How are allergies treated?

Diana Meeks
Diana Meeks on behalf of Sigma Nursing
Family Practitioner

The best treatment for allergies is avoiding the allergen-which helps prevent the allergies as well. Minor symptoms can usually be treated by antihistamines. Mast cell stabilizers and corticosteroids may be used if symptoms persist. In severe allergy cases, you should seek emergency medical treatment immediately. If you have a severe allergy, you should always carry an epinephrine syringe for immediate treatment, and you should follow up with a visit to the hospital for monitoring.

Dr. Mehmet Oz, MD
Cardiologist (Heart Specialist)

The three basic ways to treat allergies are medication, allergy shots (also called immunotherapy) and avoidance.

I recommend avoidance for allergens you know. Regularly taking medications or having allergy shots can help you with common and non-life threatening allergies, such as an allergy to pollen (causing hay fever) or cat dander. If you have a serous allergy that triggers a dangerous respiratory reaction (or anaphylactic reaction), you should carry an "epi pen" to inject yourself with epinephrine to help open your airways enough so you can get to a hospital for treatment.

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Bothered by seasonal allergies? In this WisePatient video, internist Carlos Rios, MD, of The Mount Sinai Medical Center, discusses potential treatments to relieve allergy symptoms, starting with over-the-counter antihistamines.

One of the best ways to treat allergy symptoms is with a nasal-corticosteroid spray such as Flonase or Nasonex (which requires a prescription) because steroids help with inflammation.

Nasal steroid sprays deliver the medication directly to the source of the issue—the sinus cavity. Reduced inflammation means a reduction in symptoms such as runny nose, congestion, cough and sore throat. There are very few side effects since there is no widespread absorption of the medication.

Nasal steroid sprays are ideal for people suffering from allergy symptoms that are not responding to OTC antihistamines.

For allergies, we’ll treat your symptoms too: if you’re itching, we’ll give you medication to soothe the itchiness. However, allergies are caused by allergens. Once we find out what you’re allergic to and remove it, then your symptoms should subside. For example, you can leave a room if there’s something you’re allergic to in it.

Allergies are treated in three ways: avoidance of allergy triggers, immunotherapy and medications. Avoidance of outdoor allergy triggers includes using an air conditioner and staying indoors during times when pollen and mold levels peak. People with dust allergies might consider removing wall-to-wall carpeting (which can trap dust) and wash bedding, curtains and clothing often in hot water to kill or reduce dust mites.

Immunotherapy, or allergy shots, involve injection of a mixture of the various things you are allergic to into your arm. Over time, the dose of what you are allergic to is increased so that your immune system learns to become desensitized to the allergens. Typically, the shots are given once or twice a week for the first three to six months of treatment and then are given every two to four weeks for up to 12 months. Allergy medications include antihistamines, decongestants, bronchodilators and anti-inflammatory medications. Histamine is released in your body in an allergic reaction causing inflammation, and antihistamines block this reaction. Some people may benefit from decongestants to relieve a stuffy nose and other allergy symptoms. Other medications include bronchodilators, which help open narrowed airways, and anti-inflammatory medications like cromolyn, nedocromil and corticosteroids.

Talk to your doctor about what treatments are right for you.

Want better allergy relief? If so, take good care of yourself. Living a healthy lifestyle makes a big difference. It's as important as getting tested, avoiding your triggers and taking your prescribed medication. That's because bad habits, stress and poor sleep not only aggravate allergy symptoms—they also make them much harder to cope with.

