakness, and anaphylaxis, collapse or loss of consciousness, in severe cases may cause death.

Acute response:

In the early stages of allergy, a type I hypersensitivity reaction against an allergen encountered for the first time and presented by a professional antigen-presenting cell causes a response in a type of immune cell called a TH2 lymphocyte; a subset of T cells that produce a cytokine called interleukin-4 (IL-4). These TH2 cells interact with other lymphocytes called B cells, whose role is production of antibodies. Coupled with signals provided by IL-4, this interaction stimulates the B cell to begin production of a large amount of a particular type of antibody known as IgE. Secreted IgE circulates in the blood and binds to an IgE-specific receptor (a kind of Fc receptor called FcεRI) on the surface of other kinds of immune cells called mast cells and basophils, which are both involved in the acute inflammatory response. The IgE-coated cells, at this stage, are sensitized to the allergen.

If later exposure to the same allergen occurs, the allergen can bind to the IgE molecules held on the surface of the mast cells or basophils. Cross-linking of the IgE and Fc receptors occurs when more than one IgE-receptor complex interacts with the same allergenic molecule, and activates the sensitized cell. Activated mast cells and basophils undergo a process called degranulation, during which they release histamine and other inflammatory chemical mediators (cytokines, interleukins, leukotriene, and prostaglandins) from their granules into the surrounding tissue causing several systemic effects, such as vasodilation, mucous secretion, nerve stimulation, and smooth muscle contraction. This results in rhinorrhea, itchiness, dyspnea, and anaphylaxis. Depending on the individual, allergen, and mode of introduction, the symptoms can be system-wide (classical anaphylaxis), or localized to particular body systems; asthma is localized to the respiratory system and eczema is localized to the dermis.

Late-phase response:

After the chemical mediators of the acute response subside, late-phase responses can often occur. This is due to the migration of other leukocytes such as neutrophils, lymphocytes, eosinophil and macrophages to the initial site. The reaction is usually seen 2–24 hours after the original reaction. Cytokines from mast cells may play a role in the persistence of long-term effects. Late-phase responses seen in asthma are slightly different from those seen in other allergic responses, although they are still caused by release of mediators from eosinophil and are still dependent on activity of TH2 cells.

Allergic contact dermatitis:

Although allergic contact dermatitis is termed an "allergic" reaction (which usually refers to type I hypersensitivity), its pathophysiology actually involves a reaction that more correctly corresponds to a type IV hypersensitivity reaction. In type IV hypersensitivity, there is activation of certain types of T cells (CD8+) that destroy target cells on contact, as well as activated macrophages that produce hydrolytic enzymes.

The allergic diseases, hay fever and asthma, have increased in the Western world over the past 2–3 decades. Increases in allergic asthma and other atopic disorders in industrialized nations, it is estimated, began in the 1960s and 1970s, with further increases occurring during the 1980s and 1990s, although some suggest that a steady rise in sensitization has been occurring since the 1920s. The number of new cases per year of atopy in developing countries has, in general, remained much lower.

Although genetic factors govern susceptibility to atopic disease, increases in atopy have occurred within too short a time frame to be explained by a genetic change in the population, thus pointing to environmental or lifestyle changes. Several hypotheses have been identified to explain this increased rate, increased exposure to perennial allergens due to housing changes and increasing time spent indoors, and changes in cleanliness or hygiene that have resulted in the decreased activation of a common immune control mechanism, coupled with dietary changes, obesity and decline in physical exercise. The hygiene hypothesis maintains that high living standards and hygienic conditions exposes children to fewer infections. It is thought that reduced bacterial and viral infections early in life direct the maturing immune system away from TH1 type responses, leading to unrestrained TH2 responses that allow for an increase in allergy.

Changes in rates and types of infection alone however, have been unable to explain the observed increase in allergic disease, and recent evidence has focused attention on the importance of the gastrointestinal microbial environment. Evidence has shown that exposure to food and fecal-oral pathogens, such as hepatitis A, Toxoplasma gondii, and Helicobacter pylori (which also tend to be more prevalent in developing countries), can reduce the overall risk of atopy by more than 60% and an increased rate of parasitic infections has been associated with a decreased prevalence of asthma. It is speculated that these infections exert their effect by critically altering TH1/TH2 regulation. Important elements of newer hygiene hypotheses also include exposure to endotoxins, exposure to pets and growing up on a farm.

