ALLERGIC RHINITIS​

If you sneeze and cough, or your nose and eyes itch and are runny during certain times of the year, you may have seasonal allergies. Grass, pollen and mold are the most common triggers of seasonal allergies.

Allergic rhinitis, or hayfever, is the medical term for inflammation of the nasal passages due to an air-borne protein called an allergen.  Symptoms can include sneezing, runny nose, nasal congestion, and itchy nose.  Often, recurrent symptoms are confused for colds or sinus infections.  Uncontrolled allergic rhinitis can lead to restless sleep, chronic fatigue, poor concentration, antibiotic overuse, and sometimes poor performance in school or work. 

Perennial or “year-round” allergies might be caused by dust mites, mold, pet dander, cockroach, mice/rats. We work with you to help identify potential triggers for your symptoms.  Once potential triggers have been identified, we can work on a regimen that will include avoidance techniques and possible medications to help manage or alleviate your problems.  Only trained allergy physicians can effectively offer allergen immunotherapy (allergy shots) as a tool to help patients who suffer from allergic rhinitis.

ALLERGY TRIGGERS​

If you sneeze and cough, or your nose and eyes itch and are runny during certain times of the year, you may have seasonal allergies.

Grass, pollen and mold are the most common triggers of seasonal allergies.

Fall allergies include:

  • Burning bush
  • Cocklebur
  • Lamb’s-quarters
  • Pigweed
  • Sagebrush and mugwort
  • Tumbleweed and Russian thistle
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Seasonally Related Triggers:

While the term “seasonal allergies” generally refers to grass, pollen and mold, there is a different group of allergy triggers that are closely tied to particular seasons.
Among them:
  • Smoke (campfires in summer, fireplaces in winter)
  • Insect bites and stings (usually in spring and summer)
  • Chlorine in indoor and outdoor swimming pools
  • Candy ingredients (Halloween, Christmas, Valentine’s Day, Easter)
  • Pine trees and wreaths (Thanksgiving to Christmas)
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ANAPHYLAXIS​

In most cases, people with allergies develop mild to moderate symptoms, such as watery eyes, a runny nose or a rash. But sometimes, exposure to an allergen can cause a life-threatening allergic reaction known as anaphylaxis. This severe reaction happens when an over-release of chemicals puts the person into shock. Allergies to food, insect stings, medications and latex are most frequently associated with anaphylaxis.

A second anaphylactic reaction, known as a biphasic reaction, can occur as long as 12 hours after the initial reaction.

Anaphylaxis symptoms occur suddenly and can progress quickly. The early symptoms may be mild, such as a runny nose, a skin rash or a “strange feeling.” These symptoms can quickly lead to more serious problems, including:

  • Trouble breathing
  • Hives or swelling
  • Tightness of the throat
  • Hoarse voice
  • Nausea
  • Abdominal pain​
  • Vomiting
  • Diarrhea
  • Dizziness
  • Fainting
  • Low blood pressure
  • Rapid heart beat
  • Feeling of doom
  • Cardiac arrest

An anaphylactic reaction should be treated immediately with an injection of epinephrine (adrenaline). Doses, available by prescription, come in an auto-injector that should be kept with you at all times.

Identify triggers: The most common triggers are:

Food: including peanuts, tree nuts such as walnuts and pecans, fish, shellfish, cow’s milk and eggs.

Latex: found in disposable gloves, intravenous tubes, syringes, adhesive tapes and catheters. Health care workers, children with spina bifida and genitourinary abnormalities and people who work with natural latex are at higher-risk for latex-induced anaphylaxis.

Medication: including penicillin, aspirin and non-steroidal anti-inflammatory drugs such as ibuprofen, and anesthesia.

Insect sting: with bees, wasps, hornets, yellow jackets and fire ants being the most likely to trigger anaphylaxis.

DRUG ALLERGY​

Adverse reactions to medications are common, yet everyone responds differently. One person may develop a rash or other reactions when taking a certain medication, while another person on the same drug may have no adverse reaction at all.

Only about 5% to 10% of these reactions are due to an allergy to the medication.

An allergic reaction occurs when the immune system overreacts to a harmless substance, in this case a medication, which triggers an allergic reaction. Sensitivities to drugs may produce similar symptoms, but do not involve the immune system.

