Treatment for allergies is as follow:
Avoidance to exposure to the allergen identified.
- Food allergen avoidance.
- Hay fever and oral allergy syndrome, avoid high peak times of pollen and take antihistamines.
Antihistamines for symptoms of an allergic reaction:
There are 2 types of antihistamines can be taken, long active non- drowsy either Cetirizine, Fexofenadine or Loratadine. Antihistamines to be taken when required, either Chlorphenamine (including Piriton), Hydroxyzine and Promethazine.
Antihistamines block histamines that trigger allergic reaction of swelling. They also can reduce runny, itchy nose, runny, nose, sneezing, body itching, and hives. They prevent histamine cascade; it prevents the histamine being produced that will affect the cells.
Antihistamines can be purchased over the counter, or by prescription (note that some antihistamines can only be prescribed by the doctor). Some antihistamines can cause drowsiness, do check the packet before taking. They can come in tablet form, capsules, sprays, gels, eye drops, syrups, and creams.
Do Not use for treatment for anaphylaxis as these will not treat symptoms, they take too long to get into your system, and relying on this medication can be dangerous. Antihistamines can make you drowsy this can cause problems for assessment of anaphylaxis symptoms and worsen Hypotension symptoms (low blood pressure).
Lactose free Antihistamines
- Loratadine https://www.nhs.uk/medicines/loratadine/
- Cetirizine https://www.nhs.uk/medicines/cetirizine/
- Fexofenadine https://www.nhs.uk/medicines/fexofenadine/
- Chlorphenamine (including Piriton) https://www.nhs.uk/medicines/chlorphenamine-including-piriton/
- Promethazine (including Phenergan) https://www.nhs.uk/medicines/promethazine/
These reduce swelling, reduces runny nose, and reduces itchy nose.
Nasal Corticosteroid Sprays
|Generic Name||Proprietary Name|
|Fluticasone & Azelastine||Dymista|
|Fluticasone Propionate Fluticasone Furoate||Flixonase, Nasofan Avamys|
Mast cell stabilisers:
These medications stop your body releasing histamines. They are available in eye or nose drops, and they help with itchy watery eyes and runny nose.
These reduce swelling in the membranes in the nose, in which reduces the stuffiness feeling. The airways are opened, allowing breathing through the nose to be less congested and easier to breath.
These can only be used up to 3 days as they can make symptoms worse, this is called a rebound reaction, and this can happen even after using the decongestant.
Decongestants can be found in some antihistamines, and /or some painkillers.
Can come in form of nasal sprays, drops, tablets, capsules, liquids, and powders.
Not suitable for some children between the ages of 6-12 and should not be given to under 6-year-olds.
Not suitable for people with diabetes or high blood pressure, please discuss this before purchasing or with the medical professional supplying the prescription.
Corticosteroid creams, lotions, and creams:
These are to reduce itching and reduce the spread of the rash. You are normally told to use for a week only, and if the rash has not resolved then see you doctor. Creams and lotions can keep the skin moist giving it a barrier to protect against allergens.
Some creams and lotions can be purchased over the counter, but specialised creams and lotions will be prescription only.
Speak to your GP or pharmacist which is the best cream for your allergic reaction.
Corticosteroid creams can be bought over the counter, but stronger strengths can only be prescribed by a doctor.
Steroids, reducing inflammation:
These are prescribed to reduce or stop swelling in an allergic reaction. The immune system is calmed, and stop the cascade of histamines when an allergen is digested or breathed in. The dose of steroids given will depend on the severity if allergic reaction.
Steroids can come if form of tablets, nasal sprays, eye drops, creams, and inhalers.
Steroids can cause serious side effects if you notice any of the following contact your doctor immediately.
- indigestion or heartburn
- increased appetite, which could lead to weight gain.
- difficulty sleeping
- changes in mood and behaviour, such as feeling irritable or anxious.
- an increased risk of infections – especially chickenpox, shingles, and measles
- high blood sugar or diabetes
- weakening of the bones (osteoporosis)
- high blood pressure
- Cushing’s syndrome – which can cause symptoms such as thin skin that bruises easily, a build-up of fat on the neck and shoulders and a red, puffy, rounded face.
