Controlling Your Allergies

Overview

An allergy is what happens when your immune system — your body's natural defence against germs — mistakes something harmless for a danger. The thing it reacts to is called an allergen. Common allergens include pollen, dust mites, pet fur or saliva, mold, certain foods, insect stings and some medicines. When you touch, breathe in or eat the allergen, your body releases a chemical called histamine. That chemical is what causes the sneezing, itching, runny nose, watery eyes, rash or wheezing. Allergies are not a sign of weakness, and they are not 'all in your head' — they are a real reaction your body is having.

Yes. Allergies are among the most common long-term health problems worldwide. Hay fever alone affects millions of people every spring and summer, and food allergies, eczema and asthma are also widespread, especially in children.

Anyone can develop an allergy, at any age. Many start in childhood, but it is also possible to become allergic to something for the first time as an adult or in later life. Allergies often run in families — if a parent has asthma, eczema or hay fever, a child is more likely to have an allergy too.

Symptoms

Common symptoms

• Sneezing, often in bursts
• Runny or blocked nose
• Itchy, watery or red eyes
• Itchy roof of the mouth, throat or ears
• Coughing or wheezing
• Itchy skin rash, hives (raised red bumps) or dry itchy patches
• Feeling tired or foggy because symptoms disturb sleep
• For food allergies: tingling mouth, tummy pain, feeling sick, being sick or diarrhoea

Symptoms in children

• Eczema — dry, itchy, red patches, often in the creases of elbows and knees
• Rubbing the nose upwards again and again (sometimes called the 'allergic salute')
• Dark shadows or creases under the eyes
• Frequent sneezing or a constantly runny nose that lasts for weeks
• Tummy pain, vomiting or loose stools after certain foods
• Being irritable, sleeping badly or finding it hard to concentrate at school

Symptoms in older adults

• Allergies can appear for the first time in later life, even if you never had one before
• Symptoms are sometimes mistaken for a long-lasting cold or for irritation from dry air
• Allergy symptoms can overlap with other long-term chest or breathing conditions, so it is worth getting them checked
• If you take other medicines, ask your pharmacist before starting any allergy treatment, so they can check it suits you

Causes

Main causes

• The immune system reacting to a harmless substance as if it were a threat
• Breathing in allergens such as pollen, dust mite droppings, mold spores or pet proteins
• Eating allergens such as nuts, eggs, milk, shellfish, wheat or soya
• Skin contact with allergens such as latex, nickel in jewellery, or certain creams and cosmetics
• Insect stings, most often from wasps or bees
• Some medicines, which can cause reactions in certain people

Risk factors

• A family history of allergy, asthma, eczema or hay fever
• Having one allergy — it makes other allergies more likely
• Having asthma or eczema
• Being a child or teenager, when allergies most often begin
• High exposure to certain allergens at work, such as flour dust, latex gloves or animal proteins

When to see a doctor

See a doctor urgently if:

• Any swelling of the face, lips, tongue or throat
• Breathing difficulty, wheezing that is new or getting worse, or a tight chest
• A severe reaction after a sting, a food or a new medicine
• A rapidly spreading rash with feeling unwell

Book a routine appointment if:

• Symptoms that keep coming back or last more than a few weeks
• Allergy symptoms that are disturbing your sleep or affecting school, work or daily life
• You are not sure what is triggering your symptoms
• Over-the-counter treatments are not helping enough
• You suspect a food allergy — get this checked before cutting foods out of your diet

Diagnosis

Your doctor will usually start by asking about your symptoms: when they happen, where you are when they start, what makes them better or worse, and whether allergies run in your family. That conversation often gives the answer on its own. If it is not clear, they may arrange a simple test. Diagnosis is usually done in primary care, and you may be referred to an allergy clinic for more detailed tests.

Tests that may be done

• Skin prick test — a tiny amount of allergen is placed on your skin and lightly pricked; a small itchy bump suggests a reaction
• Blood test — measures allergy antibodies (proteins your body makes in response to an allergen) in your blood
• Patch test — small patches are taped to your skin for a couple of days to check for contact allergies
• Food and symptom diary — you record what you eat and how you feel, to spot patterns
• Supervised food challenge — only done in a specialist setting, where a food is eaten in small amounts under medical watch

What to expect at your appointment

Most tests are quick and only mildly uncomfortable. Skin prick tests can itch for a short while, and you may need to stop certain medicines before the test — your clinic will tell you what to do. Results are always looked at alongside your symptoms, because a positive test does not always mean you react in real life. Ask for the results to be explained in plain words so you understand what they mean for you.

Treatment

Managing an allergy usually comes down to two things: reducing contact with your trigger, and calming the symptoms when they appear. Your doctor or pharmacist can help you build a simple plan that fits your life. Nobody expects you to avoid your trigger perfectly — the aim is to keep symptoms small enough that they do not get in the way.

