Allergy treatment

What exactly is an allergy?

An allergy is generally understood as an over-sensitivity of the immune system to substances from the environment which are not harmful in and of themselves. Some examples of these are pollen, animal hair and dandruff, insecticides and food.

These substances are referred to as allergens. The tendency to oversensitivity is hereditary.

 It can manifest itself in a range of clinical pictures such as conjunctivitis, rhinitis, hives, bronchial asthma and others, which are ultimately all due to a reaction to an inflammation.

This only occurs following external factors such as particularly intense contact to certain allergens which act as the tipping point.

The best route to being completely free from symptoms is to consistently avoid (eliminate) the allergen which triggers the disorder. However, for most allergens such as pollen, certain types of mould and some animal hairs, this is not possible.

Acute allergic complaints may be treated using medications. Depending on the type of active substance, they can either weaken or fully suppress allergic reactions. A distinction is made between systemic and topical medications.

Systemic medications:

Systemic medications affect the whole body and are mostly administered in the form of tablets or injections.

Topical medications:

The effect of topical medications is restricted to the area of the body to which they are applied. Typical examples are ointments, nasal or eye drops and asthma inhalers.

Advantages and disadvantages of treatment using medications 

Advantage:

• Fast, positive effect 

Disadvantage:

• No lasting improvement of the allergy
• Very expensive over the long term
• Patients need to keep their medications close at hand always      

An allergy may deteriorate over the course of time The symptoms may intensify and spread to the lungs, additional allergies may also emerge. Therefore, you should check whether hyposensitisation applies in your case because the allergy can then be treated from a causal viewpoint. This therapy can cure your symptoms fully or at least significantly reduce them.

Specific immune therapy or hyposensitisation is basically nothing other than an allergy vaccine. Not only does this type of treatment reduce the symptoms, it also tackles the cause of your allergy: an over-reaction of your immune system. By opting for this treatment, you grasp your allergy by the roots.

The principle is simple: In an allergy, the immune system is reacting to substances that are, in effect, harmless. Defence cells wrongly categorise these substances as harmful. This overreaction can be reduced by the process of hyposensitisation. Through confrontation with controlled quantities of a specific allergen, the defence cells become accustomed to these allergens. In this respect, hyposensitisation is a type of training – towards higher tolerance.

Specific immune therapy may be carried out in the form of either injections or drops or tablets.

The difference between subcutaneous immune therapy (SCIT) and sublingual immune therapy (SLIT) is in the manner of application. Subcutaneous immune therapy is carried out using an injection, whereby the allergen is injected into the subcutaneous fatty tissue. In sublingual immune therapy, the allergen is applied under the tongue in the form of either drops or tablets. High doses of immune formulations are used in both cases.

Starting from when and for how long is the specific immune therapy carried out?
The treatment can be started from approximately age 5, if corresponding symptoms such as allergic hay fever, conjunctivitis or bronchial asthma are present. The doctor carries out a range of tests before the start of the treatment to determine which allergens are responsible for the disorder. This stage also includes checking for accompanying illnesses which could obstruct a specific immune therapy. If all findings of the tests are in favour of the treatment, it should be started without delay. Your doctor will define the exact timeframe.

The treatment time is usually about 3 years, but you will already notice a perceptible improvement during the first year of treatment. Among other factors, the duration depends how well the increasing doses of allergen solution are tolerated and how quickly the symptoms subside. A quick reduction in symptoms should not entice you to terminate the therapy prematurely however, since long-term success depends to a significant extent on the duration of therapy. The timeframe of 3-5 years sounds long, but bear in mind that treatments using medications such as cortisone have to be carried out for a patient’s whole lifetime and are not free from side effects. The close collaboration between patient and doctor is extremely important.

Does the specific immune therapy also have unwanted effects?
Like any other treatment, the specific immune therapy may lead to unwanted reactions. The doctor with experience in allergology knows all measures and has access to resources to treat side effects. Before the start of therapy, the doctor talks to the patient about what requires special attention.

Slight skin reactions (redness and swelling) at the injection point are relatively frequent, but usually harmless. Any significant swelling of the arm must be observed in the practice and possibly locally treated. In such cases, a reduction in the dose will usually be required.

In rare cases, general reactions such as itchy skin, rash, coughing or shortness of breath, palpitations or dizziness may occur. A life-threatening circulatory shock is seen even more rarely. This may occur if small quantities of the allergen solution enter the bloodstream despite all precautions. In such cases, the doctor will carry out the necessary shock treatment without losing any time.

Your collaboration is especially important for the therapy. Its success is in your hands.

Please note the following points:

• It is essential that you comply precisely with the intervals between the individual injections or drop administrations.
• After each injection, you must remain in the practice for at least 30 minutes so that your doctor can intervene in a quick and competent manner. If you notice anything unusual during the waiting period (e.g. itching in your throat, on your hand or the sole of your foot, sneezing, coughing, shortness of breath, itchy skin, hot flushes, dizziness), please contact your doctor or the receptionist immediately.
• Also, if unusual symptoms occur after you leave the practice or the existing symptoms worsen, contact the treating physician immediately.
• Before every injection, please inform the doctor when your last injection was administered, what medications you are currently taking and whether you are ill at present (refer to the existing allergic symptoms also if these have come back).
• It is essential that you avoid strenuous physical activity of all kinds (especially sports) as well as unusual strain (such as hot showers) on the day of the injection.
• As far as possible, try to avoid the allergens which trigger your symptoms throughout the course of treatment.

In particular, house dust mite allergy sufferers can optimally support the therapy by using anti-mite mattresses and bed sheets, since most mites are in the bed.

These sheets lead to a drastic reduction in the amount of allergens breathed in. They are pulled over mattresses, duvets and pillows and carefully sealed using the zipper.

The normal bed linen is then put on. The covers are water vapour permeable, so that the sweat produced during the night can be transported away easily.