Common Allergies & Sensitivities
Dust Mites
Dust mites can be difficult to detect due to their small size, as you can only see them under a microscope. The reason why dust mites are so prevalent in people’s homes is that they feed off of dead skin cells. Dust mites make their homes in places where dead skin cells are most likely to accumulate, such as bedding, furniture, and carpeting. Rugs and stuffed animals also make good homes for dust mites. While you can find dust mites all over the world, these creatures tend to favor hot and humid climates. Since they can burrow themselves deep into cloth fibers, they can also travel with you when you move or are on a vacation or business trip. Dust mites themselves are allergenic, meaning they can cause allergies. They also leave behind skin and fecal matter that may also trigger allergies.
Dust mites are difficult to get rid of completely, but removing as many as possible from your home can help prevent allergic reactions. The best way to get rid of dust mites is to target the areas they tend to live in and thrive. These include:
- bedding
- pillows
- carpets
- rugs
- pet bedding and furniture
- furniture
- blinds and curtains
- toys and stuffed animals
Frequent vacuuming, wet mopping, dusting, and washing can all treat dust mites. You don’t need any specialized products. You just need to make sure you wash bedding in hot water and use wet cloths that can properly trap dust when you clean.
Prevention is key to avoiding allergies, including dust mites. It may be challenging to prevent them altogether, but you can take the following steps to control the dust mite population in your household:
- Avoid carpeting in your home as much as possible.
- Vacuum and deep clean all carpet and rugs as often as you can.
- Dust regularly, paying extra attention to blinds, furniture crevices, and other small areas where dust mites may accumulate.
- Keep the humidity in your home under 50 percent to ward off the conditions dust mites thrive in. You can use a dehumidifier and a humidity meter to achieve this.
- Use certified allergen-capturing filters in all air conditioning units and vacuums to make sure dust mites and their fecal matter are fully captured.
- Wash all bedding weekly using hot water.
- Use zippered mattress and pillow covers to prevent dust mites from entering your bedding.
- It’s important to note that pesticides do not get rid of dust mites.
Mold
Molds are microscopic fungi; their spores float in the air like pollen. Molds thrive in damp areas with decaying materials. There are many molds, the most common being Alternaria and Cladosporium.
Outdoor mold spores begin to appear after a spring thaw and peak in July through October. These molds can be found in soil, leaves on the ground and rotting wood.
Indoor molds (mildew) may be found in basements, bathrooms, refrigerators, garbage containers, houseplant soil, carpets, upholstery and even Christmas trees.
To limit your child’s contact with mold:
- Avoid damp and dusty places such as attics and basements.
- Regularly clean and ventilate basements, bathrooms and kitchens.
- Use a dehumidifier with adequate capacity (at least 40 pints) to keep a basement dry. Empty collected water often, or drain.
- Clean cool mist vaporizers weekly. Inspect air conditioner filters weekly.
- Keep houseplants to a minimum and out of the bedroom.
- Use window air conditioners with the vent to the outside closed.
- Do not use carpeting in damp areas.
- Repair leaks in your roof, walls, and windows.
- Vent the clothes dryer to the outside.
- Keep windows closed, as outdoor molds can blow into the home through open windows and doors.
- Don’t stir up piles of leaves during the fall season, as this releases mold and pollens.
Cockroaches
Roaches thrive in areas with food and moisture and elimination may be very difficult. To keep them out of your home:
- Exterminate/fumigate (professional), then thoroughly clean. Add bleach to the wash water.
- Keep the stove and all kitchen areas clean, dry and free of food particles.
- Keep the house dry. Allow sinks, tubs, and floors to dry every day. Remove sources of standing water.
- Keep food tightly sealed and all surfaces clean.
- Use strategically place roach baits.
- Vacuum and wet wash home thoroughly.
- Place trash outside nightly.
- Seal all cracks.
Cigarette Smoke & Airborne Irritants
Exposure to tobacco smoke has been proven over and over to worsen asthma in all ages, even if exposure is only second hand. Other airborne irritants can have a similar effect. To limit his exposure to these allergens, your child should:
- Avoid being in confined areas with smokers: riding in cars, public places, at home.
- Avoid spraying insecticides or other strong smelling products in the house.
