Allergy: An itchy issue

You’re at a party, enjoying yourself and feeling very upbeat when suddenly you sense your nose tingling, your eyes burning and before you know it your skin has broken out into a rash. You replay the events of the evening in your mind, trying to trace back what could it be—was it the flowers you smelled, the drink you had or someone’s perfume. But how does one find out for sure? Because when it comes to allergies, ‘anything and everything under the sun, including the sun, can cause an allergy.’ How you wish there was a vaccine that could shield you from allergies.

The incidence of allergies is increasing all over the world due to various factors like change in lifestyle, air pollution, automobile fumes, increased use of pesticides and to sum it up, a ‘stressful’ life. When any foreign substance from the atmosphere enters the body by various routes—food, water, air, odour, touch or change in temperature—the body reacts adversely to produce abnormal reactions in the form of symptoms. It is called allergy and the substance that causes the reaction is called an allergen. But not everyone reacts to same substances. Some people do and some don’t. The same person may at times show adverse reaction to a particular allergen which at other times s/he may tolerate well.

Read on to understand what can cause allergies and how you can live a healthy life by taking precautions.

Types of allergies

The most common form of an allergy is cold, also known as allergic rhinitis. If you get a cold less than once in a year it could be common cold or flu but if there is a pattern to it that keeps recurring, such as every season or when exposed to some fumes or perfumes, it could be due to an allergen. The symptoms of allergic rhinitis are the same as regular cold, the only way to tell the difference is to observe if it is brought on by exposure to some particular allergen. About half the patients with allergic rhinitis go on to develop bronchial asthma. People who develop this are also found to have very dry and itchy skin since childhood.

When the allergy shows up on the skin in the form of red raised patches, with itching and warm skin it is called as urticaria. This may come up due to some internal or external allergen such as extreme cold temperature or a reaction to metal, wood or detergent. It may even occur due to pressure of tight clothing or ornaments. Urticaria may sometimes be associated with swelling of lips and eyelids, called as angioedema.

Allergies can also be present in the form of vomiting or loose stools, in which case food or drugs can be a cause.

How does one identify allergens?

1. The key to diagnosis is a detailed history. Most often it’s the keen observations of the patient, of his daily routine and food habits that help identify the cause, since the doctor can’t be present with you at all times.
2. If both the parents have allergy, chances of the child getting an allergy is about 50 per cent. If any one of the parent has it then the chances are about 30 per cent and if none of the parent has any history of allergies, still there is a 13 per cent chance of the child developing one. In history, you should be particularly watchful of exposure to dog dander, cat saliva, bird droppings, house dust, cotton dust, grain dust, occupation dust and fumes from industrial areas. Dust from mattresses, pillow, carpets and dead parts of insects or cockroaches can cause allergies. Aroma oils, perfumes or incense stick fumes can also cause allergies in many. Substances from the atmosphere like pollen of flowers or spores of wildly grown plants across the roads or in your garden may cause allergy.
3. If you have visited a new place or if the allergy returns during a particular season or festival, or after a dental, salon or spa treatment then the allergen could be from there. It could also be due to latex; present in gloves, swim wear, balloons or condoms. Certain cosmetics or paints can cause allergies too.

Allergy test

Allergy testing can be done by three ways, prick or scratch method, intra-dermal, and patch method.

In the prick method, an allergen extract is put on the forearm in the form of a droplet and a very superficial prick or scratch is done to allow the allergen to enter the skin. The test is read after 15 – 20 minutes. If there is redness and swelling at the site, it is a positive prick test to a particular allergen. This is a gold standard method to detect allergies and specific allergens.

In the intra-dermal test, as the name implies, the allergen is injected into the skin and this is done when one strongly suspects a particular allergen to be causing the allergy. However, that substance does not reflect positive in the prick test.

For a patch test, the allergen is placed on a patch that is taped to the skin for 24 – 72 hours and then checked for a reaction.

Allergies are also checked for by doing a blood test and checking for presence of antibodies.

Are allergies life long?

Allergies like bronchial asthma and allergic rhinitis may be life long. Reactions due to drugs can also be life long. But there has also been complete remission in some cases of rhinitis and bronchial asthma, especially, those which start in childhood.

How does one treat them?

Allergies are treated mainly by anti-histamine drugs. Till you identify the exact cause of your allergy, you could continue with these medications. Check with your physician for anti-histamines that do not cause any drowsiness, to be taken during the day.

Allergic rhinitis can be treated by anti-histamine drugs like cortisol and nasal sprays. Bronchial asthma can be managed by inhalers. Many have a misconception that use of inhalers is habit forming and they can be used only in severe form of asthma. But most doctors use it as a first line of treatment for prevention and control of bronchial asthma. If patient don’t respond to them, then tablets and injections can be added along with inhalers and rotahalers or transhalers.

Can allergies be fatal?

Allergies are always brushed off as merely an annoyance and not a serious health problem. This isn’t true, because only some allergies like anaphylaxis or anaphylactic reactions may cause sudden death. This is usually caused by injectible drugs like penicillin or pain killers.  Sometimes food allergy due to prawns and shell fish may also cause this reaction. Symptoms of anaphylaxis starts immediately after injection. It causes sudden fall of blood pressure, rashes on the body, increased breathlessness. In such cases, an injection of adrenaline can save the patient’s life.

Are there any preventive medicines?

Preventive measures for allergic disorders can keep the  symptoms of allergy well under control. The trigger factors like stress, fumes, perfumes, irritants and so on from the atmosphere can be avoided. Anti-histamine medications can be taken as a preventive before the flare up of the allergy and to control the intensity of the reaction.

Consult your doctor to know which allergy prevention method may work best for you.

This was first published in the December 2012 issue of Complete Wellbeing.