Allergy Treatment

Medicines

If you cannot adequately avoid airborne allergens, your symptoms can often be controlled by medicines. You can buy medicines without a prescription that can relieve allergy symptoms. If, however, they don’t give you relief or they cause unwanted side effects such as sleepiness, your health care provider can prescribe antihistamines and topical nasal steroids. You can use either medicine alone or together.

Antihistamines

As the name indicates, an antihistamine counters the effects of histamine, which is released by the mast cells in your body’s tissues and contributes to your allergy symptoms. For many years, antihistamines have proven useful in relieving itching in the nose and eyes, sneezing, and in reducing nasal swelling and drainage. Many people who take antihistamines have some distressing side effects such as drowsiness and loss of alertness and coordination. Adults may interpret such reactions in children as behavior problems.

Antihistamines that cause fewer of these side effects are available over-the-counter or by prescription. These non-sedating antihistamines are as effective as other antihistamines in preventing histamine-induced allergy symptoms, but most do so without causing sleepiness.

Topical Nasal Steroids

You should not confuse topical nasal steroids with anabolic steroids, which athletes sometimes use to enlarge muscle mass and which can have serious side effects. The chemicals in nasal steroids are different from those in anabolic steroids.

Topical nasal steroids are anti-inflammatory medicines that stop the allergic reaction. In addition to other helpful actions, they decrease the number of mast cells in the nose and reduce mucus secretion and nasal swelling. The combination of antihistamines and nasal steroids is a very effective way to treat allergic rhinitis, especially if you have moderate or severe allergic rhinitis. Although topical nasal steroids can have side effects, they are safe when used correctly and at recommended doses.

Cromolyn Sodium

Cromolyn sodium is a nasal spray that in some people helps prevent allergic rhinitis from starting. When used as a nasal spray, it can safely stop the release of chemicals like histamine from mast cells. It has few side effects when used as directed and significantly helps some people manage their allergies.

Decongestants

Sometimes helping the nasal passages to drain away mucus will help relieve symptoms such as congestion, swelling, excess secretions, and discomfort in the sinus areas that can be caused by nasal allergies. Your doctor may recommend using oral or nasal decongestants to reduce congestion along with an antihistamine to control allergic symptoms.

You should not, however, use over-the-counter or prescription decongestant nose drops and sprays for more than a few days. When used for longer periods, these medicines can lead to even more congestion and swelling of the nasal passages creating an endless cycle. Because of recent concern about the bad effects of decongestant sprays and drops, some have been removed from store shelves.

Immunotherapy

Immunotherapy, or a series of allergy shots, is the only available treatment that has a chance of reducing your allergy symptoms over a longer period of time. You would receive subcutaneous (under the skin) injections of increasing concentrations of the allergen(s) to which you are sensitive. These injections reduce the level of IgE antibodies in the blood and cause the body to make a protective antibody called IgG.

About 85 percent of people with allergic rhinitis will see their hay fever symptoms and need for medicines drop significantly within 12 months of starting immunotherapy. Those who benefit from allergy shots may continue it for 3-5 years and then consider stopping. While many are able to stop the injections with good results lasting for several years, others do get worse after the shots are stopped.

One research study shows that children treated for allergic rhinitis with immunotherapy were less likely to develop asthma. Researchers need to study this further, however. As researchers produce better allergens for immunotherapy, this technique will be become an even more effective treatment.

This information was adapted from the National Institute of Allergy and Infectious Diseases handouts on airborne allergens and food allergy.