Wednesday, June 1, 2016

Understanding and Treating Allergic Asthma

Drs. Diana Balekian and Paul Hesterberg, Allergy and Immunology specialists, share insights in allergies and asthma and preventive ways to care for the conditions.


My child has allergic asthma.  What treatments are available?
Allergic asthma, like other forms of asthma, is usually treated with inhaled medications.  These medications may include controller (for daily maintenance) and rescue (for quick relief) medications.  Some asthma medications are also available in an oral formulation. 

Avoidance of allergic triggers is a major component of asthma flare prevention and allergy testing is an important step in identifying these triggers.  Another treatment that may help your child is allergen immunotherapy, or allergy shots.  Allergy shots have been shown to be very effective in treating both allergic asthma and allergic rhinitis.  For this treatment, your child would receive shots that contain a small amount of an allergen, helping them build tolerance of the allergen.  The shots are administered at different intervals over the course of 3-5 years, during which time the dose of allergen is slowly increased.  Some studies have shown that allergy shots may also prevent the development of allergic asthma in children with allergic rhinitis.

Your child’s physician will determine which treatment is best based on your child’s medical history.

What are symptoms of environmental allergies?
Symptoms of environmental allergies include runny or itchy nose, nasal congestion, itchy and watery eyes, sneezing, and post-nasal drip.  These symptoms are collectively known as allergic rhinitis.  You may notice your child rubbing his or her eyes and nose, sniffling and coughing.  If your child also has asthma or eczema, you may notice flares of your child’s disease when they are around allergens.  While some patients have clear-cut symptoms when exposed to allergens, others may not have such obvious symptoms.  For those individuals, allergy testing may be helpful in identifying the specific allergens that trigger symptoms. 

How do environmental allergies affect asthma and its symptoms?
Approximately 80% of children with asthma have environmental allergies, especially those children that are over 3 years old.  Children may be allergic to indoor allergens, like dust mites, cockroaches and mice; furry pets, like cats and dogs; pollens from trees, grasses and weeds; or molds.  Children with allergies are less likely to outgrow their asthma.  Exposure to their specific allergens can worsen asthma, sometimes leading to asthma exacerbations.

If I think my child is experiencing environmental allergies, what testing is needed for a diagnosis?
The most accurate and common type of allergy testing is skin prick testing, which is performed by an allergist/immunologist.  During skin prick testing, different allergen extracts are scratched onto the skin on the upper back or forearm using a plastic device.  After 15-20 minutes, each scratch test is read.  If there is a hive at the testing site, this indicates that the test is positive, meaning that your child is allergic to that particular allergen.

Your child’s allergist/immunologist may choose to conduct other types of tests if a skin test cannot be performed; for example, in patients who are on medications that interfere with skin testing or in patients who have severe eczema.

What are some tips for avoiding allergens in the home?

Dust mites: Remove carpeting in your child’s bedroom, use dust-mite proof mattress and pillow case covers, wash bedding in hot water weekly and limit how many stuffed animals are in their bedroom.

Pollen: Keep windows in the car and house closed when there are high pollen counts, make sure your child takes a shower and changes his or her clothing after coming indoors.

Pets: Ideally, pets should be removed from the household if your child has allergic asthma.  However, at the very least, pets should stay out of your child’s bedroom.


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