How Are Allergies Treated?

Allergies, or allergic disease, is a condition that occurs when the immune system overreacts to a foreign substance (allergen) that is ordinarily harmless. Exposure to an allergen, such as pollen, animal dander, or certain foods, can cause a range of symptoms, from runny nose and sneezing to trouble breathing and swelling in the mouth and throat. Allergy treatments include lifestyle modifications to avoid the allergens, medicines, and immunotherapy.

If you have allergies, you may see an allergist—a doctor with special training in diagnosing and treating allergies. Your allergist will perform allergy testing to determine the specific allergens you are sensitive to and develop an effective treatment plan.

There is no cure for allergies, so treatment focuses on boosting tolerance to allergens, minimizing exposure, and relieving symptoms. This article covers what you need to know about allergy treatments and how to live well when you have an allergic condition. 

Medications 

Allergy medications help reduce or eliminate symptoms. Prescription and over-the-counter (OTC) medications work by blocking or reducing the body’s immune response to the allergen and reducing symptoms.

Antihistamines 

Antihistamines are the most common type of allergy medication. Available over the counter or by prescription, antihistamines come in pill, liquid, nasal spray, and eye drop forms. Antihistamines block histamine—a chemical released by the body when exposed to an allergen. These medicines help relieve symptoms, including runny nose, sneezing, itching, watery eyes, and hives. 

Antihistamines provide fast symptom relief and can be used as needed or daily. Antihistamines are most effective when you begin taking them every day before allergy season begins.

Corticosteroids 

Corticosteroids work by reducing inflammation throughout the body to relieve allergy symptoms. These medicines are very effective the oral form but should be used short-term, as long-term use can cause serious side effects (e.g., weight gain, osteoporosis, insomnia). 

Corticosteroids come in several forms, and each type treats different allergies:

• Creams or ointments: Topical corticosteroids treat allergies that affect the skin and cause an itchy, red rash. 
• Nasal sprays: Nasal corticosteroids treat allergic rhinitis, reducing inflammation and congestion in the nasal passages. 
• Oral: Oral corticosteroids may be prescribed in pill, capsule, or liquid form to treat severe allergic reactions. This is not a first-line treatment and is only used in special circumstances.

Mast Cell Stabilizers 

Mast cell stabilizers prevent histamine from being released by mast cells—a type of white blood cell that plays a key role in the body’s immune response to allergens. These medicines are available over the counter as nasal sprays, eye drops, and prescription eye drops. 

Mast cell stabilizers are most effective when used regularly and at least one week before allergy season begins. They help reduce allergy symptoms like stuffy nose, sneezing, postnasal drip, and red, itchy eyes.

Leukotriene Modifiers 

Leukotriene modifiers block the action of leukotrienes, which are chemicals produced by the body in response to an allergen. These chemicals cause inflammation, constrict the nasal passages, and lead to allergy symptoms. Leukotriene modifiers are usually prescribed for people who also have asthma. These medicines are available as tablets for adults and chewable tablets and sprinkles for children. 

Leukotriene modifiers are most effective when taken consistently at the same time every day.

Decongestants

Decongestants narrow the blood vessels in the nasal passages to reduce inflammation and stuffiness. Most decongestants are available over the counter as nasal sprays, pills, capsules, or liquids. 

Decongestants are only for short-term use because they can cause swelling and stuffiness to worsen over time. They also narrow blood vessels throughout the body and can lead to high blood pressure. You may also have a rebound effect with this medication; long-term use can provoke worsening symptoms once you discontinue the medication. 

Epinephrine 

Epinephrine is a prescription medication used to treat severe allergic reactions, also known as anaphylaxis. Anaphylaxis is severe and life-threatening and can occur in response to exposure to an allergen such as food, medication, or an insect sting. 

Epinephrine is available in an injectable form and is given as an auto-injector device (EpiPen, AuviQ, or Twinject) which can be self-administered in emergencies. Epinephrine, which is a hormone that's also called adrenaline, works by constricting blood vessels, relaxing smooth muscles in the lungs, and increasing heart rate, which can help reverse the symptoms of anaphylaxis. People at risk of anaphylaxis should always carry an epinephrine auto-injector and know how to use it.

Epinephrone is highly effective at slowing or stopping an allergic reaction and can be life-saving.

Immunotherapy 

Immunotherapy, also known as “allergy shots” or allergen-specific immunotherapy, is a treatment option for people with chronic environmental allergies. Immunotherapy involves gradual exposure to increasing amounts of allergens to change the immune system's response to the allergen, so you become less sensitive over time.