Effective management of allergic diseases relies on the ability to make an accurate diagnosis. Allergy testing can help confirm or rule out allergies. Correct diagnosis, counseling, and avoidance advice based on valid allergy test results reduces the incidence of symptoms and need for medications, and improves quality of life. To assess the presence of allergen-specific IgE antibodies, two different methods can be used: a skin prick test, or an allergy blood test. Both methods are recommended, and they have similar diagnostic value.

Allergy undergoes dynamic changes over time. Regular allergy testing of relevant allergens provides information on if and how patient management can be changed, in order to improve health and quality of life. Annual testing is often the practice for determining whether allergy to milk, egg, soy, and wheat have been outgrown, and the testing interval is extended to 2–3 years for allergy to peanut, tree nuts, fish, and crustacean shellfish. Results of follow-up testing can guide decision-making regarding whether and when it is safe to introduce or re-introduce allergenic food into the diet.

Skin Prick Testing:

Skin testing is the oldest and most reliable form of allergy testing. This form of testing has been performed for 100 years and continues to be the testing of choice for the diagnosis of allergic disease. Testing begins with a prick, puncture or scratch method, which involves the placing a drop of the allergen in question (usually a commercially available extract of pollens, molds, foods, pet dander, etc) on the skin and abrading the skin with a needle.

Skin testing is also known as "puncture testing" and "prick testing" due to the series of tiny punctures or pricks made into the patient's skin. Small amounts of suspected allergens and/or their extracts (e.g., pollen, grass, mite proteins, peanut extract) are introduced to sites on the skin marked with pen or dye (the ink/dye should be carefully selected, lest it cause an allergic response itself). A small plastic or metal device is used to puncture or prick the skin. Sometimes, the allergens are injected "intradermally" into the patient's skin, with a needle and syringe. Common areas for testing include the inside forearm and the back.

If the patient is allergic to the substance, then a visible inflammatory reaction will usually occur within 30 minutes. This response will range from slight reddening of the skin to a full-blown hive (called "wheal and flare") in more sensitive patients similar to a mosquito bite. Interpretation of the results of the skin prick test is normally done by allergists on a scale of severity, with +/− meaning borderline reactivity, and 4+ being a large reaction. Increasingly, allergists are measuring and recording the diameter of the wheal and flare reaction. Interpretation by well-trained allergists is often guided by relevant literature. Some patients may believe they have determined their own allergic sensitivity from observation, but a skin test has been shown to be much better than patient observation to detect allergy.

The positive control is usually histamine, which will cause a raised, itchy bump in anyone who is not taking an antihistamine medication, such as Benadryl. It is not possible to be allergic to histamine, as this chemical is present in the body. A positive histamine skin test means that any skin tests performed at that same time with a negative result are in fact, truly negative (and that the negative result was not just due to the person taking an antihistamine, for example).

The negative control is usually a saltwater, or saline, substance. The purpose of this test is to ensure that a person does not have an irritant effect from the pricking of the needle. A negative skin test result to the negative control ensures that the positive skin test results are not due to an irritant effect from a person with very sensitive skin.

If the prick skin test results are negative to various allergens, but a person’s history of allergies suggest that these results should be positive, then another test, called an intradermal skin test, can be performed. Intradermal skin testing, which involves the injection of a diluted allergen extract under the top layer of the skin with a needle, may be able to diagnose more people with the allergic disease than with the prick test alone. Unfortunately, intradermal skin tests may cause false-positive results, and these tests cannot be used in testing for food allergies.

A skin test represents allergic disease in miniature. It is a useful tool for people to see (and feel) their positive skin test to cat dander, for example, to truly understand that they are allergic to cats. This educational experience is much more dramatic than handing a person a report of a positive cat allergy test performed using a blood test.

Patch Testing:

Patch testing is a method used to determine if a specific substance causes allergic inflammation of the skin. It tests for delayed reactions. It is used to help ascertain the cause of skin contact allergy, or contact dermatitis. Adhesive patches, usually treated with a number of common allergic chemicals or skin sensitizers, are applied to the back. The skin is then examined for possible local reactions at least twice, usually at 48 hours after application of the patch, and again two or three days later.

