Derek Burnett
Derek Burnett is a Contributing Writer at Bottom Line Personal, where he writes frequently on health and wellness. He is also a contributing editor with Reader’s Digest magazine.
Asthma, eczema, and allergies are all conditions in which a person’s immune system is hyper-responsive to environmental stimuli that most people don’t find bothersome. For someone with one of these conditions, certain triggers such as mold, pollen, particulate matter in air pollution, dust mites, or pet dander have been permanently identified by the immune system as warranting a robust response. As the body tries to protect us from what it perceives as a serious threat, it releases a host of inflammatory substances to stamp out the invader. The result is a series of symptoms that can range from annoying to life-threatening. For someone with mild eczema, for example, the main symptom may be an itchy rash on one part of the body. Another person with a moderate allergy might experience face swelling. And for someone with severe asthma, their breathing could become so troubled by a restricted, inflamed airway that they must seek immediate medical attention, a condition called anaphylaxis.
But one thing is clear. Even the mildest form of eczema, allergy or asthma is unpleasant. It’s therefore understandable to want to reduce the instances and severity of cases. Here’s what you should know.
Generally speaking, there are no cures for any of these three hypersensitivity diseases. Instead, patients should take a manage/control approach to the condition. Getting control of eczema, allergies, or asthma requires a few key steps:
Allergies, eczema, and asthma all have symptoms that may cause them to be confused with other conditions. For example, congestion and watery eyes could be caused by an allergy, but they could also simply be a side effect of a medication you’re on.
If you suspect you have one or more allergies, your primary doctor will probably refer you to an allergy specialist for diagnostic testing. This usually consists of a skin or blood test, along with a thorough clinical history.
Usually when the skin test is performed, the doctor tests dozens of potential allergens at a time, not just one or two. The patient removes their shirt and lies facedown while the doctor lightly scratches or punctures the skin of the back in several places. Each prick inserts a tiny amount of a separate allergen. The wounds are then observed for evidence of allergic reaction, including swelling, redness, and itching. Such reactions are nearly instantaneous, which means that the test results are usually available more or less in real time.
A blood test for allergies requires that a blood sample be drawn with a needle and sent to a laboratory for analysis. Results are only available to be discussed during a follow-up doctor visit.
To get the best possible picture of your situation, the doctor will ask for a complete history of your experience with common allergens. They’ll want to know whether you’ve ever had even mild reactions to potential allergy triggers. Before visiting with a doctor to discuss potential allergies, give some thought as to whether you’ve ever had reactions to things like laundry detergent, tobacco smoke, pollen, bee stings, or medications.
For diagnosing asthma, doctors use a technique called spirometry to measure airflow in the lungs, and they may order imaging of your airway.
Testing and consultation with an allergy specialist should give you a clear understanding of what environmental irritants trigger your allergies. Obviously, the surest way to avoid allergy attacks is to completely remove all triggers from your life. But that’s not always possible. For example, if you develop an allergy to your child’s favorite pet, you might not have the heart to banish it from your home. Or if you find that the air quality in your neighborhood triggers your asthma, it might not be financially possible for you to move out of the area. But there are things you can do to mitigate the impact of triggers that aren’t completely avoidable.
If a pet triggers your allergies, consider having the animal professionally groomed to reduce the amount of dander in your home. Limit the areas of the home where the pet is allowed to wander, making especially sure to keep it out of your bedroom.
If the air you breathe is problematic, use high-quality filters in your HVAC system and be sure to change them regularly. Consider installing air purifiers for the rooms where you sleep and spend most of your time.
If you suffer from a dust mite allergy, purchase mattress and pillow covers, use air purifiers, and be sure to keep your home as clean as possible, which could entail hiring a professional cleaning service if your budget allows it.
Especially as you first set out to manage your hypersensitivities, keep a log of your allergic flare-ups. This may help you identify patterns in how you’re triggered, but it can also help you and your doctor zero in on whether your medications are working and are set at the right dosage.
For asthma patients, an important part of disease monitoring is using a peak flow meter. This is a simple device you blow into to measure how easily you can expel air from your lungs. Periodically using the device can help you determine whether your disease is stable, improving, or getting worse. Your doctor can use the results to increase or decrease your medications.
Asthma is generally controlled using some combination of fast-acting bronchodilators (rescue inhalers), slow-acting bronchodilators (daily inhalers), anti-inflammatory drugs, and biologic therapies that target specific inflammatory proteins.
Allergies are often treated with antihistamines, drugs that combat symptoms such as hives, runny nose, and sneezing. Some examples are loratadine (Claritin), azelastine (Astepro), and cetirizine (Zyrtec). Leukotriene inhibitors such as montelukast (Singulair) are also used to tamp down inflammatory chemicals triggered by allergens such as mold and pollen.
For eczema, drugs called immunosuppressants are sometimes used to inhibit the immune response long enough to give the skin an opportunity to heal, thus breaking the itch/scratch cycle. Examples of drugs that suppress inflammation include azathioprine (Imuran), cyclosporine (Neoral) and the topical creams tacrolimus (Protopic) and pimecrolimus (Elidel).
It should also be noted that while, again, there is no cure for allergies, sometimes doctors succeed in desensitizing the immune system to a trigger. This is done via immunotherapy, in which the allergen is injected or swallowed in a miniscule amount, just enough to give the immune system exposure. Gradually, the amount of allergen is increased until eventually the patient is able to encounter the substance in normal amounts without experiencing a severe reaction. Immunotherapy successfully reduces symptoms in about 80% of patients, although it can take years, and you still will likely experience some mild symptoms. Many people experience mild symptoms from the treatments, as well.