Subcutaneous immunotherapy (SCIT), which are commonly known as allergy shots, are given as injections and are typically administered in an allergist’s office 1-2 times a week. The injections contain a small amount of the allergens you are allergic to, and the dose is increased gradually over 6-12 months to help you build a tolerance to multiple allergens. Once you have built a tolerance, your allergist may recommend less frequent allergy shots. Immunotherapy may be discontinued if you no longer need allergy medications and no longer experience allergic reactions.

Sublingual immunotherapy (SLIT) is a sublingual tablet that dissolves under the tongue. It is considered an alternative to allergy shots and may be recommended to treat grass, ragweed, and dust allergies. The first tablet is administered in an allergist’s office, and most people can continue the therapy at home. How long and how often your allergist recommends you continue oral immunotherapy depends on the type of allergy being treated.

Immunotherapy is considered a safe and effective treatment option for allergies, and it can be beneficial for people whose symptoms do not respond well to other medications. It can take several months or even years for the full benefits of immunotherapy to be seen. While it's not a cure, it can substantially reduce symptoms and the need for other medications.

Complementary and Alternative Medicine 

Many people with allergies consider using complementary and alternative medicine (CAM) to help relieve allergy symptoms. The effectiveness and safety of many CAM treatments for allergies have not been rigorously studied, and most are not supported by scientific evidence. 

While some CAM treatments may help reduce allergy symptoms, they should not be considered a substitute for standard treatment. Always consult your allergist before using CAM treatments, as some may interact with allergy medications and may not be safe for everyone.

Saline Nasal Irrigation

Saline nasal irrigation involves flushing out the nasal passages (nostrils) with a saltwater solution. The solution can be administered using a nasal spray bottle, a neti pot, or a bulb syringe.

The goal of saline nasal irrigation is to remove excess mucus, allergens, and other irritants from the nasal passages, which can help relieve allergy symptoms such as congestion, runny nose, and sneezing. It can also help soothe dry and irritated nasal passages. 

Saline nasal irrigation is considered a safe and well-tolerated treatment for allergies. It's also relatively inexpensive and can be done at home. There are no known side effects, but it is important to use a sterile saline solution and to clean the equipment properly to avoid infections. Using tap water for nasal irrigation can be dangerous.

Acupuncture

Acupuncture involves the insertion of thin needles into specific points on the body, which may help control allergy symptoms. Some studies suggest acupuncture may help reduce allergic rhinitis (hay fever) symptoms. More research is needed to confirm these findings and to determine the best way to use acupuncture for allergies.

Herbal Medicine 

Some herbal supplements, such as butterbur and stinging nettle, may reduce seasonal allergy symptoms. However, the quality and purity of herbal supplements can vary widely, and some may contain dangerous contaminants. If you plan to use herbal remedies to treat your allergies, talk to your healthcare provider before consuming them, and use only high-quality products from reputable sources.

Probiotics

Probiotics are dietary supplements that contain live bacteria and yeasts that help promote a healthy gut microbiome. Some studies have found that probiotics may reduce the symptoms of allergic rhinitis, but more research is needed to confirm these findings.

Lifestyle 

Along with following your allergist’s treatment recommendations, certain lifestyle habits can help prevent or reduce allergy symptoms:

• Avoid exposure to allergens: Avoidance of your allergic triggers is the best way to control allergy symptoms. Depending on your allergy triggers, this may involve avoiding outdoor activities during peak allergy season, avoiding food allergens that cause allergic reactions, dusting and vacuuming regularly, eliminating carpet, and installing high-efficiency particulate air (HEPA) air filters in your home. 
• Eat a healthy, balanced diet: Eating a diet rich in fruits and vegetables, and getting enough vitamins and minerals, can help to boost the immune system and reduce inflammation. Drinking enough water can help keep mucus membranes hydrated and flush out allergens from the nasal passages.
• Stress management: Stress does not cause allergies, but stressful situations can trigger the body to release histamines, which may worsen allergy symptoms. Finding ways to manage stress, such as deep breathing exercises, meditation, or journaling can help manage stress.

Living With and Managing Allergies 

Living with allergies can be challenging, but it is possible to minimize symptoms and maintain a good quality of life with proper treatment. Treatment, including medications, immunotherapy, and lifestyle modifications, plays a significant role in managing allergies. 

Seeking support from friends, family, and healthcare providers can help you cope with allergies and minimize their impact on your life. Joining support groups and online communities can also provide a sense of community and camaraderie with others who also live with allergies. 

A Quick Review

Allergy treatments include medications, such as antihistamines, corticosteroids, and immunotherapy (e.g., allergy shots). Lifestyle modifications, such as limiting exposure to allergens, can also help manage allergies. Managing allergies can be a lifelong process, but with the proper treatment and lifestyle modifications, people with allergies can lead healthy lives. An allergist can help develop an individualized treatment plan that works best for you.