How are allergies treated?

Your healthcare provider will figure out the best treatment based on:

• Your age

• Your overall health and health history

• How sick you are

• How well you can handle specific medicines, procedures, or therapies

• Your preference

The most effective ways to treat allergies are staying away from your triggers, getting allergy immunotherapy, and taking other medicine as directed by your healthcare provider.

What is avoidance?

Avoidance is staying away from a substance (allergen) that causes an allergic reaction. Using nasal irrigation and saline sprays can help rinse the allergen and irritants out of your nose. Ask your healthcare provider which method is best for you.

Suggestions for staying away from (some) allergens

• Stay indoors when the pollen count is high and on windy days.

• Dust proof your home, especially the bedroom.

  • Get rid of wall-to-wall carpet, Venetian blinds, and down-filled blankets or pillows when possible.

  • Wash bedding, curtains, and clothing often and in hot water to eliminate dust mites.

  • Keep your mattress and pillows in dust covers when possible.

• Use air conditioning instead of opening the windows when possible.

• Consider putting a dehumidifier in damp areas of the home but remember to clean it often.

• Wear face masks when working in the yard.

Your healthcare provider will also have suggestions for other ways to stay away from allergens.

What is allergy immunotherapy?

Allergy immunotherapy improves your tolerance of the allergen and reduces symptoms. There are 2 types of allergy immunotherapy: allergy shots and sublingual (under the tongue) immunotherapy.

• Allergy shots. This is the most common form of allergy immunotherapy is given through a small shot under the skin. Allergy shots work well for people with allergies to pollen, pets, dust, stinging insects, and for people with allergic asthma. The shots contain a small amount of the allergen you are allergic to. There is a small risk of severe allergic reaction.

• Sublingual immunotherapy (SLIT). For this treatment, a quick dissolving tablet or drops are placed under the tongue. It's taken daily. This treatment is approved for allergies to dust mites, grass, and ragweed. Ask your healthcare provider if this treatment is right for you. It's rare for SLIT to cause a severe allergic reaction.

How often are allergy immunotherapy shots needed?

You may get shots every week or twice a week until you can tolerate a maximum dose. This is called the maintenance dose. It may take about 1 year to reach the maintenance dose. At that point, you may then need the shots every other week and finally once a month. You may need the allergy shots for up to 5 years or longer. Your healthcare provider will set the schedule and the length of time you will need the shots.

Symptom improvement and allergy immunotherapy

People with allergies can get better with allergy immunotherapy. But it often takes from 12 to 18 months before your symptoms can get better. Some people get relief as soon as 6 to 8 months.

Immunotherapy is only part of the treatment plan for people with allergies. Because it takes time for allergy immunotherapy to work, you will need to keep taking allergy medicines as prescribed by your healthcare provider. It's also important to continue keeping allergens, such as dust mites, out of your environment.

Are there side effects to allergy immunotherapy?

There are 2 types of reactions to allergy immunotherapy: local and systemic.

• The local reaction is redness and swelling at the injection site. If this condition occurs again and again, your healthcare provider will change the extract strength or schedule.

• A systemic reaction involves a different place in the body, not the injection site. Your symptoms may include stuffy nose, sneezing, hives, swelling, wheezing, and low blood pressure. These can be serious and life-threatening but rarely fatal. If a systemic reaction occurs, you may keep taking shots, but at a lower dosage. Your healthcare provider may recommend having self-injectable epinephrine available to treat severe reactions.

If you have any questions about immunotherapy, see your healthcare provider or allergist. 

Medicines used to treat allergy

The specific medicine your healthcare provider recommends or prescribes is based on your symptoms and your health history. These are the most commonly used medicines:

• Antihistamines. These are used to relieve or prevent the symptoms of hay fever (allergic rhinitis) and other allergies. Antihistamines prevent the effects of histamine. Histamine is a substance your body makes during an allergic reaction. Antihistamines can be tablets, capsules, liquids, nasal sprays or drops, eye drops, or shots. They can be bought over the counter and by prescription. Some antihistamines can cause drowsiness. Contact your healthcare provider for advice before taking this medicine.

• Decongestants. These help ease swelling and congestion in the nose. They come in pills and nasal sprays or drops. Don't use decongestant nasal sprays for more than 3 days, or they can make your symptoms worse. The FDA does not recommend decongestants or antihistamines for children 2 years or younger. Decongestants shouldn't be used by people with certain health conditions, including high blood pressure and other cardiovascular problems. Contact your healthcare provider for advice before taking this medicine.

• Corticosteroids. These come in 3 types:

  • Nasal. This type of medicine reduces swelling in the nose. It comes as a spray.

  • Creams or ointments. These help stop itching and rashes from spreading on the body.

  • Oral (by mouth). This type of medicine decreases swelling and helps with severe allergy symptoms or asthma attacks. Oral corticosteroids have many side effects and are not recommended for routine treatment of allergies.

• Mast cell stabilizers. This medicine eases allergy symptoms by helping stop the release of histamines from the body. Histamine causes itching, swelling, and mucus. An example of this kind of medicine is cromolyn.

• Epinephrine. This self-injectable medicine is given within minutes of a serious allergic reaction (anaphylaxis). It's the most effective treatment to give during an anaphylactic reaction. Call 911 right away after using epinephrine or if you have symptoms of a severe allergic reaction. If your healthcare provider prescribed epinephrine for you, make sure you know exactly how to use it. Your healthcare provider or pharmacist can show you.

Precautions for children

The American Academy of Pediatrics recommends against some over-the-counter medicines for children. Talk with your child's healthcare provider before giving any over-the-counter medicine to your child. Always talk with your child's provider before starting or stopping any allergy or asthma medicines.