- Avoid smoke from fireplaces and wood burning stoves.
- Avoid strong cooking orders, especially from frying.
- Limit physical activity during periods of high air pollution or ozone alert days.
- Use an adequate air filtration system with a HEPA filter.
- Avoid painting in enclosed areas and spending extended periods of time in freshly painted areas.
- Not use spray room deodorizers or dust sprays in the bedroom.
Rodents
It’s important to hire a professional to exterminate your home, then thoroughly clean it. Once rodents have been removed, keep food in tightly sealed containers and seal all cracks to keep them out.
Milk Protein Allergy
Milk allergy is one of the most common allergens in young children. Most children will outgrow this allergy within their first year of life. If you have significant symptoms from exposure it’s currently recommended that your avoid sources of milk, although this can be difficult.
SOURCES OF MILK
Obvious sources of allergy-causing milk proteins are found in dairy products, including:
- Whole milk, low-fat milk, skim milk, buttermilk
- Butter
- Yogurt
- Ice cream, gelato
- Cheese and anything that contains cheese
- Half-and-half
Milk can be harder to identify when it’s used as an ingredient in processed foods, including baked goods and processed meats. Hidden sources of milk include:
- Whey
- Casein
- Ingredients spelled with the prefix “lact” — such as lactose and lactate
- Candies, such as chocolate, nougat and caramel
- Protein powders
- Artificial butter flavor
- Artificial cheese flavor
- Hydrolysates
Even if a food is labeled “milk-free” or “nondairy,” it may contain allergy-causing milk proteins — so you have to read the label carefully. When in doubt, contact the manufacturer to be sure a product doesn’t contain milk ingredients.
When eating out, ask how foods have been prepared. Does your steak have melted butter on it? Was your seafood dipped in milk before cooking?
If you’re at risk of a serious allergic reaction, talk with your doctor about carrying and using emergency epinephrine (adrenaline). If you have already had a severe reaction, wear a medical alert bracelet or necklace that lets others know you have a food allergy.
MILK ALTERNATIVES FOR INFANTS
In children who are allergic to milk, breastfeeding and the use of hypoallergenic formula can prevent allergic reactions.
Breastfeeding is the best source of nutrition for your infant. Breastfeeding for as long as possible is recommended, especially if your infant is at high risk of developing milk allergy.
Hypoallergenic formulas are produced by using enzymes to break down (hydrolyze) milk proteins, such as casein or whey. Further processing can include heat and filtering. Depending on their level of processing, products are classified as either partially or extensively hydrolyzed. Or they may also be called elemental formulas.
Some hypoallergenic formulas aren’t milk based, but instead contain amino acids. Besides extensively hydrolyzed products, amino-acid-based formulas are the least likely to cause an allergic reaction.
Soy-based formulas are based on soy protein instead of milk. Soy formulas are fortified to be nutritionally complete — but, unfortunately, some children with a milk allergy also develop an allergy to soy.
If you’re breastfeeding and your child is allergic to milk, cow’s milk proteins passed through your breast milk may cause an allergic reaction. You may need to exclude from your diet all products that contain milk. Talk to your doctor if you know — or suspect — that your child has milk allergy and develops allergy signs and symptoms after breastfeeding.
If you or your child is on a milk-free diet, your doctor or dietitian can help you plan nutritionally balanced meals. You or your child may need to take supplements to replace calcium and nutrients found in milk, such as vitamin D and riboflavin.
COW’S MILK SENSITIVITY
Lactose intolerance occurs when your small intestine doesn’t produce enough of an enzyme (lactase) to digest milk sugar (lactose). Normally, lactase turns milk sugar into two simple sugars — glucose and galactose — which are absorbed into the bloodstream through the intestinal lining. If you’re child is lactase deficient, lactose in your food moves into the colon instead of being processed and absorbed. In the colon, normal bacteria interact with undigested lactose, causing the signs and symptoms of lactose intolerance.
