Allergies Health Article

Skin reactions

A variety of herbal remedies, either applied topically or taken internally, can assist in the treatment of contact dermatitis. A poultice made of jewelweed (Impatiens species) or chickweed (Stellaria media) can soothe the skin. A cream or wash containing calendula (Calendula officinalis), a natural antiseptic and anti-inflammatory agent, can help heal the rash. Chinese herbal remedies have been effective in treating atopic dermatitis. The following are homeopathic remedies to be taken internally:

• Apis (Apis mellifica) for hives that feel better with cold application and bee stings
• Poison ivy (Rhus toxicodendron) for hives that feel better with hot applications and for poison ivy, oak, or sumac rashes
• Stinging nettle (Urtica urens) for hives
• Marsh tea (Ledum) for itching insect bites
• Croton (Croton tiglium) oil for poison ivy, oak, or sumac rashes

Food allergies

Food allergy may be managed by oral desensitization. Children with allergy to milk, eggs, fish, or apples who followed an oral desensitization procedure developed resistance to the allergenic food. Oral desensitization exposes the patient to allergens in controlled, but increasing, doses. Control subjects, who had avoided the allergenic food during the study, were still sensitive.

Allopathic treatment

A large number of prescription and over-the-counter drugs are available for treatment of immediate hypersensitivity reactions. Most of these drugs work by decreasing the ability of histamine to provoke symptoms. Other drugs counteract the effects of histamine by stimulating other systems or reducing immune responses in general.

ANTIHISTAMINES. Antihistamines block the histamine receptors on nasal tissue, decreasing the effect of histamine released by mast cells. They may be used after symptoms appear, though they seem to prove more effective when used preventively. A wide variety of antihistamines are available.

DECONGESTANTS. Decongestants constrict blood vessels to counteract the effects of histamine. Nasal sprays and oral systemic preparations are available. Decongestants are stimulants and may cause increased heart rate and blood pressure, headaches, and agitation. Use of nasal sprays for longer than several days can cause loss of effectiveness and rebound congestion, in which nasal passages become more severely swollen than before treatment.

TOPICAL CORTICOSTEROIDS. Topical corticosteroids reduce mucous membrane and skin inflammation and are available by prescription. Allergies tend to become worse as the season progresses and topical corticosteroids are especially effective at reducing this seasonal sensitization. As a result, they are best started before allergy season begins. A 2001 study revealed that steroid nasal sprays work better for seasonal allergies on an as-needed basis than do antihistamines. Side effects are usually mild, but may include headaches, nosebleeds, and unpleasant taste sensations.

MAST CELL STABILIZERS. Cromolyn sodium prevents the release of mast cell granules, thereby preventing the release of histamine and other chemicals contained in them. Cromolyn sodium is available as a nasal spray and aerosol (a suspension of particles in gas).

BRONCHODILATORS. Because allergic reactions involving the lungs cause the airways or bronchial tubes to narrow, bronchodilators, which cause the smooth muscle lining the airways to open, can be very effective. Bronchodilators include adrenaline, albuterol, and theophylline. Other drugs, including steroids, are used to prevent and control asthma attacks.

Immunotherapy

Immunotherapy, also known as desensitization or allergy shots, alters the balance of antibody types in the body. Injections involve gradually increasing amounts of allergen, over several weeks or months, with periodic boosters. Full benefits may take up to several years to achieve and are not seen at all in about one in five patients. Individuals receiving all shots will be monitored closely following each shot because of the small risk of anaphylaxis, a condition that can result in difficulty breathing and a sharp drop in blood pressure.

Possible future treatments

In late 2001, a reports stated that a monoclonal antibody called omalizumab might be effective in treating seasonal allergies and preventing related asthma. By blocking immunoglobulin E (IgE), an antibody that is found in excessive amounts in those with hay fever, the drug treats hay fever and helps prevent related asthma. Trials on the drug continue, and other immune-based medicines will likely accompany its ultimate release.

Treatment of contact dermatitis

Calamine lotion applied to affected skin can reduce irritation somewhat. Topical corticosteroid creams are more effective, though overuse may lead to dry and scaly skin.

Treatment of anaphylaxis

The emergency condition of anaphylaxis is treated with injection of adrenaline, also known as epinephrine. People who are prone to anaphylaxis because of food or insect allergies often carry an "Epi-pen" containing adrenaline in a hypodermic needle. Prompt injection can prevent a more serious reaction from developing.

Expected results

Allergies can improve over time, although they often worsen. While anaphylaxis and severe asthma are life-threatening, other allergic reactions are not. Learning to recognize and avoid allergy-provoking situations allows most people with allergies to lead normal lives.