Blood Testing:

An allergy blood test is quick and simple, and can be ordered by a licensed health care provider (e.g., an allergy specialist) or general practitioner. Unlike skin-prick testing, a blood test can be performed irrespective of age, skin condition, medication, symptom, disease activity, and pregnancy. Adults and children of any age can get an allergy blood test. For babies and very young children, a single needle stick for allergy blood testing is often more gentle than several skin pricks.

An allergy blood test is available through most laboratories. A sample of the patient's blood is sent to a laboratory for analysis, and the results are sent back a few days later. Multiple allergens can be detected with a single blood sample. Allergy blood tests are very safe, since the person is not exposed to any allergens during the testing procedure.

The test measures the concentration of specific IgE antibodies in the blood. Quantitative IgE test results increase the possibility of ranking how different substances may affect symptoms. A rule of thumb is that the higher the IgE antibody value, the greater the likelihood of symptoms. Allergens found at low levels that today do not result in symptoms can’t help predict future symptom development. The quantitative allergy blood result can help determine what a patient is allergic to, help predict and follow the disease development, estimate the risk of a severe reaction, and explain cross-reactivity.

A low total IgE level is not adequate to rule out sensitization to commonly inhaled allergens. Statistical methods, such as ROC curves, predictive value calculations, and likelihood ratios have been used to examine the relationship of various testing methods to each other. These methods have shown that patients with a high total IgE have a high probability of allergic sensitization, but further investigation with allergy tests for specific IgE antibodies for a carefully chosen of allergens is often warranted.

Laboratory methods to measure specific IgE antibodies for allergy testing include enzyme-linked immunosorbent assay (ELISA, or EIA), radioallergosorbent test (RAST) and fluorescent enzyme immunoassay (FEIA).

Radioallergosorbent testing (RAST) is an outdated form of allergy testing that involves measuring specific allergic antibodies from a blood sample. While RAST is still available, newer forms of blood testing for allergies involves the use of enzyme-linked immunosorbent assays (ELISA), which involves the binding of allergic antibodies in a blood sample to an allergen, which results in a color change when a developer is added. The darkness of this color change can be measured and translated into a concentration or amount of allergic antibody in the blood sample. While the quality of allergy blood testing has improved in recent years, it is still limited in the number of tests available, as well as the smaller amount of minor allergens present in a particular test (such as a certain pollen or pet dander).

Allergy blood testing has recently become more useful in the diagnosis and management of food allergies, however. While skin testing to foods can give a sense, based on the size of the reaction, whether a person is truly allergic to the food, allergy blood testing actually measures the amount of allergic antibody to the food. This value can help determine is a child has possibly outgrown the food allergy, for example.

The high cost of allergy blood testing, as opposed to the less expensive skin test, as well as the delay in results of days to weeks, also makes it less desirable than skin testing. Skin testing also continues to be the better test, with less false-positive and false-negative results.

Challenge Testing:

Challenge testing is when small amounts of a suspected allergen are introduced to the body orally, through inhalation, or via other routes. Except for testing food and medication allergies, challenges are rarely performed. When this type of testing is chosen, it must be closely supervised by an allergist.

Challenging a person to an allergen means that the person is deliberately exposed to the substance, such as having the person eat a food to which an allergy is suspected. Food challenges are frequently performed to see if a child has outgrown a food allergy, or if a positive skin test actually represents an allergy. Food challenges are potentially very dangerous and should only be performed by allergy physicians experienced in their use.

Challenging a person to a non-food allergen, such as pollen or pet dander, is not usually done in an office setting; however, these tests may be performed in academic or research settings.

Elimination/Challenge Tests:

This testing method is used most often with foods or medicines. A patient with a suspected allergen is instructed to modify his diet to totally avoid that allergen for a set time. If the patient experiences significant improvement, he may then be "challenged" by reintroducing the allergen, to see if symptoms are reproduced.

Unreliable Tests:

There are other types of allergy testing methods that are unreliable, including applied kinesiology (allergy testing through muscle relaxation), cytotoxicity testing, urine auto-injection, skin titration (Rinkel method), and provocative and neutralization (subcutaneous) testing or sublingual provocation.

Is Allergy Testing Safe?

Skin testing is extremely safe, especially when performed by an allergist experienced in the diagnosis of allergies. Whole-body allergic reactions, sometimes called anaphylaxis, are extremely rare from skin testing. However, given the possibility that anaphylaxis could occur as a result, skin testing should only be performed in a doctor’s office with equipment available to treat such reactions.

