Apr 30, 2013 8:00 AM

Author: Kevin Wilson, MD

What Are Allergies?

Allergies are a common chronic disorder that affects about 50 million Americans. They afflict people of all ages, often beginning in childhood or young adult years. They can be seasonal or perennial (year-round), depending on the offending allergens. Common causes of allergies are pollens, pet dander, dust mites, and mold. Symptoms include nasal congestion, runny nose, sneezing, itching, coughing, wheezing, and itchy-watery eyes. They can contribute to sinus infections, ear infections, and asthma.

How Are Allergies Treated?

Many allergy sufferers self-medicate with over-the-counter medications such as antihistamine pills or decongestants. While these can be helpful for some, they may not adequately treat a patient’s specific symptoms. Prescription medications like nasal sprays and eye drops can be useful for many who have persistent symptoms. Many people find nasal/sinus rinses (e.g., neti pot) to be helpful in washing out the allergens and mucus, especially after a large exposure like mowing the lawn or visiting a relative or friend with a cat.

Why Allergy Testing?

It can be useful to know what you are allergic to in order to decrease exposure through avoidance and environmental modification. Allergy skin testing is a quick and painless way to determine which allergens you might be sensitized to. These results can also be used to specifically treat those offending allergens with immunotherapy.

What Is Immunotherapy?

Immunotherapy, or allergy desensitization, is a treatment in which a patient is exposed to their most significant allergens in order to desensitize their immune system to those allergens. Rather than treat the symptoms alone, as in medications, immunotherapy actually eliminates the underlying allergy. Increasing doses of the allergen are administered over time to induce tolerance. Typical treatment length is 3-5 years, and the immunity can be maintained for many more years.

Subcutaneous Immunotherapy

Traditional “allergy shots” induce the immune system to fight allergies safely, effectively, and naturally. Beginning with small doses and increasing gradually on a weekly basis, the therapy continues until a maintenance level is achieved. The maintenance dose is then injected on a less frequent basis. This therapy is usually covered by insurance.

Sublingual Immunotherapy

Sublingual immunotherapy (SLIT) is a newer method for treating allergies where drops of the allergen solution are placed under the tongue daily. They have been shown to be as effective as shots, but without the needles. They are also safer than shots, allowing the drops to be given at home without having to come to the clinic. While SLIT is not FDA-approved (off-label) and, therefore, not covered by insurance, the cost is reasonable and preferred by many patients.

Personal Experience

It has been very rewarding for me to see the benefit of specific allergy treatment in my patients. Most of my patients who are receiving immunotherapy have had reduced symptoms, reduced need for medications, and improved quality of life. My patients tell me that they are so happy not to have to rely on their medications to help them lead a normal life. Even I suffer from seasonal allergies and am currently undergoing immunotherapy with good results.

Kevin Wilson, MD

Kevin F. Wilson, MD, is a board-certified physician specializing in otolaryngology and head and neck surgery.


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