Allergic Skin Reaction: Is it Eczema?

Is your skin itchy, red or dry? Does it leak fluid that crusts over when scratched? 
If so, there’s a chance it’s Atopic dermatitis, more commonly known as Eczema.

Eczema is the most common skin condition, especially in children. It affects one in five infants but only around one in fifty adults. It arises from a “leakiness” of the skin barrier, which causes it to dry out and become prone to irritation and inflammation by many environmental factors.

In about half of patients with severe atopic dermatitis, the disease is due to inheritance of a faulty gene in their skin called filaggrin. Patients with the faulty filaggrin gene often have hand eczema with excessive little lines on their palms.

Unlike hives, the itch of eczema is not only caused by histamine so anti-histamines may not control the symptoms. Eczema is often an allergic skin reaction linked with asthma, allergic rhinitis (hay fever) or food allergy. This order of progression is called the atopic march.

The location of the rash depends on the age individual. In infants, eczema is often seen on the face. Children are prone to have the rash on the elbow, wrists, behind the knees and behind the ears. Adolescents and young adults typically have the rash in the same locations as children, but also have it on the hands and feet.

In many children, the exact cause of the eczema is not clear and treatment depends on regular use of moisturizer and topical medicines to dampen down the inflammation. One such treatment is topical steroids. In children where the skin is oozing, crusting and painful, an infection that needs treatment with antibiotics may be the primary trigger.

Some people with eczema have a food sensitivity which can make eczema symptoms worse. Infants and young children with more severe eczema should be evaluated for food allergy. If this is the case for your child, come in and see us for diagnosis and management. We also have our dietician in-house, who can be a great help in this.

Food allergies causing eczema are much less common in older children and adults. If you think your eczema is an allergic skin reaction caused by a food allergy, diagnosis begins with testing and a discussion with an allergist before starting any elimination diets.

Eczema is sometimes described as an “itch which rashes.” The rash is caused by scratching, so the more the patient scratches the more severe the rash will be. This is why it’s important to avoid scratching.

The best way to treat eczema is to use moisturizers and topical ointments that reduce the inflammation e.g. topical steroids or calcineurin inhibitors. The itch is not relieved by antihistamines although these are sometimes used at night to help people with eczema sleep.

Antibiotics may be prescribed if a skin bacterial infection is suspected as a trigger for your eczema flare-up. Symptoms of infection include crusting, oozing and pain. Oral steroids should be avoided, as although they are effective the eczema usually returns when the medicine is stopped. Oral steroids can also cause serious side-effects if taken for long periods of time.

Sometimes, wearing cotton undergarments and body suits can help protect the skin from irritants and scratching. We recommend you avoid using soap products that contain sodium laurel sulfate and any triggers that cause a reaction. If you come in and see us, will be able to help determine whether there is a trigger that can be avoided.

These skin allergy treatment and management strategies can relieve social challenges as well. People with eczema, especially children, are sometimes ignored or singled out by others who believe the rash is contagious.

Come in today to find out if you have eczema and to get the treatment you need. We can’t wait to meet you!

Rhinitis Symptoms & Treatment

Rhinitis Symptoms & Treatment

Rhinitis is more commonly referred to as Hay Fever. The name Hay Fever came about because symptoms would strike during hay harvesting season, when these pollens would be in the air. While a hay allergy is possible, usually people with hay fever are allergic to trees, grasses and ragweed – not hay. Hay Fever, has two types: allergic and non-allergic.

Allergic Rhinitis
If you have allergic rhinitis, your immune system mistakenly identifies a typically harmless substance as an intruder. This substance is called an allergen. The immune system responds to the allergen by releasing histamine and chemical mediators that typically cause symptoms in the nose, throat, eyes, ears, skin and roof of the mouth.

Seasonal allergic rhinitis (hay fever) is most often caused by pollen carried in the air during different times of the year in different parts of the country.

Allergic rhinitis can also be triggered by common indoor allergens such as the dried skin flakes, urine and saliva found on pet dander, mold, droppings from dust mites and cockroach particles. This is called perennial allergic rhinitis, as symptoms typically occur year-round.
In addition to allergen triggers, symptoms may also occur from irritants such as smoke and strong odors, or to changes in the temperature and humidity of the air. This happens because allergic rhinitis causes inflammation in the nasal lining, which increases sensitivity to inhalants.