Young children can also be safely skin tested, including infants. Typically, infants do take tests for food allergies, although they may have a pet or dust mite allergies as well.

Since allergy blood testing involves testing for allergies on a person’s blood, there is no chance that the person will develop an allergic reaction as a result of the testing. However, the chance that a person will have a side effect from drawing blood, such as fainting, excessive bleeding, or infection, is actually higher than that of a side effect from allergy testing.

Certain groups of people cannot have skin testing, and therefore allergy blood testing is a better test. These groups include those who cannot stop their antihistamine medications; those with sensitive skin (and a “reaction” to the negative control), those taking certain blood pressure medications (such as beta-blockers), and those with serious heart and lung conditions that put them at increased risk if anaphylaxis should occur.


First step is to determine if the reaction is allergic. This is usually done by a doctor. Before a diagnosis of allergic disease can be confirmed, other possible causes of the presenting symptoms should be considered. Vasomotor rhinitis, for example, is one of many illnesses that share symptoms with allergic rhinitis, underscoring the need for professional differential diagnosis. Once a diagnosis of asthma, rhinitis, anaphylaxis, or other allergic disease has been made, there are several methods for discovering the causative agent of that allergy:

Establish if there are other members of the family or close relatives that have allergy.
Identify possible allergens that may have triggered the allergic reaction.
History of recent contacts or intake (eating, drinking or injection) of possible allergens that may have triggered the allergic reaction.
Radiometric assays include the radioallergosorbent test (RAST test) method, which uses IgE-binding (anti-IgE) antibodies labeled with radioactive isotopes for quantifying the levels of IgE antibody in the blood. Other newer methods use colorimetric or fluorescence-labeled technology in the place of radioactive isotopes.

The RAST methodology was invented and marketed in 1974 by Pharmacia Diagnostics AB, Uppsala, Sweden, and the acronym RAST is actually a brand name. In 1989, Pharmacia Diagnostics AB replaced it with a superior test named the ImmunoCAP Specific IgE blood test, which uses the newer fluorescence-labeled technology.

American College of Allergy Asthma and Immunology (ACAAI) and the American Academy of Allergy Asthma and Immunology (AAAAI) issued the Joint Task Force Report "Pearls and pitfalls of allergy diagnostic testing" in 2008, and is firm in its statement that the term RAST is now obsolete:

The term RAST became a colloquialism for all varieties of (in vitro allergy) tests. This is unfortunate because it is well recognized that there are well-performing tests and some that do not perform so well, yet they are all called RASTs, making it difficult to distinguish which is which. For these reasons, it is now recommended that use of RAST as a generic descriptor of these tests be abandoned.

The new version, the ImmunoCAP Specific IgE blood test, is the only specific IgE assay to receive Food and Drug Administration approval to quantitatively report to its detection limit of 0.1kU/l.

Giving peanut products early may decrease the risk allergies while only breastfeeding during at least the first few months of life may decrease the risk of dermatitis. There is no good evidence that a mother's diet during pregnancy or breastfeeding affects the risk. Nor is there evidence that delayed introduction of certain foods is useful. Early exposure to potential allergens may actually be protective.

Fish oil supplementation during pregnancy is associated with a lower risk. Probiotic supplements during pregnancy or infancy may help to prevent atopic dermatitis.

Holistic approach for the prevention and treatment of allergies through medication, vitamin and mineral supplements, exercise, herbal medicine, home remedy, Chinese medicine, homeopathy, and medications:

Prognosis and Complications:

Are, your symptoms of allergic rhinitis will be readily treated, but they will continue to appear with each exposure to an allergen. Although perennial allergic rhinitis is not a serious condition, it nonetheless can interfere with many important aspects of life. Depending on the severity of your case, allergic rhinitis may be mildly disruptive to temporarily debilitating, resulting in missed days from school or work. Medication may cause drowsiness and other side effects. Your allergies could also trigger other conditions such as eczema, asthma, sinusitis, and ear infection (called otitis media). Seasonal allergic rhinitis may diminish as you age.

Desensitization may cause uncomfortable side effects (such as hives and rash) and may have dangerous side effects such as anaphylaxis. It often requires years of treatment and is effective in about two-thirds of cases.

