Perennial Allergy

Perennial Allergy is the persistent of allergic symptoms throughout the year. Allergy is an immunologically mediated reaction to substances which are considered harmless. This harmless substances are Allergens.

Causes of Perennial Allergy

• House dust mite
• Cockroach
• Animal dander

Symptoms :

Common symptoms include:

• Sneezing
• Runny nose
• Itchy nose
• Stuffy nose
• Sore or scratchy throat
• Coughing
• Watery eyes
• Itchy eyes
• Dark circles under the eyes
• Frequent headaches
• Extremely dry, itchy skin
• Hives
• Fatigue

Diagnosis of Perennial Allergy:

Diagnosis is based obtaining a clinical history. However, an allergist can order certain test to find out the cause. Finding the causes are important to formulate the management plan. Following tests are helpful:

1. Skin prick test:

   SPT is one of the most common test to find out the allergen. It is very sensitive and cost-effective test and it is easy to perform.

2. A blood test, or radioallergosorbent test (RAST)/ Immunocap:

It can measure the amount of immunoglobulin E antibodies to particular allergens in your blood.

Skin Prick Test:

1. In skin prick testing, a small drop of the possible allergen is placed on your skin.
2. Then the nurse or doctor will lightly prick the spot with a needle / sterile lancets through the drop. If you are allergic to the substance/allergen, you will develop redness, swelling, and itching at the test site. This result will be obvious within 15-20 minutes of pricking.
3. There will be wheal and flare at the site of pricking. Usually, the larger the wheal, the more likely you are to be allergic to the allergen.
4. A positive SPT to a particular allergen does not necessarily mean you have an allergy to the particular allergen.
5. An SPT only indicates sensitization. Clinical correlation is necessary. Health care providers must compare the skin test results with the time and place of your symptoms to see if they match or not.

Allergen specific IgE testing:

1. Blood testing for allergen-specific IgE is usually performed when the skin prick test is contraindicated. The test is also suitable in extreme of age i.e., an infant and elderly patients where skin prick test is not appropriate.

2. In this test, blood is drawn from the patient.  Then sample sends to the laboratory for testing. The laboratory will add the particular allergen extracts to that blood. If the specific antibody is present in the blood then the antigen added to the blood sample will attach with the specific antibody. This test is called Specific IgE (sIgE) Blood Testing.   As with skin testing, a positive specific IgE testing does not necessarily mean that an allergen caused your symptoms.

Treatments of Perennial Allergy:-

Medications

1. Antihistamines: Most common medicine used in mild to moderate allergic reaction.

Antihistamines include:

• Fexofenadine
• Levocetirizine
• Cetirizine
• Diphenhydramine
• Desloratadine
• Loratadine

2. Decongestants:

Decongestant can be used to relieve a stuffy nose and sinus pressure. But decongestant can only be used for shorter time usually for three days. Longer time can cause a rebound effect, means once you stop the medicines your symptoms will actually get worse.

Decongestants include:

• Oxymetazoline
• Pseudoephedrine
• Phenylephrine
• Cetirizine with pseudoephedrine

3. Eye drops and nasal sprays:

Eye drops and nasal sprays can help relieve itchiness and other allergy-related symptoms for a short time. However, depending on the product, you may need to avoid long-term use.

Like decongestants, overusing certain eye drops and nose drops can also cause a rebound effect.

4. Corticosteroids:

   Corticosteroids can help with inflammation and immune responses. These do not cause a rebound effect. Steroid nasal sprays are suitable for  long-term use. Nasal steroid medications are the most effective medications.

5. Immunotherapy:

   Your doctor may recommend immunotherapy, or allergy shots if you have severe allergies. You can use this treatment plan in conjunction with medications to control your symptoms. These shots decrease your immune response to particular allergens over time. They do require a long-term commitment to a treatment plan.