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Allergy Treatment

Allergy Treatment

Allergy treatment starts with knowing what you are allergic to, which should be followed by practising allergen avoidance - or environmental allergen control, as it is sometimes called. If symptoms are severe it might be necessary to also use certain medical drugs.

Frequently Asked Questions

There are a number of different drugs that can be used to treat the symptoms of allergy. The choice should depend upon the nature of your allergy and how serious it is. There is a range of non-medical products that can significantly reduce your exposure to your allergy symptoms triggers. Such as:

Allergy air purifier: which captures and retains allergens and other pollution from the air
Allergy friendly cleaning products: can destroy allergens in dust, carpets, bedding, etc
Allergy vacuum cleaners: will collect dust, dust mite remains, and other allergens without releasing them back into the air
Allergy friendly bedding

Medical treatments include:

Corticosteroids: which damp down inflammation and are available in a topical and oral form
Antihistamines: which block the action of histamine. Older antihistamines, like diphenhydramine, cause drowsiness, while the newer longer-acting drugs, including loratadine, do not
Decongestants: like Claritin, are helpful in treating hay fever symptoms
Leukotriene receptors antagonists: may be useful in allergy cases where antihistamines have not proved effective

The main medical treatments available are antihistamines and steroids, which come as tablets, creams or nose or eye drops. The choice depends on what the allergy symptoms are and their severity. Allergy is an over-reaction of the immune system to a normally harmless substance (the allergen) such as pollen or house dust mite. The more scientists learn about the intricacies of immunity, the more likely it is that newer, more effective treatments will be introduced. Here is a summary of what is available:

Antihistamines: These drugs block the production of histamine, which is responsible for allergy symptoms such as itching, watery eyes, and sneezing. There are two main types available:

Older antihistamines: such as chlorphenamine and hydroxyzine which are not very powerful and also have a sedating effect. Piriton tablets are suitable for adults and children over the age of six, while the syrup can be given to kids over the age of 12 months. Piriton is used to treat the symptoms of hay fever, allergy to house dust mite, mould and pet dander, and nettle rash (urticaria). Atarax is a tablet used mainly to treat eczema and nettle rash.
Newer (second generation) antihistamines: such as Neoclarityn and Telfast are non-sedating and longer-acting. Neoclarityn comes as tablets (for those over the age of 12) or solution (for children aged one and over) and is used in the treatment of allergic rhinitis (hay fever and non-seasonal rhinitis). Telfast is a tablet used for allergic rhinitis and nettle rash, and suitable for those over the age of 12.

Steroids: The steroids used in the treatment of allergy are corticosteroids (not to be confused with the anabolic steroids used by some athletes).
Steroids are available in tablet, topical (cream), nasal drop, nasal spray or eye drop formulations. They are used in the treatment of hay fever and non-seasonal rhinitis, seasonal allergic conjunctivitis and other forms of allergic conjunctivitis, urticaria, and eczema. Steroids have an anti-inflammatory effect. It is hard to generalize, but steroids are often used as 'second line' treatment in cases of allergy where antihistamines have not been found effective. Oral steroids tend to be reserved for very severe cases of allergy and would only be available on prescription (other formulations can usually be bought over the counter).

There is sodium cromoglicate, which prevents mast cells in the immune system from releasing histamine. Known as Catacrom®, Pollenase Allergy® and a number of other brand names, sodium cromoglicate comes in the form of eye drops which can be bought without a prescription. It is used for treating red, itchy, puffy eyes arising from hay fever or allergic conjunctivitis.

You may also consider trying Singulair or Accolate. These are relatively new drugs, known as leukotriene receptor antagonists, available on prescription only. They block the action of leukotrienes, which are immune system molecules involved in the inflammatory process. Both are used to treat allergic symptoms like nasal congestion, runny nose, sneezing, and itching.

Immunotherapy reduces or tries to eliminate, symptoms by retraining the immune system so that it no longer responds to an allergen. This is done by injecting a tiny, but gradually increasing, amount of the allergen responsible for the symptoms over a long period of time. The treatment is done under the supervision of an allergy clinic. In the UK, immunotherapy is available for:

Wasp and bee venom allergy

Allergic rhinoconjunctivitis arising from grass or tree pollen allergy, or from a cat or house dust mite allergy
Sub-lingual drops, which are placed under the tongue, may be used instead of injections. Although this form of treatment is not yet widely available as it is unknown whether it is as effective as injections.
There is also a tablet form of immunotherapy for grass pollen allergy, known as Grazax ®, which is licensed in the UK

Efficiency and safety are the two main things to consider when choosing an allergy treatment. The way the drug is administered (tablet, cream, spray, or drops) is also a factor. Any of the treatments described above may be effective in relieving allergy symptoms but some people do not respond to the first treatment they try, so it may be necessary to try more than one until you find something that works for you. While allergy symptoms are not usually dangerous, with the exception of anaphylactic shock responses and asthma attacks, they can be distressing and annoying. Allergen avoidance / environmental allergen control is an important part of treating allergies. You can read more about environmental allergen control by visiting our environmental allergen control page.

As far as safety is concerned, there will be ample information supplied with your medicine – usually as a leaflet insert. Read this carefully. Here are also some important points on the safety of allergy medicines:

The older sedating antihistamines can make you drowsy and may impair concentration. Do not mix with alcohol and don't drive or operate machinery when you are taking them. Research has shown that these drugs also interfere with academic performance. Unless these medicines are the only treatment that works for your allergies, they are probably best avoided, particularly by students and pupils during the exam season. The newer generation of antihistamines is a better choice for most people with allergies.
A short course of oral steroids can be very effective when dealing with severe allergic symptoms. However, long-term use of oral steroids can cause health problems including thinning of the skin, osteoporosis, impaired glucose tolerance (raising the risk of diabetes) and reduced resistance to infection.
If you are treating a child's allergy, check whether medicines are suitable for that age. Some allergy medicines are not recommended for babies or very young children.
Immunotherapy commonly causes local inflammation at the site of the injection. Occasionally, this reaction can be quite large and persist for up to 48 hours. More rarely, the patient will have reactions like nasal congestion or sneezing. More serious side effects such as lowered blood pressure, angioedema (soft tissue swelling) or bronchospasm (chest spasm) may affect a minority of patients. Very rarely, immunotherapy can trigger an attack of anaphylaxis, which is potentially fatal.
If in any doubt, consult your pharmacist. They are usually very knowledgeable about the medicines they dispense or sell over the counter.

There is a monoclonal antibody drug which targets the IgE antibody produced by the allergen. This approach gets to the root cause of hay fever, because IgE activates mast cells, making them produce histamine which triggers the allergic symptoms. It is currently available for treatment of asthma with seasonal allergic rhinitis. As with all other monoclonal antibodies, some are given by injection and it is very expensive. It may, at some point, be licensed for the treatment of other allergies.

A skin prick test is a usual test for allergy. A tiny drop of an allergen extract is placed on the skin (either the arm or the back). If the person is allergic to this substance, a small red weal will appear, usually within 15 minutes. To find out more visit out Allergy Testing page.

The best way to manage an allergy generally is to practice allergen avoidance. There are several ways in which you can do this, depending on what the allergen is. Some general allergen avoidance tips include:

Immunotherapy may reverse the sensitisation process in some allergy cases. Patients have to be carefully selected, and treated in a specialist centre. The procedure involves four injections and can give lasting benefit. There is also a home version known as sublingual immunotherapy, in which the patient places medication under the tongue, however, this is currently only available for grass pollen allergy.

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