Nutrition and Diet for Allergies:

Nutrition and diet help in the allergy treatment and allergy prevention. If you have food allergy, eliminate those items from your diet. Even if you don't have any identified food allergy, try a diet that is rich in fruits and vegetables, reduce the intake of foods that may stimulate inflammation (such as meats, full fat dairy products, sugar, and highly processed foods). Change in your diet may improve allergic symptoms. Include essential fatty acids in your diet:

Omega-6 fatty acids have a longstanding history of folk use as allergy treatment. They are essential fatty acids (EFAs), meaning that they are needed by the body and must be obtained from the diet. People who are prone to allergies may require more essential fatty acids and often have difficulty converting linoleic acid (an inflammation-provoking type of omega-6 fatty acid) to gamma-linolenic acid (an anti-inflammatory omega-6 fatty acid). Studies on the use of essential fatty acids for allergy treatment and prevention have had mixed results. Whether taking a gamma linoleic acid supplement improves your symptoms, therefore, may be very individual. Work with your healthcare provider to first determine if it is safe for you to try gamma linoleic acid and then follow your allergy symptoms closely for any signs of change. Gamma linoleic acid is found in spirulina and seed oils of evening primrose, black currant, borage, and fungal oils.

In terms of dietary changes relative to essential fatty acids, you should try to eat foods rich an omega-3 fatty acids (such as cold-water fish, flaxseeds, and walnuts). Eating foods rich in omega-3 fatty acids and limiting foods with omega-6 fatty acids (found, for example, in egg yolks, meats, and cooking oils including corn, safflower, and cottonseed,) may reduce allergy symptoms in general. This is because omega-3 fatty acids tend to decrease inflammation while omega-6 fatty acids (other than GLA) tend to increase inflammation.

Studies suggest that L. acidophilus, "friendly" bacteria found in the intestines, enhance the immune system and helps in the allergy treatment and allergy prevention. It is thought to have the potential to lower the risk of allergies and suppress allergy symptoms, including allergic rhinitis. Low-allergen foods are being developed, as are improvements in skin prick test predictions; evaluation of the atopy patch test; in wasp sting outcomes predictions and a rapidly disintegrating epinephrine tablet, and anti-IL-5 for eosinophilic diseases.


Several medications may be used to block the action of allergic mediators, or to prevent activation of cells and degranulation processes. These include antihistamines, glucocorticoids, epinephrine (adrenaline), mast cell stabilizers, and anti-leukotriene agents are common treatments of allergic diseases. Anti-cholinergic, decongestants, and other compounds thought to impair eosinophil chemo taxis, are also commonly used. Although rare, the severity of anaphylaxis often requires epinephrine injection, and where medical care is unavailable, a device known as an epinephrine auto injector may be used.


In conditions where the allergens cannot be avoided, allergen immunotherapy is used for allergy treatment and alleviation of allergy symptoms. Immunotherapy, commonly called allergy shots or injections, can be given to desensitize a person to the allergen. With allergen immunotherapy, allergic reactions can be prevented or reduced in number or severity. Immunotherapy involves exposing people to larger and larger amounts of allergen in an effort to change the immune system's response. However, allergen immunotherapy is not always effective. Some people and some allergies tend to respond better than others. Immunotherapy is used most often for allergies to house dust mites, pollen, insect bites, animal dander, allergic rhinitis in children and in asthma. The benefits may last for years after treatment is stopped. It is generally safe and effective for allergic rhinitis and conjunctivitis, allergic forms of asthma, and stinging insects.

The evidence also supports the use of sublingual immunotherapy for rhinitis and asthma but it is less strong. For seasonal allergies the benefit is small. In this form the allergen is given under the tongue and people often prefer it to injections. Immunotherapy is not recommended as a stand-alone treatment for asthma.

Immunotherapy injections in some occasions may cause dangerous allergic reactions in itself. Thus, this should be done by a certified medical practitioner and done with sufficient medical observation. If the person has mild allergic reactions to immunotherapy, a drug- antihistamine is given.

Allergy Shots:

Allergy shots (subcutaneous immunotherapy) are the most common form of immunotherapy. They can be used as a long-term treatment for seasonal, indoor and insect sting allergies.

They work by getting your body used to the allergen slowly, with the hopes that you will develop an immunity or tolerance to the allergen. The process takes place in two phases, the build-up phase and the maintenance phase.