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Certain medications are more likely to produce allergic reactions than others. Certain medications are more likely to produce allergic reactions than others. The most common are:

  • Antibiotics, such as penicillin
  • Aspirin and non-steroidal anti-inflammatory medications, such as ibuprofen
  • Anticonvulsants
  • Monoclonal antibody therapy
  • Chemotherapy

The chances of developing an allergy are higher when you take the medication frequently or when it is rubbed on the skin or given by injection, rather than taken by mouth.

The most frequent types of allergic symptoms to medications are:

  • Skin rashes, particularly hives
  • Itching
  • Respiratory problems
  • Swelling, such as in the face

Anaphylaxis is a serious allergic response that often involves swelling, hives, lowered blood pressure, and in severe cases, shock

Anaphylaxis requires immediate medical attention because the result can be fatal.
If you think you might be allergic to a medication prescribed by your doctor, call your physician before altering or stopping the dosage.

Drug allergy treatment & management

If you have side effects that concern you, or you suspect a drug allergy has occurred, call your physician. If your symptoms are severe, seek medical help immediately. A serious anaphylactic reaction requires immediate medical attention because the result can be fatal.

In most cases of adverse reactions, your physician can prescribe an alternative medication. For serious reactions, your doctor may provide antihistamines, corticosteroids or epinephrine.

Standardized allergy testing is available for penicillin and may be followed by an oral challenge in the clinic. When no alternative is available and the medication is essential, a desensitization procedure to the medication may be recommended. This involves gradually introducing the medication in small doses until the therapeutic dose is achieved.

Make sure your physician, dentist and pharmacy are kept current regarding your drug allergies. This will help determine which medications should be avoided.

ASTHMA​

Asthma is a chronic disease involving the airways in the lungs. These airways, or bronchial tubes, allow air to come in and out of the lungs.

If you have asthma your airways are always inflamed. They become even more swollen and the muscles around the airways can tighten when something triggers your symptoms. This makes it difficult for air to move in and out of the lungs, causing symptoms such as coughing, wheezing, shortness of breath and/or chest tightness.

For many asthma sufferers, timing of these symptoms is closely related to physical activity. And, some otherwise healthy people can develop asthma symptoms only when exercising. This is called exercise-induced bronchoconstriction (EIB), or exercise-induced asthma (EIA). Staying active is an important way to stay healthy, so asthma shouldn’t keep you on the sidelines. Your physician can develop a management plan to keep your symptoms under control before, during and after physical activity.

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People with a family history of allergies or asthma are more prone to developing asthma. Many people with asthma also have allergies. This is called allergic asthma.

Occupational asthma is caused by inhaling fumes, gases, dust or other potentially harmful substances while on the job.

Childhood asthma impacts millions of children and their families. In fact, the majority of children who develop asthma do so before the age of five.

There is no cure for asthma, but once it is properly diagnosed and a treatment plan is in place you will be able to manage your condition, and your quality of life will improve.

An allergist / immunologist is the best qualified physician in diagnosing and treating asthma. With the help of your allergist, you can take control of your condition and participate in normal activities.

ECZEMA​

Atopic Dermatitis, more commonly known as eczema, is a chronic skin condition that mainly affects children but may also continue into adulthood.

The symptoms of eczema include red, itchy, cracked and dry skin.

It affects one in five infants but only around one in fifty adults. It is now thought to be due to “leakiness” of the skin barrier, which causes it to dry out and become prone to irritation and inflammation by many environmental factors.

Also, some people with eczema have a food sensitivity which can make eczema symptoms worse. In about half of patients with severe atopic dermatitis, the disease is due to inheritance of a faulty gene in their skin called filaggrin.

