Allergy symptoms are common problems for more than 20 percent of the United States population. Allergies also account for nearly 40 percent of all physician visits annually, and patients with allergies can be treated by physicians in a wide array of specialities.
The most common specialties offering allergy treatments are family practice, pediatrics, internal medicine, obstetrics and gynecology, allergy and immunology and otolaryngology (ear, nose & throat). No matter what kind of physician you see, allergies are generally treated in the same way.
Avoiding allergens and using saline spray and other irrigation methods have long been useful in preventing allergy symptoms. However, in 2008, new treatment guidelines were presented at a meeting of the American Academy of Allergy and Immunology and then subsequently published. These guidelines have changed the way in which allergy treatment is managed through medication. Allergy management is now taken in two steps.
1. Medications reduce allergy symptoms
For people with inhalant allergies, like pollen or pet dander, topical nasal antihistamines are the standard first line of treatment.
There are two antihistamine sprays in the market: Astepro (azelastine, Astelin is the generic), and Patanase (olopatadine). There is also a combination product out on the market as well, Dymista (azelastine and fluticasone).
“These medications offer the same effects as oral antihistamines in terms of decreasing runny nose and post-nasal drip,” said Ewen Tseng, M.D., an otolaryngologist on the medical staff at Baylor University Medical Center at Frisco. “They also help relieve congestion without being an actual decongestant.”
Dr. Tseng added that he recommends topical medications in general since they usually have significantly fewer side effects compared to oral medications. In oral medications, very little of the medication is absorbed into the body, so topical tend to have a greater localized effect.
Other classes of allergy medications can be added with topical antihistamines as needed, such as topical nasal steroid sprays and leukotriene inhibitors.
2. Immunotherapy as allergy treatment
If you do not respond well to medication or are unable to tolerate medications, your physician will typically prescribe immunotherapy.
This can come in the form of injections given once or twice a week, or topical immunotherapy in the form of drops under the tongue.
“About 85 percent of the patients we place on immunotherapy feel better,” said Dr. Tseng. He also noted that the effectiveness of both the drops and injections are statistically equivalent and the serums in both forms are FDA approved.