What is allergies (allergic rhinitis)?

Allergies occur when your body's defense system (immune system) overreacts to certain substances. The immune system treats a harmless substance as if it is a harmful germ or virus. Many things can make this happen. These include pollens, medicine, food, dust, animal dander, and mold.

Allergies can be mild or severe. Mild allergies can be managed with home treatment. But medicine may be needed to prevent problems.

Managing your allergies is an important part of staying healthy. Your doctor may suggest that you have testing to help find out what is causing your allergies.

Severe allergies can cause reactions that affect your whole body (anaphylactic reactions). Your doctor may prescribe a shot of epinephrine to carry with you in case you have a severe reaction. Learn how to give yourself the shot and keep it with you at all times. Make sure it is not expired.

When you have allergies, you may feel better or worse at different times of the year. Learning what triggers your allergy symptoms will help you manage and treat your allergies. Managing your allergies is an important part of your health and can help you avoid other problems.

Allergy symptoms may start within minutes or hours after you breathe in an allergen. And the symptoms can last for days.

When symptoms start right away, you may sneeze over and over again. This often happens after you wake up in the morning. You may have a tickle in your throat or coughing caused by postnasal drip. Your nose may be runny. And your eyes may be watery and itchy. Your ears, nose, and throat may also be itchy.

Other symptoms may take longer to appear. For example, you may have a stuffy nose. You may feel pressure in one or both ears, or have pain in your face. Your eyes may be sensitive to light. You may also have a long-lasting cough. Some people notice dark circles under their eyes.

Your symptoms may be better or worse at different times of the year.

The main treatments for allergic rhinitis are avoiding things you are allergic to (allergens), managing symptoms with medicine, and in some cases, getting immunotherapy (such as allergy shots). How often you need treatment depends on how often you have symptoms.

Avoiding allergens

Staying away from allergens may help you reduce your symptoms and manage them without medicine or with fewer medicines. For example, you may need to clean your house often to get rid of animal dander. Or you may need to stay indoors when pollen counts are high.

Managing symptoms

Taking medicines can help you manage your symptoms. For example, over-the-counter (OTC) or prescription allergy medicines may help relieve some of your symptoms. These include OTC corticosteroid nasal spray and prescription antihistamine nasal spray. Other medicines include antihistamine and decongestant pills and antihistamine eye drops.

Using immunotherapy

If medicines can't control your allergic rhinitis, you may think about having immunotherapy in the form of allergy shots or sublingual tablets. Each treatment has a small amount of allergen in it. They help your body "get used to" the allergen, so your body reacts less to it over time.

• Allergy shots are small doses of allergens that your doctor injects under your skin. The shots can be expensive, but they may cost less than the combined cost of medicine, doctor visits, emergency room visits, and missed days of school or work.
• With sublingual immunotherapy, you dissolve a tablet under your tongue daily.

Treatment for children

Treatment for children who have allergic rhinitis is much the same as for adults who have allergies. Treating children with medicine may be harder because of the possible side effects. Some medicines also may not be approved to treat children. Be safe with medicines. Read and follow all instructions on the label.

Many children are allergic to dust and dust mites. Dust mites are tiny bugs that get into bedding, furniture, and carpets. Dust mites are too small to be seen with the naked eye. When you sit on a chair, walk over a carpet, or lie on a bed, material produced by the mites is blown into the air. When breathed in, these can cause a runny nose, wheezing, and other symptoms.

It is impossible to get rid of dust or dust mites completely, but reducing them in your house may improve your child's allergy symptoms. Keep in mind that some of these measures may be costly. Start by doing what you and your budget can manage. Since your child spends one-third of his or her day in bed, focus on your child's bedroom first.

Your doctor can most often diagnose allergic rhinitis by doing a physical exam and asking you questions about your symptoms, activities, and home.

You may need allergy tests if:

• You and your doctor need to find out exactly what things you are allergic to. And then you can take steps to avoid them.
• Treatment is not helping your symptoms.
• You have severe symptoms.
• You are thinking about trying immunotherapy (such as allergy shots).

A skin test can show how your skin reacts to an allergen. Or a blood test can measure the level of antibodies that your body makes in response to certain allergens.

These tests can help your doctor know what is causing your symptoms and find the best treatment.

Side effects depend on the type of medicine.

• Corticosteroid sprays can dry or irritate the nose. They can cause coughing, sneezing, diarrhea, or nausea.
• Antihistamines such as cetirizine (Zyrtec) and loratadine (Claritin) cause few side effects. Antihistamines like diphenhydramine (Benadryl) and chlorpheniramine (Chlor-Trimeton) may have more side effects. For example, they may make you tired or cause dry eyes or a dry mouth. They can also cause heart, bowel, or bladder problems.
• Decongestants can cause a dry or irritated nose, sneezing, or a stinging or burning feeling in the nose. They may also cause a rapid heartbeat, blurred vision, or dizziness. Side effects can also include sleep problems or feeling anxious or over-excited.

