Treatment for allergies

The old saying that prevention is better than cure is certainly true in the case of common allergies. If you have an allergy to cats or dogs, not owning one and avoiding the houses of friends who do can help minimise your symptoms. Other allergens maybe much more difficult to avoid.

If you have seasonal allergic rhinitis, commonly called hay fever, your allergy is to grass pollen and it is difficult to avoid exposure. Treating the symptoms can give considerable relief, but it needs to be done consistently and as soon as you first notice them.

Most patients with mild hay fever get relief from an antihistamine tablet and then supplement it with eye drops on days when their eyes are particularly itchy or with a topical steroid nasal spray if eye drops don’t provide relief.

Common treatments include:

  • Eye drops: these usually contain sodium cromoglicate, an anti-allergic agent that acts locally to cut down inflammation in the eyes.
  • Nasal sprays: these often have a corticosteroid as their active ingredient. Corticosteroids reduce the inflammation that is caused when the cells in the nose respond to the allergen. Nasal sprays are particularly effective at treating congestion (a blocked nose). If you use a nasal spray and an antihistamine tablet you may not need eye drops.
  • Inhalers for allergic asthma: if your allergy either causes asthma symptoms or makes your underlying asthma worse, you will be encouraged to take a reliever inhaler containing a short-acting beta-2-agonist such as salbutamol or terbutaline when you experience wheezing or difficulty breathing. You may also be prescribed an inhaler to prevent symptoms in the longer term. These contain a corticosteroid that you inhale directly into the lungs.
  • Systemic allergy treatments: antihistamine tablets taken every day can reduce symptoms in the eyes, nose and upper respiratory tract. If your symptoms are severe you may be prescribed corticosteroid tablets, usually as a 5- or 10-day course, to provide some relief from your symptoms until your antihistamine therapy has a chance to start working.
  • Omalizumab (Xolair®) is used for persistent allergic asthma that is severe. This type of allergy treatment was recommended by the National Institute of Clinical Excellence in 2007. It inhibits the action of one of the molecules produced in the body during an allergic response. At the moment it has to be given by injection and is only suitable for patients with chronic, severe and steroid-dependent asthma.