Common symptoms in young babies are frequent stools with hard to control diaper rashes. These babies are often fussier than other babies and this fussiness often responds to acid suppression therapy. Typically reduction but not elimination of cow’s milk in the mother’s diet is necessary when breastfeeding, to do this first fully eliminate for 2 weeks by watching out for dairy and hidden dairy as above in the milk allergy section. Then slowly add back dairy, starting with baked in goods and then moving to less processed forms of dairy like cheese and yogurt. By slowly adding back dairy you’ll find what level your child is able to tolerate.
If you are on formula, you child may not be able to tolerate a regular formula but may tolerate a similarly priced “sensitive” or lactose reduced formula.
Formula examples with decreasing amounts of lactose and other allergens:
- Normal Formulas
- Similac Advanced, Enfamil Neuropro
- Decreased Lactose & Milk Protein
- Similac Total Comfort, Enfamil Gentlease
- No Lactose, No Milk Protein
- Similac Alimentum, Enfamil Nutramigen
- No Allergens
- Elecare, Neocate, Puramino
Your pediatrician can check your child’s stool for unprocessed lactose sugars that can confirm the diagnosis. For most children, this will be a lifelong condition that will vary in severity dependant upon the amount of cow’s milk the child gets. Lactose intolerance runs in the family, so if you or a family member has it, your child has an increased chance of being born with it.
Pet Dander
The standard advice from allergists to control allergic symptoms to pets is to remove animals from the home, but often these animals are full fledged family members and this advice is not realistic. The good news is there are tactics to minimize your exposure to cat and dog allergens.
USE AIR PURIFIERS
Pet allergens are lightweight and airborne, which means they can be captured by a high-quality air purification system. Opt for an air-cleaning system that is equipped with HEPA technology and is effective at removing ultra-small particles. To ensure that the purifier is effective against allergens, replace the filter regularly as directed. Since forced air heating and air-conditioning spread allergens around the house, install filters on bedroom ventilation grids.
REGULAR CLEANING
An effective plan to control animal allergens in the home must include a system for regular cleaning, as pet allergens tend to have a jagged shape that allows them to cling to surfaces such as furniture, bedding and fabric. Lifting the allergens from the various surfaces in your home takes a multi-pronged approach.
- Use a HEPA Filter Vacuum Cleaner
- Twice weekly, vacuum your carpeting, furniture and draperies with a HEPA filter vacuum cleaner. This process will dislodge and remove dander buildup.
- Steam Clean Carpeting Frequently
- Steam cleaning every three months helps to remove embedded dander.
- Mop Uncarpeted Flooring & Wipe Down Walls
- Two times a week, remove pet allergens from hard flooring with a damp mop or an electrostatic cloth. Do the same to the walls every three to six months.
- Wash Bedding Weekly
- Wash all pet blankets and bedding covers in hot water weekly.
Bathe Pets Frequently
- Washing pets regularly will cut down on dander. Wipe down their coats daily with a damp microfiber cloth.
Manage the Litter Box
- Clean the litter box regularly
- Ammonia builds up over time and the more concentrated it becomes, the stronger it will smell and the more likely it will cause unpleasant physical symptoms. Scoop out feces at least once a day and change the litter every five days. Prior to changing the litter, prevent dust inhalation by spraying it with water, and wear an allergy mask and gloves to minimize exposure.
- Change your litter type
- Rather than using standard kitty litter, which tends to produce dust and may contain fragrances that cause allergic reactions, try a hypoallergenic variety such as one made from pine or cedar sawdust, which are absorbent materials that neutralize ammonia.
- Keep the litter box in a well-ventilated area
- Placing the box in a location where the ammonia odors can escape helps keep air clean. A nearby air purifier will also help.
Outdoor Allergies
Seasonal allergic rhinitis, commonly referred to as hay fever, affects millions of people worldwide. Symptoms include sneezing, stuffiness, a runny nose and itchiness in your nose, the roof of your mouth, throat, eyes or ears. These allergic reactions are most commonly caused by pollen and mold spores in the air, which start a chain reaction in your immune system.
POLLEN AND MOLD LEVELS
Pollen and mold counts measure the amount of allergens present in the air. There is a difference between a pollen count and a pollen forecast. Pollen counts reflect real-time conditions. Pollen and mold forecasts are often based on past pollen data and general weather forecasts.
