Any patient presenting with symptoms of rhinitis, wheezing, cough, eczema or hives deserves a complete medical evaluation including environmental history.
If allergies are suspected, allergy testing is recommended.
Two types of skin test are used both utilizing a very minute amount of the allergen (a safe amount) to produce a very local allergic reaction of the skin. Skin testing is considered the “Gold Standard” for allergy diagnosis. Prick testing is performed usually on the back with a special testing device while intradermal testing involves injection of a small amount of allergen into the top layer of the skin (usually done on upper arm.)
- This as a treatment strategy has limited efficacy as avoidance of outdoors pollen or mold spores is impractical and impossible.
- For indoor allergens such as: pets, dustmites, coackroaches the degree of exposure can be diminished but not eliminated.
- However, for food allergy avoidance is the only option currently available.
- Exposure to other allergens causing severe anaphylaxis such as latex or stinging insects, likewise, may not be predictable.
Several classes of drugs are available OTC (over-the-counter)
Antihistamines: Frontline therapy for allergic rhinitis, may control sneezing, runny nose and itching; not very effective against nasal stuffiness and eye symptoms.
Topical Nasal Steroids: Available by prescription and OTC. Good at relieving nasal obstruction, throat itching, sneezing and cough. May improve seasonal asthma symptoms. Side effects are minor.