Many people with allergic rhinitis are prone to allergic conjunctivitis (eye allergy). In addition, allergic rhinitis can make symptoms of asthma worse for people who suffer from both conditions.

Nonallergic Rhinitis
At least one out of three people with rhinitis symptoms do not have allergies. Nonallergic rhinitis usually afflicts adults and causes year-round symptoms, especially runny nose and nasal congestion. This condition differs from allergic rhinitis because the immune system is not involved.


Some typical symptoms of allergic rhinitis symptoms include itching in the nose, roof of the mouth, throat, eyes, sneezing, stuffy nose, runny nose, tearing eyes, and dark circles under the eyes.

You can expect to see these symptoms in the spring and fall, but sometimes they last all year long.

Thankfully, the physicians at Asthma & Allergy Specialists have specialized training and experience to diagnose specific allergens that trigger your illness, or to determine if your symptoms are non-allergic. Your allergist will take a thorough health history followed by allergy testing.


Once specific allergens are diagnosed, your immunologist will work with you to develop a plan to avoid allergens that trigger your symptoms. For example, if you are allergic to dust mites or indoor mold, you will want to take steps to reduce these allergens in your house as much as possible.

For outdoor allergies such as pollen, avoidance measures include limiting outdoor activities during times of high pollen counts. The National Allergy BureauTM (NAB) provides the most accurate and reliable pollen and mold levels from approximately 80 counting stations throughout the United States, two counting stations in Canada and two counting stations in Argentina.

Allergy shots can be used to provide long-term relief for many people suffering from allergic rhinitis.

Another form of allergy immunotherapy was recently approved in the United States called sublingual immunotherapy (SLIT) allergy tablets. Rather than shots, allergy tablets involve administering the allergens under the tongue generally on a daily basis.

Your allergist might prescribe medication to decrease allergic rhinitis symptoms. These medications may include nasal corticosteroid sprays, antihistamine pills, nasal antihistamine sprays or decongestant pills.

The treatment options for non-allergic rhinitis include nasal corticosteroids, nasal antihistamines and nasal saline formulations. If there is a lot of runny nose, ipratropium nasal spray can provide relief. If nasal congestion is a major problem, decongestant pills or sprays can be used, but the nasal decongestant sprays should not be used for more than four days unless they are used in conjunction with a nasal corticosteroid spray.

Be proactive. The majority of allergy medications for seasonal allergic rhinitis (hay fever) work best if started before tree pollen is in the air each spring and allergy symptoms develop. If you start taking allergy medications before you first come into contact with spring allergens, the medication can prevent the release of histamine and other chemicals. As a result, allergy symptoms are prevented from developing or are much less severe. In other words, come see us before spring!

Asthma and Pregnancy


When women are pregnant or thinking of becoming pregnant, they begin to strictly monitor what they eat and drink. One thing that’s easy the forget about is the relationship between asthma and pregnancy.

If you’re a mom-to-be, it is vital that you keep your asthma under control. It is important to avoid triggers and take your asthma medications as prescribed. These disciplines can all help ensure a healthy pregnancy for you and your little one.

If you struggle with asthma, it is encouraged that you monitor your asthma during prenatal visits. It is impossible to predict how your asthma will react to your pregnancy. One third of women experiences a worsening of symptoms, one third have a decrease in the severity and one third tend to stay the same. It is important to have these check-ins so your doctor can increase or decrease your medication if necessary.

Asthma attacks are most common during the later weeks of pregnancy, but are very rare during labor itself.

Managing Your Asthma During Pregnancy

What happens if you have an asthma flare-up during your pregnancy? An asthma flare-up causes decreased oxygen levels in the blood. This, in turn, can lead to less oxygen reaching the fetus. Low oxygen can impair healthy fetal growth and development.

If you were receiving allergy shots (immunotherapy) prior to becoming pregnant, it is safe for you to continue this treatment during pregnancy. Just be sure to let your allergist know that you are pregnant. If you are interested in starting allergy shots, it is best to wait until the baby is born.