Try these five steps to boost your health so you can fend off allergy symptoms:

  • Eat a healthy diet. Can the right diet cure your allergies? No. But it can help soothe your symptoms. Load your plate with inflammation quenchers, such as fresh fruits and vegetables, nuts and fish. At the same time, cut back on foods that aggravate allergy-causing inflammation, including refined grains, red and cured meats, alcohol and foods high in saturated fat and sugar.
  • Exercise. Will regular exercise improve your allergy symptoms? It may not help directly, but it can help you cope with them. Exercise improves your sleep, overall health, immunity, fitness and energy levels. It also increases the production of mood-boosting neurotransmitters, such as dopamine, serotonin and norepinephrine, to help ease allergy-induced stress. Ask your doctor about exercises that are safe for allergies and asthma.
  • Kick bad habits. You'll have an easier time taming nasal allergy symptoms if you don't smoke and you avoid inflammation-inducing junk food and cut back on the mai tais.
  • Get more sleep. Allergy symptoms can steal your sleep, adding to the daytime fatigue and misery brought on by a stuffy nose, constant sneezing and itchy, watery eyes. Ease nighttime symptoms with dust-proof pillow and mattress covers, a high-efficiency particulate air (HEPA) filter in your bedroom and a hot shower before bed.
  • Reduce stress. Allergies can dial up stress fast, so carve out time for a daily round of meditation, positive visualization, yoga, tai chi or even a weekly massage. These remedies won't cure your allergies, but they'll dampen the stress that comes with them.

There are many effective treatments for allergies. For mild to moderate allergies, steroid nasal sprays are the medications of choice. These sprays block the release of certain chemicals that cause inflammation in the nasal cavity. Steroid nasal sprays can begin working in as little as 30 minutes, but it usually takes several hours to several days to notice an improvement in all-around symptoms. Some of the more common side effects of these sprays include nasal irritation, such as drying or stinging, and occasionally, nosebleeds. In general, nasal steroids are quite safe and they are now available over-the-counter.

For more severe allergies, antihistamines are often needed along with nasal steroids. These medications block histamine, a substance released by the body in response to allergens. Some oral antihistamines, such as diphenhydramine, can cause drowsiness and may be best when taken at night. For daytime use, consider loratadine (Claritin), fexofenadine (Allegra) or cetirizine (Zyrtec). Antihistamines in the form of a nasal spray are only available by prescription and are typically used to treat more severe allergy symptoms. Compared with oral antihistamines, nasal antihistamines directly target the nasal passages, but may cause a bitter taste and/or headache.

Over-the-counter decongestants may also be helpful in treating the stuffy noses that often go along with allergies. Pseudoephedrine and phenylephrine are common oral over-the-counter decongestants. Some asthma medications can also be used to treat allergies, but they are generally not as effective as nasal steroids or antihistamines.

There are many effective ways to free yourself from allergy symptoms. If you’re not helped by over-the-counter medicines or if you can’t find one that you can take without significant side effects, your doctor can offer alternatives that may relieve your suffering.

Prescription medications and inhaled steroids are just a few of the treatments that can block the histamines in your body causing a runny nose, watery eyes or itching skin. If those aren’t enough, you can try allergy shots. Allergy shots are an injection of small amounts of the thing that you’re allergic to. As the dose of that is increased gradually over time, your body builds up good antibodies.

Finding the treatment that works for you can be truly life changing. People who have year-round allergies find them hugely debilitating, and proper treatment makes a big difference in their lives. It gets them back to work and feeling better.

It is important to know what causes allergy symptoms, because the right diagnosis will lead to the right treatment.

There are three main causes of allergy symptoms: allergic rhinitis, irritant (nonallergic) rhinitis and mixed rhinitis.

Allergic rhinitis is an immune system response that has positive allergy tests (either scratch test or blood test). Allergic rhinitis is treated with the following medications that help reduce the immune response:

  • Nasal steroids and nasal antihistamines block the start of the immune cause of allergies.
  • Antihistamines block the effects of the immune cause of allergies.
  • Allergy immunotherapy changes the immune system’s response completely.

Irritant rhinitis is a nonimmune response that has negative (normal) allergy tests. Sometimes, a computed tomography (CT) scan of the sinuses may be necessary to make sure there are no structural causes of allergy symptoms. Irritant rhinitis is treated with the following medications that help reduce the topical (local) response.

  • Nasal steroids and nasal antihistamines are the best treatment for irritant allergy symptoms.
  • Sinus rinses also help treat an irritant cause of allergies.

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.