||Information for patients with allergy and related
in the Southwest
Seasonal Advice, Treatment and Prevention
Allergy Advisor - Seasonal Update WINTER/ SPRING/ SUMMER/ FALL
Limiting Exposure to Allergens in the Home
Prevention of Allergy and Asthma in Children
Treatment of Allergy and Asthma
Skin Testing and Allergy Injection Treatment
Inhalers for Asthma
Spacers for Asthma Inhalers
Inhalers for Rhinitis
Tricks for - children to swallow pills
Skin Testing and Allergy Injection Treatment for Allergies and Asthma
Allergy skin testing and allergy injection treatment
(allergen immunotherapy) are not needed for every patient with allergic rhinitis and/or
asthma. Effective medications are available for both conditions and may be
sufficient for adequate treatment of many patients without starting allergen
Allergy Skin Testing
- Testing for skin sensitivity to a number of different
allergens confirms and amplifies information from the history of symptoms and a physical
examination done by the allergist. It does not replace the initial clinical
evaluation by the allergist. Indiscriminant testing with a large panel of allergens
including foods is not routinely appropriate in the investigation of patients with
- The testing can help to identify allergy to avoidable
allergens, to determine if the allergy is mainly to unavoidable allergens (such as
pollen), and to help in distinguishing respiratory disease that is triggered by allergens
from non-allergic respiratory disease.
- Blood testing by RAST and similar tests in a reliable
laboratory can provide information comparable to that from skin tests. Currently
these tests are more expensive and, depending on the methods used, are often less
sensitive than skin testing. Regardless of the choice between skin testing and blood
testing, the panel of allergens tested must be chosen by an allergist who is familiar with
locally important allergens. IgG (immunoglobulin G) testing for allergy is not of
proven diagnostic value.
- If the patient to be tested has moved from a botanically
different area (such as from Seattle to Tucson) within only a few months, testing is
best delayed until all of the seasons' pollens have been encountered.
Allergen Immunotherapy ("Allergy Shots")
- What is it? When
appropriate medications and avoidance of allergens are inadequate for control of
respiratory allergy (allergic rhinitis or asthma), allergen immunotherapy (allergy
injection treatment) may be indicated. The treatment consists of repeated injections
of one or more mixtures of extracts of allergens over a period of several
years. Studies of oral immunotherapy with allergens (drops under the tongue)
suggest that this might be effective under certain circumstances, but has not been proven
to be effective for treatment of sensitivities to multiple allergens seen in most allergic
- How does it work? In the
first year of treatment, the injections redirect the immune system toward more normal
functioning. This has the effect of suppressing the levels of IgE antibodies and reducing allergic inflammation, so that
tolerance of exposure to allergen steadily improves.
- How is it done? The
allergens selected for treatment are determined by the allergist to be important in
provoking disease in the patient. Initially the injections are very small doses of
weak allergen extracts given once or twice a week, and the doses are progressively
increased as the reactivity of the patient's immune system to the allergens
- Is it effective and safe?
Allergen immunotherapy has been proven by scientifically controlled studies to be
effective in reducing symptoms. Although immunotherapy never provides a permanent
cure for asthma or allergic rhinitis, it reduces the need for medications in many patients
with allergic rhinitis and asthma. Because there is a risk of allergic reactions to
the injections that varies from one patient to another, the allergist gives advice on the
balance between benefits and risk before starting treatment.
- Does it work for all allergies?
Allergy injection treatment is more effective for allergy to pollen, cats and house
dust mites than it is for mold allergy. This is fortunate for us in the desert,
where mold allergy is less of a problem than in more humid climates and where both
allergic rhinitis and allergic asthma are commonly triggered by
pollen. Immunotherapy appears to be less effective in the treatment of allergic
asthma than in the treatment of allergic rhinitis, but patients who have both conditions
usually benefit from immunotherapy. It is not indicated for treating food allergy.
- Does it replace the need for medications?
Since improvement in symptoms is normally delayed for 9-12 months, medications
taken before starting the injections must NOT be stopped during this period.
Medication requirements usually decrease after one year of treatment, but some patients
never become independent of medications.
Calderon MA. Alves B. Jacobson M. Hurwitz B. Sheikh A. Durham S.
Allergen injection immunotherapy for seasonal allergic rhinitis.[Review] [316 refs] Cochrane Database of Systematic Reviews. (1):CD001936, 2007.
Creticos PS: The
consideration of immunotherapy in the treatment of allergic asthma. Journal of
Allergy and Clinical Immunology Vol 105: pp s473-s476, 2000.
Norman, PS: Immunotherapy, past and present. Journal of Allergy and
Clinical Immunology Vol 102, pp 1-10, 1998.
Durham SR, Till SJ: Immunologic changes associated with allergen
immunotherapy. Journal of Allergy and Clinical Immunology Vol 102, pp 157-164,
Platts-Mills TAE, Mueller GA, Wheatley LM: Future directions for
allergen immunotherapy. Journal of Allergy and Clinical Immunology Vol 102, pp
What is allergy testing?
What are allergy shots?
Disclaimer: This site is for educational purposes
only. Any information that you have found in this web site is not intended to
replace medical care or advice given to you by your own physicians. You should consider
consulting your local medical library and other web sites for additional
Comments and suggestions welcome! Email: email@example.com
Content Owner: Michael J. Schumacher, MB, FRACP, The
University of Arizona