What About Medications?

Make sure to continue taking your medications throughout your pregnancy. Many mothers-to-be are concerned about taking medications during pregnancy. Yet the risks posed by uncontrolled asthma are much greater than those from asthma treatments.

Inhaled corticosteroids are often the treatment of choice for persistent asthma. Studies have shown them to be effective and low-risk for pregnant women. The National Asthma Education and Prevention Program (NAEPP) recommends two specific drugs: budesonide (inhaled corticosteroid) and albuterol (short-acting Beta 2-agonist) as having good safety profiles when used during pregnancy.

Oral corticosteroids are not preferred for regular asthma treatment during pregnancy. However, they can be used to treat severe asthma attacks.

If you are pregnant and think you may have asthma, make sure to have your condition diagnosed to reduce the risks to your baby. Studies have linked asthma attacks in early pregnancy to birth defects.

If you want to learn more about asthma and pregnancy, make an appointment with one of the physicians at Asthma & Allergy Specialists today!

Acute Asthma Exacerbation

Have you experienced shortness of breath simultaneously with a tight pain in your chest? If so, you’ve probably experienced an acute asthma exacerbation. This is a fancy way to say ‘asthma attack.’

So what is happening in your body when you have an asthma attack? Well, your airways become swollen, your muscles contract and your bronchial tubes get narrow. This situation is not one to be taken lightly. Acute asthma exacerbation can be life-threatening, so we recommend you come see us.

The symptoms and severity of asthma attacks vary from person to person. An individual can experience wheezing, coughing, chest tightness, and/or shortness of breath. Acute asthma exacerbations also vary in length. Some attacks can last for one minute while others can last for hours.

There is a wide range of options that can cause an asthma attack. Some common triggers are upper respiratory infections, colds, pollen, mold, dust mites, pets, tobacco smoke, cold/dry air, exercise and gastroesophageal reflux disease. Sometimes it can be a combination of these factors.

If these symptoms sound familiar to you, we advise that you come in to get some tests done! It is important to learn how to treat an attack when it comes since it does have the potential to be life-threatening.

Understanding Pollen Counts

The term pollen count (or mold count) is very common and you’ve probably seen this on the news: “ pollen count today ”. But what exactly is a pollen count and how does it related to your allergies?

Pollen counts aren’t exactly ‘counts’. They are, more so, forecasts that give an estimate of how much pollen is in the air. The pollen is divided into categories of tree pollen, grass pollen and weed pollen. They are associated with specific numbers in addition to the levels high, medium and low.

Some reports go into more detail about which specific pollens are in the air, such as oak tree or ragweed.

Many people think that if a pollen count is high, they will experience a high level of allergy symptoms that day. But that is not always the case. There are too many variables to be able to say that for sure.

One of the first variables lies in the way the pollen counts are obtained. Most pollen counters are placed on tall buildings and they collect samples of pollen from the air. These samples are examined under a microscope and counted. The results are then extrapolated to make an estimate of how much pollen is in the air.

It is important to note that the levels of pollen (high, medium or low) are reported based on averages of pollen collected over the years. Also, these counts are not full-proof due to factors such as time of day collected, weather changes, and the area from which the pollen was collected.

Other factors that affect pollen counts include the types of local plants in the area where the pollen was collected and the fact that the types and amounts of pollen collected change over the course of a day and from day to day.

Lastly, what these counts mean to allergy sufferers can differ. For one person, a high pollen count of ragweed could cause severe allergy symptoms and for another person, it could cause only mild symptom. This just depends on how allergic a person is to the pollen in question.

Now when you see “ pollen count today ” on the news, you’ll know exactly what they’re talking about. Pollen counts can be helpful if you know what you’re allergic to and what reactions you have at the different levels. Find out today’s pollen count on our website or come in and find out what you’re allergic to!

How do Allergy Shots Work?

How do Allergy Shots Work?

Allergy shots, also known as Allergen immunotherapy, is a form of long-term treatment that decreases symptoms for many people with allergic rhinitis, allergic asthma, conjunctivitis (eye allergy) or stinging insect allergy.

