Common Allergy Treatments

There are three basic strategies used to treat allergic conditions:

Avoidance

One of the primary approaches to preventing allergic reactions is to avoid the allergens that cause symptoms. The allergens that trigger symptoms for a given individual are identified by the history, physical examination, skin testing and, occasionally, laboratory testing. Once the triggering allergens are identified, the most effective strategies to avoid further exposure are reviewed and discussed.

Medications

Medications effective in the treatment of allergic disease are used when avoidance of the allergen is difficult and the symptoms warrant treatment.

• Antihistamines block the action of histamine, which is a chemical released by immune cells in the body during an allergic response and responsible for a number of the symptoms associated with allergic reactions. They are available over-the-counter, and by prescription. Some medications contain a combination of antihistamines and other medications such as decongestants and/or cough suppressants. 
• Steroids are sometimes used to treat moderate or severe allergic reactions and are only available by prescription. Steroids work by decreasing the inflammation caused by allergic reactions. Steroids are available in preparations that can be applied topically to the site of the allergic reactions. Topical steroid formulations are available for the treatment of allergic conditions of the nose, lungs and skin. Steroids are occasionally given orally for the management of severe allergic reactions.
• Leukotriene modifiers are medications that block the production or effects of leukotrienes, which are chemicals involved in causing the inflammation associated with allergic reactions. These medications are used in the treatment of asthma and allergic nasal and ocular symptoms.
• Asthma medications: Medications used in the treatment of asthma include "quick-relief" medications and controller medications. The quick-relief medications, of which albuterol is an example, are used to treat sudden onset symptoms of shortness of breath, wheezing and labored breathing. The controller medications are used to calm the airways, reduce inflammation, provide better asthma control and decrease the need for quick-relief medications. Examples of controller medications include leukotriene antagonists and inhaled steroids. The recommendation for the use of asthma medications is individualized for each patient based upon the history, findings on physical examination, and lung function testing.
• Anti-IgE is a relatively new medication that is a special antibody that attaches to the allergy antibody (IgE) in the bloodstream and prevents it from reaching cells in the body's tissues involved in the allergic response. It is given as a shot once every 2 to 4 weeks and reserved for the treatment of severe asthmatic patients whose symptoms are triggered by allergic reactions and unresponsive to other milder forms of therapy. Anti-IgE is only available by prescription.

Immunotherapy (allergy shots)

Allergen immunotherapy is occasionally used to treat patients whose symptoms have been demonstrated to be caused by allergies and the allergens have been clearly identified. Candidates for allergen immunotherapy have significant symptoms for a good portion of the year and remain symptomatic despite otherwise appropriate medical management. In these situations, dilute extracts of the appropriate allergens are prepared and injected into the patient in gradually increasing amounts over a period of several months in an attempt to induce tolerance. Once the maintenance dose is reached, the allergen immunotherapy is continued every few weeks for several years. A usual course of immunotherapy lasts from 3 to 5 years.