The build-up phase involves a small amount of the allergen being injected into the upper arm once or twice a week for a few months. The dosage is gradually increased at each visit. The length of the build-up phase depends entirely on your body’s reaction.

Once you have reached the effective dose, typically the most you can handle without showing symptoms, the maintenance phase will begin. The dosage is no longer increased at each visit and the number of shots is decreased. The maintenance phase involves an allergy shot once every month for three to five years.

Since allergy shots contain a substance you are allergic to, there are some risks involved. Swelling and redness usually develop at the site of injection but are quick to clear up. Sneezing, nasal congestion and hives may develop as well as more severe reactions such as wheezing or chest-tightness. Anaphylaxis, the most serious reaction, rarely occurs. Since these shots are administered in a clinical setting, any reaction that does occur can be easily treated.

Allergy symptoms will not improve overnight; symptoms will typically improve over the first year of treatment and continue to improve over the next few years. The shots may even decrease symptoms for other allergens and prevent new allergies from developing.

Allergy Drops:

Allergy drops, also known as sublingual immunotherapy, are a more effective treatment than over-the-counter pills because they combat the cause of allergies rather than the symptoms. They are also safer than allergy shots because they aren’t administered with a needle.

The principle of allergy drops is the same as allergy shots. It is a long-term treatment that decreases symptoms by increasing the body’s immunity. The patient drips liquid containing allergens under the tongue and holds it there for one to two minutes before swallowing. This is a more convenient option than allergy shots for many patients because allergy drops can be safely administered at home rather than at the doctor’s office.

The dose varies by patient depending on several factors, including severity of allergies and sensitivity to allergy drop dosages. Patients generally self-administer treatments between three and seven days per week for an average of three to five years. The goal is to build up the body’s immunity to allergens so the patient no longer experiences symptoms once the treatment is over.

Like all medical procedures, there are possible risks and side effects. However, these are generally mild, ranging from localized itching in the mouth to intestinal discomfort, which often goes away after several weeks.

Allergy drops are an important new treatment option for patients constantly refilling over-the-counter allergy medications or taking daily trips to the doctor’s office for allergy shots. Currently, allergy drops are effective for treating asthma related to dust mites, as well as allergies to grass, ragweed, pet dander and tree pollen. Researchers hope to expand the treatment’s effectiveness for other allergies such as hay fever, eczema and food sensitivities.


Antihistamine drugs: epinephrine (Adrenalin), doxepin (Sinequan, Zonalon), cromolyn (Crolom, Intal, Nasalcrom). The drugs most commonly used to relieve the symptoms of allergies and used as allergy treatment are antihistamines. Some antihistamines are available without a prescription, and some require a prescription. Antihistamines block the effects of histamine rather than stop its production. Taking antihistamines partially relieves the itching and reduces the swelling due to hives or mild angioedema.

Homeopathic Medicine:

Homeopathy is also used for allergy treatment and prevention. Although few studies have examined the effectiveness of specific homeopathic therapies, professional homeopaths may consider the following remedies for allergy treatment especially allergic rhinitis. Before prescribing an allergy treatment, homeopaths take into account a person's constitutional type. A constitutional type is defined as a person's physical, emotional, and psychological makeup. An experienced homeopath assesses all of these factors when determining the most appropriate treatment for each individual based from their knowledge and experience:

Allium cepa (raw onion): 

Allergy treatment for frequent sneezing, a lot of irritating nasal discharge and tearing eyes. The person tends to thirst frequently.

Euphrasia (eyebright):

Allergy treatment for bland nasal discharge, with stinging, irritating tears; a suitable person for this remedy has worse nasal symptoms when lying down.

Nux vomica (poison nut):

Allergy treatment for stuffiness with nasal discharge, dry, ticklish, and scraping nasal sensations with watery nasal discharge and a lot of sneezing; an appropriate person for this remedy is irritable and impatient.

Arsenicum album (trioxide of arsenic):

For stuffiness with copious, burning nasal discharge and violent sneezing; an appropriate candidate for Arsenic feels restless, anxious, and exhausted.

Vitamins and Minerals:

If you have any food allergies, eliminate those items from your diet. Even if you don't have any identified food allergy, reducing the intake of foods that may stimulate inflammation (such as meats, full fat dairy products, sugar, and highly processed foods) may improve your symptoms.