Immunotherapy works by decreasing sensitivity to allergens. These shots often lead to lasting relief of allergy symptoms even after treatment is stopped. This potential for life-long treatment is what makes allergy shots a cost-effective, beneficial treatment approach for many people.


Who Can Benefit from Allergy Shots?

Both children and adults can receive allergy shots. When considering allergy shots for an older adult, medical conditions such as cardiac disease should be taken into consideration and discussed with us first.

We typically decide if allergy shots are right for you based on the following criteria:
•    Length of allergy season and severity of your symptoms
•    How well medications and/or environmental controls are helping your allergy symptoms
•    Your desire to avoid long-term medication use
•    Time available for treatment (allergy shots requires a significant commitment)
•    Cost, which may vary depending on region and insurance coverage

Unfortunately, allergy shots are not used to treat food allergies. The best option for people with food allergies is to strictly avoid that food.


How Do They Work?

Have you ever gotten a vaccine? Well allergy shots work the same way. Your body responds to injected amounts of a particular allergen, given in gradually increasing doses. Over time, you develop immunity or tolerance to the allergen.

There are two phases of allergy shots:
•    Build-up phase– Over the course of about 3-6 months, you receive shots with increasing amounts of allergens about one to two times per week.
•    Maintenance phase– This phase starts after the effective dose is reached. The effective maintenance dose depends on your level of allergen sensitivity and your response to the build-up phase. Over the course of this phase, there will be longer periods of time between treatments, ranging from two to four weeks. We will decide what range is best for you.

Do allergy shots work? Yes, but they do not work for everyone. Also, they require a lot of patience and consistency. It may take up to a year on the maintenance dose to notice an improvement. If the allergy shots are successful, maintenance treatment is generally continued for three to five years. Any decision to stop allergy shots should be discussed with us first.


Allergy Induced Asthma

This article has been adapted from Thanai Pongdee, MD, FAAAAI

Oftentimes, it can be hard to discern whether an individual’s asthma is caused by allergies or not. Allergic and non-allergic asthma have similar symptoms but the causes are different.


Allergy Induced Asthma Causes

Allergy induced asthma is the most common form of asthma. If this is the type of asthma you have, it will be triggered by the inhaling of allergens. Allergens come in many different forms such as dust mites, pet dander, pollen or mold.

In allergy induced asthma, the allergen triggers a response that starts in the immune system. Through a complex reaction, these allergens then cause the passages in the airways of the lungs to become inflamed. This inflammation is what causes coughing, wheezing and other asthma symptoms.

Exposure to allergens may trigger the symptoms, but the real culprit in allergic asthma is the IgE antibody. The IgE antibody is produced by the body in response to allergen exposure. The combination of the antibody with allergens results in the release of potent chemicals called mediators. The mediators cause inflammation of the airways, resulting in symptoms of asthma.


Other Asthma Causes

Some people have asthma that is not triggered by allergens. Asthma symptoms may also be triggered by exercise, viral or bacterial infections, cold air or by related conditions such as gastroesophageal reflux disease (GERD).

Knowing if your asthma is allergic or not is important for treating your condition. Given the relationship between allergies and asthma, an allergist/immunologist is the best qualified physician to diagnose your symptoms and help you manage your asthma.

Make an appointment today so we can help you find the cause of your asthma. We will do the best we can to improve your quality of life!


Antihistamines: What You Need to Know

So you have allergies. Now what? Antihistamines are typically the first thing people try to alleviate the symptoms of allergies. Before you head to your local drug store, read this article to find out a little more about them!

How Do Antihistamines Work?

When your body comes into contact with whatever you’re allergic to, whether it be dogs or dust, it creates chemicals called histamines. These chemicals cause changes in the tissues which result in symptoms such as stuffy nose, runny nose and eyes, and/or itchy eyes, nose, and sometimes mouth. Some people even develop a rash, called hives.

Antihistamines help to reduce allergy symptoms by reducing or blocking the histamines, hence the name antihistamines.

These medicines work well to relieve symptoms of different types of allergies, including hay fever, indoor allergies, and food allergies. But, unfortunately, they can’t relieve every symptom.