- eye conditions, such as glaucoma and cataracts
- mental health problems, such as depression or suicidal thoughts; get an urgent GP appointment or call 111 if this happens.
(Symptoms Source Text https://www.nhs.uk/conditions/steroid-tablets/ )
Oral Immunotherapy (Oral food challenge)-formerly known as desensitisation.
Patient introduced to small amounts of food allergen, then over time the patient is exposed to gradual increase of the food allergen. This process is done under a controlled medical environment. Testing can be unclear if allergic to the allergen, or if the child has outgrown the allergy. If there is no reaction, then the consultant decides if the allergen can be “de-labelled” and if the allergen can be reintroduced into the diet. If a reaction has occurred, the consultant will confirm the allergen to be eliminated from diet. This process in total can take several months, the desirable outcome would be that the therapy to raise the threshold that may trigger a reaction and provide the individual protection against accidental ingestion of the allergen.
Premeasured adrenaline injector administered first signs of anaphylaxis. This opens airways, reduces swelling, and raise blood pressure. Internationally adrenaline auto-injectors are called Epinephrine.
Food Ladders Milk and Eggs (baked goods)
Reintroducing foods back into the diet for children who have mild to moderate reactions to the allergen. E.g., milk ladder start will the allergen in foods highly cooked and over stages to aim for uncooked foods with milk in, to a stage where milk can be tolerated.
Food ladders are normally started after the child has been free from the allergen in their diet, and are symptom free e.g., gastro-intestinal symptoms or eczema.
A list of foods will be given which has the allergen in, and a guide how to reintroduce the food, time periods, and amounts. The list is a guide, your consultant might discuss giving smaller or larger amounts. There will be recipes, these recipes have egg and wheat free versions for allowing other children with allergies to able to take the food ladder challenge.
Once your child can fully tolerate the food allergen stage, they have eaten the food more than once without suffering allergic reaction, allowing 2-3 days for delayed symptoms, then you can consider moving on to the next stage. If you are unsure your child has had a reaction, then allow 2-3 days before retrying that stage, if severe reaction causes breathing difficulties, and or collapsing dial 999. (At this stage as the allergy is classed as mild to moderate you might not have an adrenaline auto-injector but if you do and the child’s symptoms are severe then use adrenaline auto-injector then dial 999.
If your child reacts to the stage, you are on mild to moderate reactions, then go back to previous stage, speak to consultant about the stage your child reacted to and be guided by the medical professional when to move on. If your child has had a severe reaction, speak to medical professional at hospital what you should do about continuing, once home speak to your consultant for further advice.
If your child is having no symptoms when introducing the next stage continue giving the food from the previous stages as well as the new stage.
This should be started when your child is not poorly, also not prior or after exercise, as these conditions could make reactions worse. Choose a time that is relaxed, and suitable that will not be rushed.
Asthma medication and regular asthma reviews
People with uncontrolled asthma are prone to worse allergic reactions.
Food allergies can be treated with:
- Avoiding the allergen that causes a reaction, this is prevention not a treatment.
- Antihistamines – alleviate symptoms but does not stop anaphylaxis.
- Adrenaline auto-injector for anaphylaxis
Allergic rhinitis can be treated with:
- Nasal sprays
- Keeping the bedroom, a pet free zone.
- Eye drops
- Regular washing of bedding.
Conjunctivitis can be treated with:
- Cleaning of the eyes removing crust and pus on a regular basis.
- Practice good hygiene
- Washing clothing and bedding on a regular basis.
- Antibiotics, only work if not a virus.
Hives can be treated with:
- Adrenaline if the hives are severe.
Eczema can be treated with:
- Avoidance of allergen.
- Wearing protective clothing
Contact dermatitis can be treated with:
- Avoidance of allergen.
- Wearing protective clothing
Asthma can be treated with:
- Avoiding triggers
- Leukotriene Receptors Antagonists (LTRAs)
- Surgery – a tube placed between throat and lungs, allowing for prevention of them narrowing. This option is for asthma that is life threatening.
Safe use of emollient skin creams to treat dry skin conditions – Gov UK
These lists are guidance only, and not fully extensive, people are advised that it is the responsibility of the individual when using this information.
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