Fighting Allergies Means Finding Cause

Harrison Moncino has been battling springtime allergies since he was 4 years old. If he played outside and rubbed his eye, it would swell shut.

At age 7, tests showed that Harrison was allergic to just about everything his hometown of Atlanta had to offer, including trees and grasses. Once, his family had to leave a golf course because his eyes were itching and swelling so badly. Now 10, Harrison gets allergy shots once a month and has shown remarkable improvement. He was even able to go on a hayride for a recent school field trip without swelling up.

"My son was miserable in the spring with eye symptoms. This year, after two years of shots, he has no symptoms at all," said Dr. Kathleen Sheerin, Harrison's mother and an allergist with the Atlanta Allergy and Asthma Clinic.

Who Sniffles?

Allergies affect more than 20 percent of the U.S. population, according to the American Academy of Allergy, Asthma and Immunology. A person with allergies has an immune system that malfunctions and is hypersensitive. When someone comes into contact with a substance she is allergic to, the immune system thinks it's harmful and launches an attack.

Allergic reactions vary from mild to life-threatening. Symptoms could be nasal congestion, watery eyes, scratchy throat, sneezing, wheezing, hives, redness, itching, swelling or dark circles under the eyes.

In severe cases, coughing and wheezing can lead to respiratory arrest.

Often, people think they have head colds instead of an allergy because the symptoms are similar, Sheerin said. However, a cold will resolve itself in a week to 10 days, and allergy symptoms generally persist longer. Also, allergies generally do not involve fevers or muscle aches.

What Can People Be Allergic To?

A person could be allergic to thousands of things. Allergy tests can't check for every conceivable allergen, only the most common, such as tree pollens, grasses, weeds, molds and stinging insects, which are all outdoor allergens. Common indoor allergens include dust mites, furry pets, feathers, wool, cosmetics, perfumes, mold spores, tobacco smoke, paints and chemicals.

The most common food allergies are milk, egg, wheat, soy, peanuts and shellfish.

"Although many of the allergens may be detected, there may be a host of allergens at home, at work and in the environment that are never determined," said Dr. Matthew Clarke, an allergy specialist and family physician in New York City.

Skin testing is the fastest, cheapest and quickest way of discovering a person's allergies, Sheerin said. The skin prick test introduces small amounts of several allergens into the skin by making small punctures. If someone has an allergy, redness and swelling will occur. Skin testing is used most often because results can usually be obtained in 15 minutes and it clearly shows patients what allergies they have, Clarke said.

Another way to test for allergies is through blood testing.

"It's more comfortable for the patient than skin prick testing and does not require that medications like antihistamines be discontinued before the test," said Dr. Terrence Zipfel, an allergy specialist in East Liverpool, Ohio.

Allergies From Genes, Exposure

It's not clear why some people have hyperactive immune systems and others do not, Zipfel said, although it is at least partially from genetics.

However, a person could also develop an allergy after frequent or intense exposure to a substance, said Dr. Sheryl Lucas, an allergist with the Mid-Atlantic Permanente Medical Group in Washington, D.C.

"While most allergies develop early in life, adults of all ages can develop and express allergies," Lucas said.

Avoiding Triggers

The preferred method of treating allergies is avoidance, but this can be tricky because outdoor allergens come inside when the doors and windows are open, and all kinds of allergens can be carried on clothing, Sheerin said. Also, pet lovers who are allergic to animal dander may refuse to remove pets from their homes.

Zipfel said food allergies can be the most challenging to treat, and they usually involve special diets.

Common Treatments

Clarke said mild or moderate allergy symptoms can often be treated with antihistamines such as Claritin, Benadryl and Allegra, and steroidal nasal sprays such as Flonase are effective in treating nasal congestion.

But he also has a warning about nasal sprays.

"I do not recommend over-the-counter nasal decongestant sprays be used for more than three days, or be used repeatedly for allergies. Overuse of these medications can damage the lining of the nose," Clarke said.

For those with persistent or severe symptoms, allergy shots -- similar to Harrison's -- can relieve the patient's misery. The shots are injections of allergen extracts to promote desensitization, and the precision of individual doses has greatly improved in the last 50 years, Zipfel said.

Allergies can be difficult to treat when a cause can't be found, which often happens with hives, Sheerin said. However, doctors can usually relieve the symptoms with medication.

A patient may have to try several different treatments before finding something that works for him or her, but it's important that the allergies get addressed, doctors said.

"If allergy symptoms are ignored, they may become more severe and predispose to complications such as sinusitis and asthma. Your physician is the best source for diagnosing and treating allergies," Lucas said.