Allergies

Overview

Allergies are a condition where your immune system treats something harmless, like pollen or dust, as if it were a threat. This causes symptoms like sneezing, itching, a runny nose, or a rash.

Yes. Allergies are one of the most common long-term health problems worldwide. Many people have mild symptoms, while others need ongoing care.

Anyone can develop allergies at any age. They often start in childhood, but new allergies can appear in adults. You are more likely to have them if others in your family have allergies, asthma, or eczema.

Symptoms

Common symptoms

• Sneezing
• A runny, blocked, or itchy nose
• Itchy, red, or watery eyes
• An itchy rash or hives
• Wheezing or coughing
• Feeling tired or irritable

Symptoms in children

• Sneezing and a runny nose that lasts longer than a cold
• Rubbing the nose upwards with the palm of the hand
• Itchy, red or swollen eyes
• Eczema (dry, itchy skin patches)
• Coughing at night or after exercise
• Fussy eating or poor concentration due to feeling unwell

Symptoms in older adults

• Persistent nasal congestion or a post-nasal drip (tickling sensation in the throat)
• Watery or itchy eyes that are sometimes mistaken for dry eye
• Skin itching or a rash after contact with a trigger
• Worsening of asthma, if present
• Fatigue or poor sleep due to night-time symptoms

Causes

Main causes

• Your immune system overreacts to a harmless substance, such as pollen, dust mites, animal dander, mould, certain foods, or insect stings
• The body releases chemicals, including histamine, which cause inflammation and allergy symptoms
• Any contact with that substance, whether breathed in, eaten, or touched, can cause a reaction

Risk factors

• A family history of allergies, asthma, or eczema
• Having asthma or eczema yourself
• Living in areas with high pollution or seasonal pollen
• Being around triggers at home or work, such as dust, mould, or certain chemicals

When to see a doctor

See a doctor urgently if:

• You have trouble breathing, swelling of your face or throat, dizziness, or a sudden severe reaction – call your local emergency number immediately
• If you have been prescribed an emergency injector for severe allergies and you need to use it, do so and then get emergency medical help

Book a routine appointment if:

• Your symptoms are interfering with sleep, work, school, or daily activities
• Over-the-counter allergy medicines are not giving you enough relief
• Your symptoms come and go throughout the year and you aren't sure what triggers them
• You have a baby or older adult with troublesome symptoms
• You think a food might be causing your symptoms and you need a clear plan to keep safe

Diagnosis

Your GP, or family doctor, will ask about your symptoms, when they happen, and what you were exposed to. They will also check your nose, throat, eyes and skin. Based on that, they may refer you for allergy tests or give you a management plan.

Tests that may be done

• Skin prick test – tiny drops of allergen placed on your skin to see if a small bump appears
• Blood test – measures the level of allergy-related antibodies in your blood
• Trial avoidance – removing a suspected trigger for a few weeks to see if symptoms improve
• Food diary – useful if a food allergy is suspected

What to expect at your appointment

You may be referred to an allergy clinic for testing. Tests are simple and usually done on the day. The results help you understand what to avoid and what treatment may help. Your doctor or allergy nurse will explain everything and write down a plan for you.

Treatment

Managing allergies usually involves two steps: avoiding the trigger as much as possible, and using medicines to control symptoms when they happen. For some people, treatments that help the immune system become less sensitive (immunotherapy) can also be an option.

Self-care at home

• Keep a diary of your symptoms to help identify your triggers
• If you are allergic to pollen, keep windows closed on high-pollen days and change your clothes after being outside
• Use a saline (saltwater) nasal rinse to wash out allergens from your nose
• For itchy eyes, use a clean, cool cloth over closed eyelids
• Brush or wash your pet regularly if you are allergic to pet dander (ask a family member to help if necessary)

Medical treatments

Your doctor or allergy specialist may suggest medicines that block the allergy chemicals in your body, such as antihistamines. These come as tablets, liquids, nasal sprays, or eye drops. Other options may include steroid nasal sprays to reduce nasal inflammation, and, for severe allergic reactions, an emergency injector that you carry at all times. Allergy immunotherapy (often called 'desensitisation') is a long-term treatment that gradually exposes you to a tiny amount of the allergen to reduce your reaction over time. You and your doctor will decide which approach is best for your symptoms and your lifestyle.

When is surgery considered?

Surgery is not usually used for allergies. In rare cases of severe nasal problems caused by allergy-related polyps or a blocked nose, a procedure to improve breathing may be discussed. This would only be considered after medical treatments have been tried.

Living with this condition

Living with allergies means paying a bit more attention to your environment. With a good plan and support, you can keep symptoms low and enjoy your daily life. Remember to take any prescribed medicines as directed, even when you feel well, if they are meant to be used regularly.

Lifestyle tips

• Learn which allergens bother you and take small steps to avoid them (e.g., use allergy covers on pillows and mattresses)
• Clean and vacuum your home regularly, especially bedrooms
• Keep windows closed during high-pollen times and use an air filter if needed
• After being outdoors, shower and change clothes to remove pollen
• Carry a small emergency kit with your medicines or injector if prescribed

Diet and exercise

Eat a balanced diet with plenty of fruits, vegetables, and whole grains. If you have food allergies, this is still possible with careful planning around your trigger foods. Exercise is good for you, but if you have asthma triggered by exercise, your doctor can help you manage that.

Mental health and emotional wellbeing

Allergies can affect your sleep, energy, and concentration. It is natural to feel frustrated or stressed, especially if symptoms are not well controlled. Talk to your doctor if you feel anxious or low, and remember to be kind to yourself.

Prevention

There is no known way to prevent allergies from developing. However, once you know your triggers, you can take steps to prevent or reduce symptoms. Early support from a doctor can make a big difference.

Vaccines

Allergy immunotherapy is sometimes called 'allergy vaccines'. This is a treatment that can help your immune system become less sensitive to a specific allergen. It does not prevent other allergies and is not used for everyone.

Screening programmes

There is no routine screening program for allergies. Allergy tests are done when someone has symptoms that suggest a possible allergy, so you do not need to worry about being tested unless you have trouble.

Complications

If left untreated

• Severe allergic reactions (anaphylaxis) can become life-threatening without urgent treatment
• Chronic nasal allergies can lead to sinusitis (pain or pressure in the face), ear infections, or asthma flare-ups
• Untreated eczema from allergies can become infected or affect sleep and daily comfort

Long-term outlook

Most people with allergies can lead a full and active life. Once you know your triggers and have a clear plan, symptoms can be managed very effectively. Research is always improving, and new management options are constantly being developed. With the right support, there is every reason to be hopeful.

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