Allergies - Treatment

A large number of prescription and over-the-counter drugs are available for treating allergic reactions. Most of these work by interfering with the action of histamine on cells. Other drugs counteract the effects of histamine. They stimulate other systems or reduce immune responses in general.

Antihistamines

Antihistamines prevent histamine from exerting its effect on nasal (nose) cells. They can be used after an allergic reaction has begun. But they are more effective if used preventively, before symptoms appear. Many people take an antihistamine every day, whether they feel uncomfortable or not.

A wide variety of antihistamines is available. They are among the most widely sold of all drugs. Older types of antihistamines often caused drowsiness as a side effect. Included among these drugs are diphenhydramine (pronounced DIE-fen-HI-druh-meen, trade name Benadryl), chlorpheniramine (pronounced KLOR-fen-er-uh-meen, trade name Chlor-trimeton), brompheniramine (pronounced BROM-fen-er-uh-meen, trade name Dimetane), and clemastine (pronounced KLEM-uh-steen, trade name Tavist).

Newer antihistamines do not cause drowsiness. They are available by prescription and include drugs such as astemizole (pronounced a-STEM-uh-zole, trade name Hismanal), loratadine (luh-RAT-uh-deen, trade name Claritin), and fexofenadine (pronounced fex-o-FEN-uh-deen, trade name Allegra). One of the most popular antihistamines was terfenadine (pronounced tir-FEN-uh-deen, trade name Seldane), the original nondrowsiness medication. It was taken off the market by its manufacturers in 1998 because questions about its safety had arisen. In addition, a safer alternative, fexofenadine, had become available.

Decongestants

Decongestants have the opposite reaction on blood vessels from that of histamines. They cause the blood vessels to constrict and hold fluid better. Therefore, they reduce the swelling, itchiness, and redness usually caused by histamine.

Decongestants can be taken in the form of nasal sprays or pills. They should be used with caution as they can produce side effects such as headaches, increased blood pressure and heart rate, and agitation. If used for too long a period of time, they can also cause a rebound effect. In a rebound effect, the nasal passages become even more swollen and tender than they were originally.

Topical Corticosteroids

Topical corticosteroids (pronounced KOR-ti-ko-steer-oids) are drugs used directly on the skin that reduce inflammation of mucous membranes, the tissues that line the nose, mouth, and other body openings. Topical corticosteroids tend to work more slowly and last longer than other allergy medications. A person generally starts to apply these drugs before an allergic reaction (such as hay fever) begins. The drugs can provide an extended period of protection, throughout the period during which the allergen is present.

Mast Cell Stabilizers

Mast cell stabilizers prevent mast cells from releasing histamine, which means they prevent the symptoms of allergies from developing. The most common mast cell stabilizer is cromolyn (pronounced KRO-muh-lun) sodium. The drug is often taken year-round in the form of a nose or throat spray.

Immunotherapy

Immunotherapy is also known as desensitization. This treatment takes the form of a series of injections (shots) taken over long periods of times (months or years). The shots contain a chemical that reduces the ability of IgE to cause allergic reactions. The amount of this chemical in the injection is gradually increased over time.

The effects of immunotherapy often do not show up for long periods of time. With about 20 percent of all patients, they are never very effective. The most serious possible side effect of a desensitization injection is anaphylactic shock.

Bronchodilators

Allergic reactions in the lungs cause airways to tighten, which makes it difficult for a person to breathe. Bronchodilators (pronounced brong-ko-die-LATE-urs) are substances that reverse this action. They cause air passages to dilate, or become more open, so that air flows more easily through them.

Bronchodilators are commonly used in serious asthma attacks. They are administered through nose or throat sprays. In the most serious cases, these drugs can be injected directly into the bloodstream. Some commonly used bronchodilators are adrenaline (pronounced uh-DREN-uh-lin), albuterol (pronounced al-BYOO-tuh-rol), various steroids, and theophylline (pronounced thee-OFF-uh-lin), a component of coffee and tea.

Treatment of Contact Dermatitis

Calamine lotion and corticosteroid creams can reduce the discomfort and itching of contact dermatitis. Overuse of corticosteroids can, however, lead to dry and scaly skin.

Treatment of Anaphylaxis

Anaphylaxis is one of the most serious conditions relating to allergic reactions. A person who goes into anaphylactic shock must be treated very quickly or he or she may die. The standard treatment for anaphylaxis is an injection of adrenalin, also known as epinephrine (pronounced EP-uh-nefrin). People who are at risk for anaphylaxis often carry with them an Epipen, a small needle containing a dose of adrenalin.

Alternative Treatment

The most effective alternative to medical treatment for allergies is to avoid the allergens that cause them. A person who is allergic to peanuts, for example, should avoid eating peanuts or foods that contain them.

In addition, a number of natural products have been found to be effective in treating allergic reactions. Products that have been suggested as alternatives for each of the medical treatments that have been discussed include:

• Antihistamines: Vitamin C and the natural product known as hesperidin (pronounced he-SPER-i-din).
• Decongestants: Vitamin C, the amino acid N-acetylcysteine (pronounced uh-seet-uhl-SIS-tuh-een), and the minerals iron phosphate and potassium chloride.
• Mast cell stabilizers: The natural products hesperidin and quercetin (pronounced KWER-si-tin).
• Immunotherapy: The herbs echinacea (ek-i-NAY-see-uh) and milk-vetch root (astragalus, pronounced uh-STRAG-uh-luhs).
• Bronchodilators: The herbs ephedra (pronounced i-FED-ruh), khellin (pronounced KEL-un), and cramp bark.

Alternative Treatment of Contact Dermatitis

The use of certain herbs taken internally or applied directly to the skin has been recommended as a treatment for the pain and itching of contact dermatitis. One treatment consists of a paste containing jewelweed or chickweed applied to the skin. A cream containing calendula (pronounced KUH-len-juh-luh) sometimes relieves a rash. The use of certain drinks or pills made of herbs may also be effective against contact dermatitis.