The National Allergy Bureau™ (NAB™) is the nation’s only pollen and mold counting network certified by the American Academy of Allergy, Asthma & Immunology (AAAAI). Go to the NAB link above and sign up for an email when counts are high, this should allow you to start treatment as the pollen or mold season gets underway and help you treat your symptoms more effectively.
EFFECTS OF WEATHER AND LOCATION
Hay fever symptoms are often less prominent on rainy, cloudy or windless days because pollen does not move around during these conditions. Pollen tends to travel more with hot, dry and windy weather, which can increase your allergy symptoms.
Some people think that moving to another area of the country may help to lessen their symptoms. However, many types of pollen (especially grasses) and molds are common to most plant zones, so moving to escape your allergies is not recommended. Also, you are likely to find new allergens to react to in new environments.
TREATMENT
If your seasonal symptoms are making you miserable, your doctor can help and may even refer you to a specialist in allergy.
If your symptoms continue or if you have them for many months of the year, your doctor may recommend allergy immunotherapy (allergy shots) If allergy is confirmed by testing. This treatment involves receiving regular injections given in gradually increasing doses. This helps your immune system become more resistant to the specific allergen and lessen your symptoms as well as the need for medications.
There are also simple steps you can take to limit your exposure to the pollen or molds that cause your symptoms:
- Keep your windows closed at night and if possible, use air conditioning, which cleans, cools and dries the air.
- Try to stay indoors when the pollen or mold counts are high. If your symptoms are severe, wear a pollen mask if long periods of exposure are unavoidable. When you return indoors, take a shower, shampoo your hair and change clothes.
- Avoid being responsible for mowing lawns or raking leaves. This stirs up pollen and molds. Also avoid hanging sheets or clothes outside to dry.
- When traveling by car, keep your windows closed.
- Take any medications as prescribed.
Drug Allergies
A drug allergy is the abnormal reaction of your immune system to a medication. Any medication — over-the-counter, prescription or herbal — is capable of inducing a drug allergy. However, a drug allergy is more likely with certain medications.
SYMPTOMS
- Skin rash or hives
- Itching
- Wheezing or other breathing problems
- Swelling
- Anaphylaxis, a potentially life-threatening reaction (ex. rash with difficulty breathing)
COMMON TRIGGERS
- Penicillin and related antibiotics
- Antibiotics containing sulfonamides (sulfa drugs)
- Anticonvulsants
- Aspirin, ibuprofen and other nonsteroidal anti-inflammatory drugs (NSAIDs)
- Chemotherapy drugs
MANAGEMENT AND TREATMENT
- Avoid triggers.
- Seek immediate medical care if symptoms worsen or multiple symptoms occur together (anaphylaxis).
- Make sure that all of your health care providers, including your pharmacist, are aware of your allergy. If you have a history of anaphylaxis, wear a medical alert bracelet that lists your trigger.
- Common treatments depending on severity
- Benadryl, Zyrtec (anti-histamines)
- Corticosteroids (steroids)
- Epinephrine, Albuterol (adrenalin analogs – for life threatening reactions)
DIAGNOSIS
Drug allergies can be hard to diagnose. An allergy to penicillin-type drugs is the only one that can be definitively diagnosed through a skin test. Some allergic reactions to drugs – particularly rashes, hives and asthma – can resemble certain diseases.
Your doctor will want to know the answers to these questions:
- What drug do you suspect caused your reaction?
- When did you start taking it, and have you stopped taking it?
- How long after you took the drug did you notice symptoms, and what did you experience?
- How long did your symptoms last, and what did you do to relieve them?
- What other medications, both prescription and over-the-counter, do you take?
- Do you consume herbal medications or take vitamin or mineral supplements? If so, which ones?
Your doctor will also want to know whether you have had a reaction to any other drug. If you can, bring the suspected drug with you. This will help the doctor recommend alternatives as needed.
During a physical examination, your doctor will look for problems that are part of the drug reaction, along with nonallergic reasons for the reaction
Depending on the drug suspected of causing the reaction, your doctor may suggest a skin test or, in limited instances, a blood test.
If a drug allergy is suspected, your doctor may also recommend an oral drug challenge, in which you will be supervised by medical staff as you take the drug suspected of triggering a reaction. (If your reaction was severe, a drug challenge may be considered too dangerous.
