Allergies Can Start In Infancy
Hay fever is not really fever and has nothing to do with hay.
Did you ever wonder whether that stuffy, runny nose of yours is really due to allergies? If so, you are not alone. Over 20% of the population, man or woman, child or teen has the genetic material to allow them to become allergic.
Allergies are generally inherited, although sometimes they are fussy and may skip a generation. We sometimes use the word “atopy” to describe a person who has the potential to develop an allergy. If a parent is allergic, 20-25% of his/her children will have the potential to become allergic. If both parents are allergic, 50%+ of their offspring will have the allergic potential.
Allergies can start in infancy where we might see a 6-month old child begin throwing up his/her formula. The child may even show skin reactions known as eczema, where the skin becomes red and bumpy and very itchy. The eczema may appear on the cheeks and then move to the creases of the arms and behind the knees.
What are we really talking about when we say we are allergic? What can we become allergic to? The hallmark of “allergens” (things we become allergic to) is that they are proteins. Food proteins such as cow’s milk, peanuts, egg whites, fish, and citric juices are most common. Then there are environmental proteins such as dust mites, mold spores, animal dander, and pollens from trees, grasses and weeds.
Hay fever (allergic rhinitis) is not really fever and has nothing to do with hay. But, most people use this term to describe the problems. Nasal allergies can begin in early childhood and usually are triggered by things in the immediate environment such as a dog, cat, or guinea pig. Kids can also become allergic to those tiny dust mites found living in their mattresses. As we become teenagers or adults, pollens, found in such areas as trees in the springtime, grasses in early summer, and weeds in late summer and fall often trigger the allergies. Of course, it depends on where you live as to which pollens are present seasonally and which are present year around. For instance, if you live in California or the southern United States, Bermuda grass may actually be present year round. Those of us who live in the northern part of the United States may find a more seasonal problem depending on the specific allergy. A person may be allergic to only grass pollen so the symptoms would be present only during the grass-pollinating season. Some people are allergic only to trees or weeds, so they may complain only in the spring or fall. And then there are those poor souls who react to everything and have sneezing, dripping, itching, and stuffiness for the entire year!
The latest treatment
Allergy treatment consists of just three things:
Let’s look at avoidance. It is almost impossible to avoid pollens, although if you have air conditioning, you can “close the house” during the season. I do hate it when a family doctor tells people to “stay indoors when the pollen counts are high.” After all, you have to live and be normal, and that’s what the correct treatment tries to achieve. There are excellent medications (mostly by prescription) that are available to treat nasal allergies. Non-sedating antihistamines like Allegra and Clarinex (or it’s generic version, Claritin) may be of benefit. Zyrtec is also used. Although it may be slightly sedating, it is an excellent antihistamine. The “gold standard” treatment of nasal allergies is the use of nasal steroids. Nasal steroids such as Nasacort AQ, Nasonex, Rhinocort Aqua, and Flonase can be prescribed. These medications either alone or in combination with antihistamines can be used preventatively (just before your season starts) and then continued until the season is over. Sometimes the nasal steroids can be used on an every-other-day basis with good results.
- Avoidance (if possible)
- Medication control
- Allergy immunotherapy (yes…shots)
When medications are used correctly, the person suffering from “hay fever” should be significantly better. However, if symptoms are not controlled, you may not have an allergy but could have a complicating problem such as sinus disease. Or, you could be so allergic that antihistamines and nasal steroids are not doing the job. In that case it is preferred that you get a referral from your personal physician. Your physician knows who in your area is best for treating allergies. That’s because there are a lot of physicians who are doing “allergy” who are not fully trained allergists, so be careful.
Allergy testing is nothing to be feared. And, despite what you may have been told, allergy tests done by allergists can be performed on patients of any age. Once you are tested, the allergist will go over with you the proper use of medications, the need to be compliant, and then the possible need for allergy injections. In the right hands, allergy shots are safe and very effective.
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"Allergies Can Start In Infancy"
Thom F. Rosenberg, M.D., a graduate of The Chicago Medical. Pediatric internship and residency @ The Childrens' Hospital of Pittsburgh. Allergy & Immunology Fellowship @ The University of Pittsburgh Hospitals and The Childrens' Hospital of Pittsburgh...