House Dust Mite

Overview

House dust mites are tiny creatures, far too small to see, that live in dust in your home. They feed on flakes of skin that people and pets shed. Their droppings and body parts contain proteins that some people's bodies react to. When you breathe these in, your immune system (the body's defence system) can overreact. That reaction is a house dust mite allergy. It often shows up as sneezing, a blocked or runny nose, itchy eyes, or wheezing. Many people with asthma find dust mites make their symptoms worse.

Yes. Dust mite allergy is one of the most common indoor allergies worldwide. It affects people of all ages and is often found alongside asthma, eczema (itchy inflamed skin) or hay fever.

It can affect anyone, but it is more likely if other people in your family have allergies, asthma or eczema. Symptoms often start in childhood, though adults can develop them too. People who live in damp or crowded housing, or in homes with lots of carpets and soft furnishings, may notice more symptoms.

Symptoms

Common symptoms

• Sneezing, often in bursts, especially in the morning or when dust is disturbed
• A blocked, runny or itchy nose
• Itchy, red or watery eyes
• An itchy throat or roof of the mouth
• A cough, wheeze or tight chest, particularly in people who also have asthma
• Waking up with symptoms after sleeping in a mite-rich bed
• Symptoms that are worse indoors, at night, or when cleaning or changing bedding

Symptoms in children

• Frequent rubbing of the nose or eyes, sometimes called the 'allergic salute'
• A blocked nose causing mouth breathing, snoring or restless sleep
• Coughing or wheezing at night or after being in bed
• Itchy skin or flare-ups of eczema
• Tiredness, poor concentration or missed school days because of disturbed sleep

Symptoms in older adults

• Symptoms may be blamed on 'just a cold' or on ageing, so allergy can be missed
• More noticeable breathlessness or cough, especially if there is existing lung or heart disease
• Poor sleep and tiredness that affect daily life
• Some allergy medicines can cause drowsiness or interact with other medicines, so it is worth asking a pharmacist or doctor for advice

Causes

Main causes

• An overreaction by the immune system to proteins in dust mite droppings and body fragments
• Breathing in these particles, especially while in bed, on soft furniture or carpets
• Warm, humid indoor air, which lets mites multiply quickly
• Dust collecting in bedding, pillows, mattresses, curtains, rugs and soft toys

Risk factors

• A personal or family history of allergies, asthma, eczema or hay fever
• Living in a damp or poorly ventilated home
• Lots of carpets, soft furnishings and clutter that hold dust
• Keeping bedrooms warm and humid, or drying washing indoors without ventilation
• Pets, which add to dust and skin flakes in the home (though mites, not pets, are the main trigger)
• Smoking or living with a smoker, which makes breathing symptoms worse

When to see a doctor

See a doctor urgently if:

• Breathing problems that are getting worse quickly, or a reliever inhaler that is not helping as it usually does
• Any swelling of the face, lips or throat, or feeling faint after exposure to dust or allergens
• Eye pain, sudden vision change, or a red painful eye
• Symptoms in a baby or young child that include poor feeding, unusual sleepiness or fast breathing

Book a routine appointment if:

• Allergy-type symptoms lasting more than a few weeks, or coming back at the same times each year
• A blocked nose, sneezing or itchy eyes that interfere with sleep, work or school
• Asthma that seems harder to control, or needing your reliever inhaler more often than before
• You want to discuss testing, treatment options or home advice
• Your child snores, breathes through the mouth a lot, or seems tired during the day

Diagnosis

There is no single test that proves dust mite allergy. Usually your doctor or nurse will ask about your symptoms, when and where they happen, and whether anything in your home or bedroom makes them worse. They will also check your general health and breathing, and look inside your nose. If the picture is unclear, they may arrange allergy testing or refer you to an allergy or asthma specialist.

Tests that may be done

• A careful history: what symptoms you have, when they occur, and what triggers them
• A physical check, including listening to your chest and looking at your nose and eyes
• A breathing test (spirometry), where you blow into a tube, if asthma is suspected
• Skin prick testing, where tiny amounts of common allergens are placed on the skin, done by a specialist clinic
• A blood test for allergy antibodies (IgE), which can support a diagnosis
• A trial of home changes or treatment to see whether symptoms improve

What to expect at your appointment

Most people are diagnosed by talking about their symptoms with a healthcare professional, without needing any tests. If tests are arranged, they are quick and usually done in a clinic. Results help build a picture rather than give a yes-or-no answer, so your clinician will talk through what they mean for you and your home.

Treatment

Treatment works on two fronts: reducing dust mites and the dust they live in at home, and calming the allergy symptoms with medicines or other treatments recommended by a healthcare professional. Many people manage well with home changes plus occasional help from a pharmacist.