Vitamin C:

Research has shown that vitamin C can reduce blood levels of histamine. Studies have shown that 1,000 milligrams of vitamin C drastically reduced the blood histamine level of a group of volunteers. Some doctors picking up from this study suggests vitamin C as part of allergy treatment.

Vitamin B:

Alan Gaby, M.D. said "I often get good results by treating hay fever with supplements of pantothenic acid," (from the book Blended Medicine, Michael Castleman) He recommends to take 100 to 1,000 milligrams of vitamin B every day.


Supplements is may help suppress cough, reduce nasal mucus associated with sinusitis, and relieve the swelling and inflammation caused by hay fever and is generally used for allergy treatment. This supplement is often administered with quercetin.


Is another supplement used for allergy treatment together with bromalain. Quercetin is a flavonoid, a plant pigment responsible for the colors found in fruits and vegetables. Quercetin acts as allergy treatment by inhibiting the production and release of histamine.

An experimental treatment, enzyme potentiated desensitization (EPD), has been tried for decades but is not generally accepted as effective. EPD uses dilutions of allergen and an enzyme, beta-glucuronidase, to which T-regulatory lymphocytes are supposed to respond by favoring desensitization, or down-regulation, rather than sensitization. EPD has also been tried for the treatment of autoimmune diseases but evidence does not show effectiveness.

A review found no effectiveness of homeopathic treatments and no difference compared with placebo. The authors concluded that, based on rigorous clinical trials of all types of homeopathy for childhood and adolescence ailments, there is no convincing evidence that supports the use of homeopathic treatments.

According to the National Center for Complementary and Integrative Health, U.S, the evidence is relatively strong that saline nasal irrigation and butterbur are effective, when compared to other alternative medicine treatments, for which the scientific evidence is weak, negative, or nonexistent, such as honey, acupuncture, omega 3's, probiotics, astragalus, capsaicin, grape seed extract, Pycnogenol, quercetin, spirulina, stinging nettle, tinospora or guduchi.

Herbal Medicine:

If you plan to use herbs for allergy treatment and prevention, you are advised to consult a qualified herbalist for proper dosage and administration. Herbal supplements or herbs, like other medications, may produce side effects or interact with other medications. It is best to follow instructions as prescribed by herbalist or by the product label.

Stinging Nettle (Urtica dioica/Urtica urens):

Has long history as treatment for variety of respiratory conditions, including allergic rhinitis. Though studies have shown favorable results, more research is needed. Discuss with your doctor about whether it is safe for you to try nettle as a possible allergy treatment. Freeze-dried nettle capsules can be bought from many health food stores. Recommended dose is 600 milligrams per day.

Butterbur (Petasites hybridus):

Has long been used for the treatment of asthma and bronchitis and to reduce mucus. A study of 125 people with hay fever found that an extract of this herb was as effective and less sedating than cetirizine, a commonly prescribed non-sedating antihistamine. The study lasted only 2 weeks, and while it shows promise, it is not known what would be the effect of using butterbur over a longer time period.

Echinacea (Echinacea angustifolia, Echinacea pallida, Echinacea purpurea):

Professional herbalists may recommend echinacea for allergy treatment especially allergic rhinitis. Test tube and animal studies suggest that echinacea contains substances that enhance the activity of the immune system and reduce inflammation. However, echinacea itself can cause an allergic reaction.

Evening Primrose (Oenothera biennis):

Is known as an allergy treatment especially for allergic rhinitis. Its active ingredient is gamma-linolenic acid (GLA), an essential fatty acid that may relieve allergy symptoms (see Nutrition and Dietary Supplement section).

Goldenseal (Hydrastis canadensis):

Is traditionally known to be a natural antibiotic and antiseptic. Many herbalists include it in allergy treatment. Many laboratory studies suggest that berberine, the active ingredient in goldenseal, has antibacterial and immune-enhancing properties.

Herbal Tea Bath:

Is also recommended for allergy treatment and prevention. Herbal tea bath is used to calm an overactive immune system. Herbal tea from the blend of calendula flowers, lavender flowers, eyebright flowers, or German chamomile are used. This is prepared 1 day before the planned use, by mixing equal amount of herbs to produce a ¼ mixture. Let it soak to 4 cups of tap water and allow to steep overnight. On the next day boil the mixture. Remove from heat and let it steep for 15 minutes. Strain the herbs and pour the mixture to your bath, then soak.