Skin Features Associated With Atopic Dermatitis

  • Atopic pleat (Dennie-Morgan fold)—an extra fold of skin that develops under the eye
  • Cheilitis—inflammation of the skin on and around the lips
  • Hyperlinear palms—increased number of skin creases on the palms
  • Hyperpigmented eyelids—eyelids that have become darker in color from inflammation or hay fever
  • Ichthyosis—dry, rectangular scales on the skin
  • Keratosis pilaris—small, rough bumps, generally on the face, upper arms, and thighs
  • Lichenification—thick, leathery skin resulting from constant scratching and rubbing
  • Papules—small raised bumps that may open when scratched and become crusty and infected
  • Urticaria—hives (red, raised bumps) that may occur after exposure to an allergen, at the beginning of flares, or after exercise or a hot bath.
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Each person with atopic dermatitis experiences a unique combination of symptoms, which may vary in severity over time. The doctor will base a diagnosis on the symptoms the patient experiences and may need to see the patient several times to make an accurate diagnosis and to rule out other diseases and conditions that might cause skin irritation.

Common Irritants

  • Wool or synthetic fibers
  • Soaps and detergents
  • Some perfumes and cosmetics
  • Substances such as chlorine, mineral oil, or solvents
  • Dust or sand
  • Cigarette smoke.

Treatment

includes use of Corticosteroid creams, skin care and avoidance of triggers

FOOD ALLERGY​

If you have a food allergy, your immune system overreacts to a particular protein found in that food. Symptoms can occur when coming in contact with just a tiny amount of the food

Many food allergies are first diagnosed in young children, though they may also appear in older children and adults.

Eight foods are responsible for the majority of allergic reactions:

  • Cow's milk
  • Eggs
  • Fish
  • Peanuts
  • Shellfish
  • Soy
  • Tree nuts
  • Wheat
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Many people who think they are allergic to a food may actually be intolerant to it. Some of the symptoms of food intolerance and food allergy are similar, but the differences between the two are very important. If you are allergic to a food, this allergen triggers a response in the immune system. Food allergy reactions can be life-threatening, so people with this type of allergy must be very careful to avoid their food triggers.

Being allergic to a food may also result in being allergic to a similar protein found in something else. For example, if you are allergic to ragweed, you may also develop reactions to bananas or melons. This is known as cross-reactivity. Cross-reactivity happens when the immune system thinks one protein is closely related to another. When foods are involved it is called oral allergy syndrome (OAS).

Food allergy can strike children and adults alike. While many children outgrow a food allergy, it is also possible for adults to develop allergies to particular foods.

If you believe you may have a food allergy, see an allergist / immunologist.  

Since allergic reactions to foods can be life-threatening, food allergic people must be very careful to avoid their food triggers. If you have severe allergies to food, be sure to complete an Anaphylaxis Action Plan and carry your autoinjectable epinephrine with you at all times. Use this medication in the event of an anaphylactic reaction, seek medical care, and then see an allergist/immunologist for follow-up care.

SINUSITIS​

Sinus disease is a major health problem. It afflicts 31 million people in the United States. Americans spend more than $1 billion each year on over-the-counter medications to treat it. People who have allergies, asthma, structural blockages in the nose or sinuses, or people with weak immune systems are at greater risk.

Sinusitis is an inflammation of the sinuses. It is often caused by bacterial (germ) infection. Sometimes, viruses and fungi (molds) cause it. People with weak immune systems are more likely to develop bacterial or fungal sinusitis. Some people with allergies can have “allergic fungal sinusitis.” Acute sinus disease lasts three to eight weeks. Sinus disease lasting longer than eight weeks is considered chronic.

The sinuses are air-filled cavities. They are located:

  • Within the bony structure of the cheeks
  • Behind the forehead and eyebrows
  • On either side of the bridge of the nose
  • Behind the nose directly in front of the brain

An infection of the sinus cavity close to the brain can be life threatening, if not treated. In rare cases, it can spread to the brain.

Normal sinuses are lined with a thin layer of mucus that traps dust, germs and other particles in the air. Tiny hair-like projections in the sinuses sweep the mucus (and whatever is trapped in it) towards openings that lead to the back of the throat. From there, it slides down to the stomach. This continual process is a normal body function.

Sinus disease stops the normal flow of mucus from the sinuses to the back of the throat. The tiny hair-like “sweepers” become blocked when infections or allergies cause tiny nasal tissues to swell. The swelling traps mucus in the sinuses.

Some people have bodily defects that contribute to sinus disease. The most common of these defects are:

  • Deformity of the bony partition between the two nasal passages
  • Nasal polyps (benign nasal growths that contain mucus)
  • A narrowing of the sinus openings