Hay Fever (cont.)
Melissa Conrad Stöppler, MD
Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
John P. Cunha, DO, FACOEP
John P. Cunha, DO, is a U.S. board-certified Emergency Medicine Physician. Dr. Cunha's educational background includes a BS in Biology from Rutgers, the State University of New Jersey, and a DO from the Kansas City University of Medicine and Biosciences in Kansas City, MO. He completed residency training in Emergency Medicine at Newark Beth Israel Medical Center in Newark, New Jersey.
In this Article
- Hay fever facts
- What is hay fever? What are hay fever symptoms and signs?
- Why does an allergic reaction occur?
- What causes allergic rhinitis?
- What are risk factors for allergic rhinitis?
- When and where does allergic rhinitis occur?
- Is allergic rhinitis contagious?
- How is allergic rhinitis diagnosed, and how are allergies identified?
- What is the treatment for allergies?
- What is the prognosis of allergic rhinitis?
- Is it possible to prevent allergic rhinitis?
- Find a local Asthma & Allergy Specialist in your town
What are risk factors for allergic rhinitis?
A person is programmed to be allergic by his/her genetic makeup and is destined to be allergic from birth. People of all races are affected, and the condition affects both males and females equally. Symptoms commonly begin in childhood. Having frequent exposure to the particular allergic substance is a risk factor for frequent attacks.
When and where does allergic rhinitis occur?
Since allergic rhinitis is frequently caused by pollen, symptoms occur when pollen is in the air. Trees primarily pollinate in the spring, while grasses pollinate in the spring and summer. Weeds usually pollinate in the late summer and fall. Of allergy sufferers in the United States, many are allergic to ragweed, about half are allergic to grasses, and fewer are allergic to trees. Of course, many people are allergic to other substances such as mold spores, animal protein, and dust mites, to name a few. Food is an uncommon cause of allergic rhinitis. If you wish to know the pollen count in your area, this information can often be found in the newspaper in the weather section or you can access the National Allergy Bureau's pollen count information at their web site (http://www.aaaai.org/nab/index.cfm).
Is allergic rhinitis contagious?
Allergic rhinitis, like other allergic reactions, is not contagious. However, the symptoms of allergic rhinitis can be confused with those of a common cold, which can be spread from person to person.
How is allergic rhinitis diagnosed, and how are allergies identified?
Typically, allergies are initially diagnosed by a combination of characteristic symptoms coupled with exam findings that correspond with allergies.
If a person is experiencing the typical symptoms of hay fever, a consultation with an allergy specialist can help identify the offending substances. Since the ideal way to manage an allergy is to avoid the substances that cause allergic reaction, it is important to first identify these substances (allergens). Many allergens can be suspected from information obtained in a patient's history. For example, if symptoms usually worsen with exposure to cats, then cat dander protein is a probable allergen causing the symptoms. If cutting grass is associated with the onset of symptoms, then grass allergy is probable. A patient's history of reactions is important in determining his/her unique allergies. Allergy testing is only done when allergies are debilitating enough that patients desire allergy immunotherapy.
Because the identification of allergens is important and often difficult to pinpoint, skin testing is often needed to identify exactly the specific substance causing the allergy. Skin testing is done with minimal discomfort and is performed as follows:
- A small amount of the suspected allergy substance is placed on the skin.
- The skin is then gently scratched through the small drop with a special sterile needle. This is known as the prick-puncture method and is typically used for initial evaluations. A second method, known as the intradermal method, involves injection of a small amount of the test substance into the skin. Intradermal testing is more sensitive but also tends to lead to more false-positive results.
- If the skin reddens and, more importantly, swells, then an individual is said to be "sensitized" to the particular allergen. If typical symptoms occur when a sensitized individual is exposed to the suspected substance, then allergy to that substance is probable.
- The skin testing described is tolerated by the youngest of patients and should be the standard of testing.
- Skin testing is not indicated for people who are at risk of a severe (anaphylactic) allergic reaction, who have certain skin conditions, or who are taking certain medications.
A number of blood tests are also available to aid in the diagnosis of allergy. These blood tests may be useful in people who cannot be skin tested due to skin diseases, who are taking medications that interfere with skin testing, or who are at a high risk of having an anaphylactic reaction to skin testing. These blood tests typically use various techniques to look for IgE antibodies in the blood and by inference suggest allergy in the tissues. If the allergy testing agrees with the history of symptoms upon exposure to the substance, then a diagnosis of allergic rhinitis is likely.
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