Self-care at home

• Keep a symptom diary for a couple of weeks to work out your triggers
• Check pollen forecasts and plan outdoor time for days when counts are lower
• Shower and change clothes after being outdoors during pollen season
• Keep windows closed when pollen counts are high, and avoid drying washing outside then
• Use allergen-proof covers on mattresses and pillows, and wash bedding regularly at a hot temperature
• Damp-dust with a wet cloth rather than dry dusting, which spreads dust around
• Keep pets out of the bedroom, and wash your hands after touching them
• Treat damp and mold in the home by ventilating rooms well
• Wear a mask when mowing the lawn or cleaning dusty spaces
• Ask your pharmacist which over-the-counter options suit your symptoms and any other medicines you take

Medical treatments

Treatment is chosen to match your symptoms and how much they affect you. Common options include antihistamine medicines, which block the chemical that causes sneezing and itching; steroid nose sprays, which calm swelling inside the nose; and eye drops for itchy, watery eyes. For asthma-type symptoms, your doctor may prescribe an inhaler. For skin allergies, moisturisers and medicated creams can help. For some people with severe allergies, a specialist may recommend immunotherapy — a course of treatment, given as tablets, drops or injections, that slowly teaches the body to tolerate the allergen. Your doctor or pharmacist will explain which option is right for you and how to use it safely.

When is surgery considered?

Surgery is not a treatment for allergies themselves. Occasionally, an ear, nose and throat specialist may discuss an operation for problems such as persistent nasal blockage or polyps (small growths inside the nose) if other treatments have not helped.

Living with this condition

Living with allergies is mostly about small habits rather than big sacrifices. Once you know your triggers, you can build your day around them: checking the pollen count before a run, keeping the bedroom a pet-free zone, or reading food labels carefully. Tell friends, family, school or workplace about your allergy so they can support you — and if you carry an adrenaline auto-injector, make sure the people around you know where it is and how to use it.

Lifestyle tips

• Keep your home well ventilated and free of damp
• Choose smooth flooring or washable rugs in bedrooms if dust is a trigger
• Wash pets' bedding and your own bedding regularly
• Plan outdoor activity for early morning or after rain, when pollen is lower
• Wear gloves if you react to latex or metals
• Carry any prescribed emergency treatment with you at all times
• Wear a medical alert bracelet if you have a severe food, sting or medicine allergy

Diet and exercise

There is no special allergy diet — the right approach is to avoid only the foods you actually react to, and to get advice before cutting foods out, especially for children, so you still get all the nutrition you need. If you have hay fever or asthma, exercise is still good for you. Some people find outdoor exercise harder on high-pollen days, so try indoor activity or a different time of day instead. Warm up gently, keep your reliever inhaler with you if you have one, and don't let allergies talk you out of being active.

Mental health and emotional wellbeing

Allergies can be genuinely tiring. Broken sleep, itchy skin, missed school or work, and the effort of checking everything can wear you down, and food allergies in particular can cause real worry for both children and parents. Those feelings are common and worth talking about. If low mood, anxiety or stress is building up, tell your doctor or nurse — support is available. If you ever feel in crisis or unsafe, contact your local emergency number or a crisis support line in your country straight away.

Prevention

You cannot always stop an allergy from developing, and it is not your fault if one does. What you can do is reduce how often symptoms flare up: identify your triggers, lower your exposure to them, and treat symptoms early rather than waiting for them to build. For children, current guidance does not recommend delaying common foods — introducing them at the usual time as part of a normal diet is generally advised. If your baby has severe eczema or a known food allergy, ask your health visitor or doctor before introducing foods like peanut or egg.

Screening programmes

There is no routine screening programme for allergies. Testing is offered when symptoms suggest a specific allergy, or when it would change what you or your child needs to do. If you are worried, raise it with your doctor rather than waiting for a test to be offered.

Complications

If left untreated

• Poor sleep, tiredness and trouble concentrating at school or work
• Worsening asthma control
• Sinus and ear infections from long-term nasal blockage
• Skin infections from constant scratching
• Avoiding foods or activities unnecessarily, which can affect nutrition and quality of life
• For a few people, a severe reaction (anaphylaxis), which is a medical emergency

Long-term outlook

The outlook is good for most people. With a clear plan, sensible trigger avoidance and treatment when needed, the great majority of people with allergies live comfortably and do everything they want to do. Some childhood allergies, such as milk and egg allergy, are often outgrown, and immunotherapy can reduce sensitivity for some people over time. Your symptoms may change over the years, so it is worth reviewing your plan with your doctor now and then.

Find support

External links open third-party websites. Ruqelo Health is not responsible for external content. Listing an organisation does not imply endorsement.