Frequently Asked Questions

Jack was diagnosed as having an allergic rhinitis and allergic conjunctivitis. It is also known as
“hay fever.” He and his mom had a lot of questions for the AmazingAllergist, who answers them
here for you.

Q: What is an allergy?

A: When our body’s immune mechanisms overreact to exposure, it is called an allergy. For
example, when a person without allergies to tree pollen inhales the pollen, there is no response.
If Jack inhales tree pollen, his body will overreact to the pollen and have an allergic response,
making him sneeze and have watery eyes, a runny nose, etc.

Q: Is allergy suggestive of a weak immune system?

A: No. The immune system protects us from getting infections and helps clear them once we are
exposed to germs. When the immune system gets over activated in response to other exposures
like pollen, it is considered an allergy. So, in simple terms, allergy is an overactive immune system
and not a weak immune system.

Q: What are allergic rhinitis and allergic conjunctivitis?

A: Rhinitis simply means the inflammation of the nose, and conjunctivitis is the inflammation of
the eyes. When this is related to allergic response, it is labeled so. When the nose and the eyes are
exposed to the allergy triggers, they produce chemicals under their lining. This makes them red
and swollen, or inflamed. This inflammation is the reason for all the symptoms. Someone may
have more involvement of the nose or the eyes than the other.

Q: What are the signs and symptoms of allergic rhinitis and allergic conjunctivitis?

A: You can have one, many, or all of these common signs and symptoms: runny nose, sneezing,
itchy nose, red nose, swelling inside the nose, congestion, stuffy nose, mouth breathing, snoring,
sinus pressure, headaches, nasal tone, horizontal line on the outside of the nose, nosebleeds,
throat clearing, itchy throat, postnasal drip, itchy ears, fatigue, not feeling well, itchy eyes,
tearing, red eyes, swollen eyes, feeling of sand in the eyes, light sensitivity, cough. Symptoms of
the eyes or nose can be present in the absence of other symptoms.

Q: What allergic conditions do allergy specialists treat?

A: Besides the seasonal allergic rhinitis and allergic conjunctivitis, allergy specialists can help with
similar conditions from indoor allergies, like dust mites, dog and cat dander, mold, cockroaches,
etc. The other conditions associated with allergies are listed here: asthma, eczema, food allergy,
hives, sinus conditions, insect venom allergy, drug allergy, latex allergy, chemical and cosmetics
contact allergy, poison ivy rash, plant dermatitis, frequent infections, ear infections, chronic
cough, etc.

Q: Who else can help?

A: You and your family can help you more than anyone else can. Allergy specialists as well as
other health-care professionals can give you guidance, but you are the one who can help you
the most. The long-term relief from allergies involves your active participation in decisions and
treatments.
The mainstream professionals who can help include allergists, pediatricians, family
physicians, internists, and otolaryngologists. Other complementary professionals, if trained to
treat allergic conditions, may also contribute to your wellness and include naturopaths, herbalists,
chiropractors, massage therapists, and acupuncturists.

Q: How do you diagnose allergy?

A: First of all, we ask a lot of questions about your symptoms, environment, family, what is
working, what is not working, etc. We examine your body for clues that might suggest the
presence or absence of allergies. The next step is to do some tests to confirm or eliminate allergy
as the cause of your symptoms. The allergy tests include prick skin tests, scratch skin tests, or
blood tests. Allergists prefer skin tests that can be done while you are in the office.

Q: What are the needle-free allergy skin tests?

A: The latest methods of allergy skin tests involve using disposable plastic devices that feel like
a brush, which are applied on the upper back or on the forearms. We use various testing liquids
(allergens) on the tips to check for individual allergies to indoor, outdoor, or food allergens. The
list can include grass pollen, tree pollen, ragweed, weeds, dust mites, dog cat dander, mold, milk,
eggs, wheat, soy, peanuts, tree nuts, shellfish, fish, and many more. Once the test is applied, you
wait for twenty minutes without touching or scratching. The test results are interpreted based on
the size, swelling, and redness around each dot. In the presence of the true allergies, these dots
get red and look like mosquito bites.

Q: What do the positive allergy skin tests mean?

A: The positive skin tests to different allergens reflect the presence of immunoglobulin E (IgE),
made against these allergens in the allergic individual. The exposure to these allergens has a
potential to trigger an overactive immune response that can cause allergy symptoms. The severity
of allergy symptoms depends on many factors.

Q: Who needs allergy blood tests?

A: Patients who cannot be tested on the skin as well as some of the skin-tested patients may need
blood tests.

Q: How do you fix allergies, once diagnosed?

A: The first step is to avoid or reduce the exposure to these allergens. The second step is to use
nondrug supportive measures to reduce the need for medications. The third step is to fi nd a
combination of medicines to get one’s life back to normal. The goal is to use the minimum
number of medicines for the shortest duration possible. The most important and last step is to
consider allergy vaccines to modify overactive immune responses.

Q: How do we avoid dust mites?

A: Dust mites are microscopic creatures found mainly in the mattress, pillows, and spaces that
collect dust. You can reduce your exposure significantly by encasing the pillows, mattress, and
box spring with dust mite barrier covers with zippers. Reducing the clutter, especially in the
bedroom, and removing stuffed toys can be very helpful.

Q: What can we do for pets?

A: The best solution is to find another home for your pet. If this is not possible, at least do not
allow pets in the bedroom, have someone wash the pets frequently, and consider air purifiers.
Also, washing hands and changing clothes after direct pet exposure can be helpful.

Q: Is there any way to reduce pollen exposure?

A: Keeping the bedroom windows closed and car windows rolled up during the high pollen
season can reduce exposure. Planning outdoor activities around the low pollen count and taking a
shower, washing hair, and changing clothes after outdoor exposure can help.

Q: What are the nondrug supportive methods?

A: Avoidance of allergen exposure is the beginning. Washing nose, sinuses, and eyes with saline
can remove allergens and restore normal functions. Some of the nutritional supplements and
herbs used under professional guidance can reduce the need for medications. Some nasal and
breathing exercises and facial massage and posturing are showing promising results in reducing
symptoms and draining secretions.

Q: What medications should I use for nasal and eye allergies?

A: Please allow an allergy professional to make this decision. The commonly used medications
can be purchased with or without prescription. They are in the form of nose sprays, eyedrops,
pills, chewable tablets, liquids, or capsules. The common oral medications are antihistamines,
decongestants, antileukotrienes, and steroids. The nose sprays contain corticosteroids, cell
stabilizers, or antihistamines.
Various eye drops work through many mechanisms. Based on the assessment, the allergy
professional will determine one or all of the groups of medications to maximize the relief with
minimum side effects. Some of the medications are to be used daily and some only while having
allergy symptoms.

Q: What are allergy vaccines, and how do they work?

A: Allergy medications are very helpful in controlling symptoms but do not cure allergies. As
you know, the allergic individual has high IgE for the allergens to which they are allergic. When
the allergic individual is exposed to these allergens, their body triggers an overactive immune
response. In the process of allergy vaccination, also known as immunotherapy, the allergens
are given to the patient, starting at a tolerable dose and gradually given more and more over a
period of time. In doing so, the allergic individual’s body starts developing tolerance to these
allergens and stops overreacting. It reduces inflammation. This in turn spells relief. The need for
medication lessens, and many patients can live normally without having allergy symptoms. The
most common and widely practiced method is called subcutaneous immunotherapy. The oral or
sublingual immunotherapy is beginning to get attention. Allergen immunotherapy is the only
thing that brings you close to cure for allergies.