Chinese Medicine:

Chinese skullcap (Scuterllaria baicalensis):
Has been studied for its effectiveness in both animals and people. It has antioxidative, anti-inflammatory, and antihistamine properties. This makes it potentially useful for treating allergic rhinitis, particularly when used with other herbs, including stinging nettle.


Is a Chinese herbal formula used to treat allergic rhinitis. In a recent Western study of 58 people with year-round allergic rhinitis, biminne was found to effectively relieve at least some symptoms in most of the participants. Participants took the formula five times a day for 12 weeks, and they still showed the benefit of biminne even after one year. It is not known how biminne works, or if it is safe to use for extended periods.

Ephedra (Ephedra sinica):

Also called ma huang, has been used in Traditional Chinese Medicine for more than 5,000 years. It is used to treat nose and lung congestion. Synthetic ephedrine compounds, such as pseudoephedrine, are widely used in over-the-counter cold remedies. However, ephedra and its derivatives are potentially dangerous and addictive. Take only under the close guidance and supervision of an appropriately trained specialist.

The best home remedy allergy treatment and home allergy prevention is the avoidance from allergen. The first step is to determine the allergens that would trigger your allergy. Avoid the allergens whenever possible. Avoiding an allergen may involve discontinuing a drug (medication allergy), avoiding foods and food derivatives (food allergy), keeping a pet out of the house (rhinitis), being selective in using materials, installing high-efficiency air filters. A person with severe seasonal allergies may consider moving to an area that does not have the allergen. A person with an allergy to house dust should remove items that collect dust:

  • Stay indoors as much as possible when pollen counts are at their peak, usually during the mid-morning and early evening, and when wind is blowing pollens around.
  • Keep windows closed, especially on windy days and during pollen season. Use air conditioning in your car and home when necessary. Air conditioning units should be kept clean. Avoid using window fans that can draw pollens and molds into the house.
  • Wear glasses or sunglasses when outdoors to minimize pollen getting into your eyes.
  • Avoid rubbing eyes, which will only irritate them or make your condition worse.
  • Clean floors with a damp rag or mop rather than dry dusting or sweeping.
  • Wash your hands immediately after petting any animals. Remove and wash clothing after visiting friends with pets.
  • Make sure to bathe pets once a week and keep them out of your bedroom and off the furniture.
  • Keep pets out of the bedroom to limit exposure to pet dander while sleeping.
  • Reduce indoor molds caused by high humidity by cleaning bathrooms, kitchens and basements regularly. A dehumidifier can be used to reduce molds, especially in damp, humid places like basements. Make sure the dehumidifier is cleaned often. To clean moldy areas in the home, use a 1-to-10 parts diluted mixture of chlorine bleach and water.
  • Install a filter over bedroom air vents to prevent pet dander, dust, and molds from being blown in from other parts of the house through heating or air-conditioning ducts.
  • Use window shades or curtains that can be laundered or cleaned frequently, instead of heavy drapes. Use only washable window coverings, such as cotton or synthetic curtains
  • Remove carpeting from your home and replace with easy to clean material such as hardwood or linoleum. If the wall-to-wall carpeting cannot be removed, vacuum and shampoo the carpet regularly.
  • Don't hang sheets or clothing outdoors to dry, as pollens and molds can collect on them.
  • Keep your house at 68 F to 72 F. Dust mites and mold breed best in hot humid conditions. 
  • Do not use a feather- or down-filled pillow.
  • Keep dust from accumulating by vacuuming floors and cleaning surfaces weekly.
  • Keep small knickknacks, books, and CDs inside cabinets or drawers so that they don't collect dust. Get rid of clutter. This means removing any knickknacks that sit on tables collecting dust.
  • Keep potted plants out of the house – either plant them outside or give them away.
  • Avoid using a wood-burning fireplace or stove; the smoke will worsen respiratory allergies.
  • Nasal irrigation – rinsing the nasal passages with a saltwater solution, using a bulb syringe or Neti pot – can help reduce the symptoms of hay fever.
  • Don’t allow smoking inside your home.
  • Wash bed linens in hot water (at least 130° Fahrenheit) and use your dryer's hottest setting to kill mites and control animal allergens.Enclose pillows, mattresses, and box springs in zippered, air-tight casings to curtail mite activity.
  • Replace synthetic pillows every 2 to 3 years.

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