Self-care at home

• Damp-dust and wipe surfaces with a damp cloth rather than dry dusting, which spreads dust into the air
• Wash bedding weekly on a hot wash, and consider allergen-proof covers for mattress, pillows and duvet if symptoms are troublesome
• Reduce clutter, especially in the bedroom, and choose washable soft furnishings where possible
• Lower indoor humidity by ventilating rooms, using extractor fans, and not drying washing indoors in living areas without ventilation
• Keep the bedroom cool and well aired, and avoid soft toys on the bed or wash them regularly
• Vacuum regularly with a machine that has a good filter, and ask someone else to vacuum if vacuuming triggers your symptoms
• Keep pets out of the bedroom if pet dander adds to your symptoms
• Avoid smoking indoors, and avoid strong scents and sprays that can irritate the nose and chest

Medical treatments

Your pharmacist or doctor can suggest treatments that ease symptoms rather than cure the allergy. These may include anti-allergy tablets or syrups, nasal sprays that reduce swelling and irritation in the nose, and eye drops for itchy eyes. Some of these are available without a prescription, and a pharmacist can advise on which type suits you and whether they are safe with your other medicines. If you have asthma, keeping it well controlled with the inhalers your clinician has prescribed is important. For people with persistent troublesome symptoms, a specialist may discuss allergy testing or other options such as immunotherapy (a treatment that gradually trains the immune system to tolerate the allergen). Always ask a healthcare professional before starting, stopping or changing any treatment.

When is surgery considered?

Surgery is not used to treat dust mite allergy itself. Occasionally, an ear, nose and throat specialist may consider surgery for related problems such as persistent nasal blockage or polyps (soft growths in the nose) if other treatments have not helped. This is only after discussion and assessment by a specialist.

Living with this condition

Most of the battle is in the bedroom, because that is where we spend many hours close to bedding and mattresses. A simple routine — washing bedding regularly, damp-dusting, airing rooms and keeping clutter down — often makes symptoms noticeably better within a few weeks. It helps to be realistic: you cannot remove every mite, but you can lower the numbers enough to feel the difference.

Lifestyle tips

• Build a short weekly cleaning routine rather than big occasional clear-outs
• Choose bedding and curtains that can be washed easily and often
• Keep windows open or use ventilation when cooking, showering or drying washing
• Avoid bringing outdoor dust and pollen straight into the bedroom, for example by changing clothes after being outdoors
• If you have asthma, keep your written action plan up to date and your reliever inhaler with you
• Tell family members or housemates which tasks trigger your symptoms so they can help

Diet and exercise

There is no special diet that treats dust mite allergy, but eating well and staying active support general health and lung fitness. Exercise is good for you and for your breathing; if exercise makes you wheeze, mention it to your doctor, as it may mean your asthma needs reviewing. Some people notice their nose streams when they exercise outdoors in cold air, which is usually harmless. Speak to your clinician before starting a new exercise plan if your breathing is currently unsettled.

Mental health and emotional wellbeing

Ongoing allergy symptoms can be tiring. Poor sleep, a constantly blocked nose and worry about breathing can affect mood, concentration and confidence, and parents of affected children often feel stressed too. These feelings are understandable and worth mentioning — you do not have to just put up with it. If low mood, anxiety or sleep problems are building up, tell your healthcare professional. If you ever feel overwhelmed or unsafe, contact your local emergency number or a crisis support service in your country straight away.

Prevention

You cannot fully prevent dust mites — they are a normal part of indoor life. But you can keep their numbers down and reduce your exposure, which lowers symptoms. The most useful steps are controlling damp and humidity, washing bedding often, damp-dusting, cutting clutter and ventilating rooms. Avoiding tobacco smoke at home also helps protect everyone's breathing.

Vaccines

There is no vaccine for dust mite allergy. Keep up with routine vaccinations recommended for you, including flu and other vaccines your clinician advises if you have asthma.

Screening programmes

There is no routine screening programme for dust mite allergy. If you have ongoing nasal or eye symptoms, asthma that is hard to control, or a strong family history of allergy, it is reasonable to ask your doctor whether allergy assessment would be helpful.

Complications

If left untreated

• Ongoing poor sleep, tiredness and reduced concentration at school or work
• Nasal blockage that can lead to sinus problems or snoring
• Poorly controlled asthma, with more flare-ups and more time off normal activities
• Flare-ups of eczema or other allergic conditions
• Repeated use of medicines without review, which can cause side effects or interactions
• Avoidable worry and stress about breathing and symptoms

Long-term outlook

The outlook is good. Dust mite allergy is a long-term condition for many people, but it can be managed well. Simple home changes plus advice from a pharmacist or doctor help most people feel much better, and symptoms often improve over time in some people. Working with your healthcare team, you can keep symptoms under control and get on with daily life.

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