Treating an allergy consists in tackling both its symptoms and its cause.

Of course, the first measure to be taken is to try to avoid exposure to the allergen: if the allergen is never encountered, the symptoms will never be triggered.

In order to relieve the symptoms, certain medicines have shown their efficacy.

To deal with the immune dysfunction that result in an allergy, desensitisation therapy is the only treatment of the allergy's cause.

Avoiding allergens

Allergen avoidance represents the first stage of allergy treatment, whenever possible. Avoidance can be instituted only after the airborne allergen(s) have been identified. Despite being useful and desirable, avoidance is often difficult to implement. However, it can produce a reduction in symptoms. The allergens most easily avoided are those found in the home environment, in particular mites and animal dander.

Above all, the presence of allergens in the environment should be measured by means of home tests. Depending on the results of allergen measurements, a certain number of situations can be considered. The application of global avoidance measurements requires the substantial motivation of the patient, developed by the power of conviction of the advising physician and his/her level of understanding of respiratory disease linked to interior environments.

Avoidance of mites House dust mites are happiest in bed linen where conditions are optimal for their growth and development - where it is warm, where there is some moisture, and, most importantly, where there is plenty of food in the form of dead skin (shed by us!).To reduce the level of infestation:
- Turn the heat down in the bedroom (to no higher than 18°C) and air it regularly (for at least thirty minutes a day, even when it is cold outside), especially if the room is warm and damp;
- Cut down humidity inside the house;
- Get rid of any fabric items and soft furnishings which cannot be washed at a temperature of  60°C (stuffed toys, cushions, etc.) as well as "dust traps" (curtains, carpet, rugs, etc.);
- Dust furniture and vacuum the floors regularly;
- Use medically approved, anti-house dust mite covers on mattresses, pillows, quilts and bolsters as a barrier to prevent exposure to house dust mites.

Avoidance of animals Avoid pets and the places where they spend time (baskets, kennels, etc.). Sometimes, the pet may have to be completely removed, a last resort which can be very hard if the animal is much-loved.

Avoidance of pollens Pollen is the most difficult allergen to avoid because there is no way of completely avoiding nature! Pollen grains are so small that we cannot see them and they are airborne.
However, a few basic measures can reduce the degree to which you are exposed:

- Do not go on picnics or walks during the pollen season (Spring and Summer);
- If you do go for a walk in the country, wash your hair and change your clothes afterwards;
- Do not mow the lawn or stay near a lawn being mowed;
- During the pollen season, use an air conditioner rather than leaving the windows wide open.

Symptomatic treatments

Symptomatic treatments have made considerable progress over the last ten years. They are effective and well tolerated overall. They are an absolute necessity in the symptomatic phase. Used as first line therapy, symptomatic treatments have the objective of reducing the symptoms and treating the inflammation induced by the allergy.

When rhinitis is associated with asthma, symptomatic treatment includes both treatments for rhinitis and treatments for asthma. However, their effects are brief, and therefore administration must be continued for as long as the symptoms persist.

Prescribed as first line therapy by the attending physician, symptomatic treatments have the goal of reducing the severity of symptoms and countering the inflammation caused by the allergy.

Medicinal products used in asthma:

• Mast cell stabilizers (cromoglicate)
• Inhaled corticosteroids
• Beta-2 agonists
• Theophyllines
• Anticholinergics
• Leukotriene receptor antagonists

The different therapeutic classes are used according to treatment plans defined by the international consensus on asthma.

Medicinal products used in rhinitis:

• H1 antihistamines
• Mast cell stabilizers (cromoglicate)
• Vasoconstrictors
• Anticholinergics
• Inhaled corticosteroids
• Leukotriene receptor antagonists: this therapeutic class is not yet included in the recommendations for the treatment of rhinitis.

As with asthma, the treatment plans making use of different therapeutic classes have formed the subject of international consensus positions.

Desensitisation

Desensitisation currently comprises the only treatment that treats the allergy's cause. Once entirely dependent on the physician's personal experience, how to conduct this kind of therapy is now strictly dictated by an International Consensus compiled by the World Health Organisation.

Desensitisation therapy consists of administering progressively larger doses of allergens in order to restore normal functioning of the immune system and to reduce the significance of symptoms of the allergic reaction. 

Desensitisation protocols are highly circumscribed when it comes to:

• Indications (not all forms of allergy, not all allergens, and not all patients are suitable for this approach); 
• Conduct (with such a long, demanding therapeutic procedure, commitment and involvement on the part of the patient are indispensable).

Learn more about desensitisation

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