Health professionals who can evaluate and treat mild allergic rhinitis symptoms include:

• Family medicine physicians.
• Pediatricians.
• Internists.
• Nurse practitioners.
• Physician assistants.

You may need to see an allergy specialist (allergist). This depends on your symptoms or which other treatments you may need. For example, you may need to see a specialist if your medicines are not working or cause severe side effects. Another reason is if you are thinking about getting immunotherapy (such as allergy shots).

Your doctor may refer you to an ear, nose, and throat (ENT) specialist (also called an otolaryngologist or otorhinolaryngologist). An ENT specialist may be helpful if your doctor thinks you may have nasal polyps or other things blocking your nose.

• If you have been told by your doctor that dust or dust mites are causing your allergy, decrease the dust around your bed:
  • Wash sheets, pillowcases, and other bedding in hot water every week.
  • Use dust-proof covers for pillows, duvets, and mattresses. Avoid plastic covers because they tear easily and do not "breathe." Wash as instructed on the label.
  • Do not use any blankets and pillows that you do not need.
  • Use blankets that you can wash in your washing machine.
  • Consider removing drapes and carpets, which attract and hold dust, from your bedroom.
• If you are allergic to house dust and mites, do not use home humidifiers. Your doctor can suggest ways you can control dust and mites.
• Look for signs of cockroaches. Cockroaches cause allergic reactions. Use cockroach baits to get rid of them. Then, clean your home well. Cockroaches like areas where grocery bags, newspapers, empty bottles, or cardboard boxes are stored. Do not keep these inside your home, and keep trash and food containers sealed. Seal off any spots where cockroaches might enter your home.
• If you are allergic to mold, get rid of furniture, rugs, and drapes that smell musty. Check for mold in the bathroom.
• If you are allergic to outdoor pollen or mold spores, use air-conditioning. Change or clean all filters every month. Keep windows closed.
• If you are allergic to pollen, stay inside when pollen counts are high. Use a vacuum cleaner with a HEPA filter or a double-thickness filter at least two times each week.
• Stay inside when air pollution is bad. Avoid paint fumes, perfumes, and other strong odors.
• Avoid conditions that make your allergies worse. Stay away from smoke. Do not smoke or let anyone else smoke in your house. Do not use fireplaces or wood-burning stoves.
• If you are allergic to your pets, change the air filter in your furnace every month. Use high-efficiency filters.
• If you are allergic to pet dander, keep pets outside or out of your bedroom. Old carpet and cloth furniture can hold a lot of animal dander. You may need to replace them.

You may be more likely to have allergic rhinitis and other allergies if:

• You have a family history of allergies, especially allergic rhinitis. A child is more likely to have an allergy if both parents have an allergy or have the same type of allergy.
• You are exposed to dust mites, animal dander, or other indoor allergens.
• You are exposed to pollens or molds.

Allergic rhinitis occurs when your immune system overreacts to particles in the air that you breathe. In other words, you are allergic to them. The particles are called allergens. Your immune system causes symptoms such as sneezing and a runny nose.

Allergens that cause allergic rhinitis include pollens and animal dander. Although polluted air is not an allergen, it can irritate your nose and lungs. An irritated nose or lungs may make an allergic reaction more likely when you breathe in an allergen.

Allergies occur when your body's defense system (immune system) overreacts to certain substances. The immune system treats a harmless substance as if it were a harmful germ or virus. Many things can cause this overreaction. These include pollens, medicine, food, dust, animal dander, and mold.

• The most important thing you can do is decrease the dust around your child's bed:
  • Wash sheets, pillowcases, and other bedding every week in hot water.
  • Use airtight, dust-proof covers for pillows, duvets, and mattresses. Avoid plastic covers because they tend to tear quickly and do not "breathe." Wash according to the instructions.
  • Remove extra blankets and pillows that your child does not need.
  • Use blankets that are machine-washable.
• Look for "dust catchers" in your child's room. Cloth-covered furniture, heavy drapes, flowers and houseplants, bookshelves, blinds, and stuffed animals collect dust and should be removed or wiped down with a wet cloth every week.
  • Use a wooden or metal chair instead of an upholstered one.
  • If you need to cover the windows, use lightweight curtains. Wash them every week with the bedding.
• Mop floors and wipe down furniture, tables, and other hard surfaces with a moist cloth 1 or 2 times a week.
• Change the air filter in your furnace every month. Use high-efficiency air filters.
• Keep the windows closed.
• Do not use window or attic fans, which draw dust into the air.
• Do not use home humidifiers. They can help mites live longer. Your doctor can give you further instructions on how to control dust and mites.
• Keep only clothes in the closet. Do not leave clothes on the floor.
• If possible, replace wall-to-wall carpet in bedrooms with tile, hardwood, or linoleum. You can use throw rugs as long as you wash them often. If you cannot remove carpeting, vacuum it at least 2 times a week. Use a vacuum cleaner with a HEPA filter or a special double-thickness filter. Keep your child out of the room for several hours after you vacuum.