To treat nasal congestion, your doctor may recommend a nasal spray. These medications work best at relieving nasal congestion and come in the form of intranasal steroids, antihistamines, and even combinations of the two medications together.

Are there Different Types of Antihistamines?

Yes! Antihistamines can come in the form of tablets, capsules, liquids, nasal sprays, and eye drops. You can purchase some antihistamines over the counter, but some are only available by prescription.

Some prescription antihistamines include Optivar, Astelin, Patanase, Astepro, Palgic, Pataday, Atarax, Vistaril.

You are probably more familiar with the OTC antihistamines include Zyrtec, Chlor-Trimeton, Benadryl, Allegra, Alavert, Claritin, and most recently Xyzal has gone over the counter.

Side Effects of Antihistamines

There are 3 generations of antihistamines. Older generations tend to cause more side effects, particularly drowsiness.

Newer antihistamines have fewer side effects, so they may be a better choice for some people.

Some of the main side effects of antihistamines include dry mouth, drowsiness, dizziness, nausea and vomiting, restlessness or moodiness (in some children), trouble urinating or not being able to urinate, blurred vision and confusion.

If you take an antihistamine that causes drowsiness, do so before bedtime. Don’t take it during the day before you drive or use machinery.

Read the label before you take an allergy drug. Antihistamines may interact with other medications you are taking.

Talk to us first if you have an enlarged prostate, heart disease, high blood pressure, thyroid problems, kidney or liver disease, a bladder obstruction, or glaucoma. Also check with us if you are pregnant or nursing.

Come in and see us, and we will help you determine your allergy triggers and figure out which combination of medications are the right solution for you!


Do You Have a Dust Mite Allergy?


If you find yourself having allergic reactions indoors, then a tiny creature you can’t even see might be the culprit. This creature is called a dust mite. Common dust mite allergy symptoms include, sneezing, runny nose, itchy, red or watery eyes, stuffy nose, itchy nose, mouth or throat, postnasal drip or cough. If your dust mite allergy triggers your asthma, you may also experience difficulty breathing, chest tightness or pain, a whistling or wheezing sound when breathing out, trouble sleeping caused by shortness of breath, coughing or wheezing.

Dust Mite Facts:

  1. Dust mites are among the most common trigger of year-round allergies and asthma.
  2. They are on every continent except Antarctica.
  3. It may not be possible to rid your home entirely of these creatures.
  4. A dust mite measures only about one-quarter to one-third of a millimeter.
  5. They are too small to see with your eyes alone.
  6. Under a microscope, they look like white bugs. They have eight legs, so they are not insects, but arthropods, like spiders.
  7. There are at least 13 species of mites.
  8. They are all well adapted to the environment inside your home.
  9. They feed mainly on the tiny flakes of human skin that people shed each day.
  10. They thrive inner layers of furniture, carpets, bedding and even stuffed toys.
  11. An average adult person may shed up to 1.5 grams of skin in a day. This is enough to feed one million dust mites!
  12. Both the body parts and the waste of dust mites are allergens for many people.
  13. In a warm, humid house, dust mites can survive all year.

Thankfully, there are ways you can prevent allergic reactions to these pesky creatures. There are many changes you can make in your home to reduce your dust mite allergy. The most common place for dust mites is the bedroom. So this is the best room to start with. Some things you can do are cover mattresses and pillows in zippered dust-proof covers, wash your sheets, rugs and blankets weekly in hot water, avoid wall-to-wall carpeting, curtains, blinds, upholstered furniture and down-filled covers and pillows in the bedroom (unless you can wash regularly in hot water), wear a filtering mask when dusting or vacuuming, and keep the humidity in your home less than 50 percent.

If you think you might have a dust mite allergy, come on in and we can find out for certain. We will also get you the treatment you need!



What is Sinusitis?


If you have nasal congestion, facial pressure, cough and thick nasal discharge, you may have rhinosinusitis, commonly referred to as sinusitis.

Your sinuses are hollow cavities within your cheekbones, around your eyes and behind your nose. They contain mucus, which helps to warm, moisten and filter the air you breathe. When something blocks the mucus from draining normally, an infection can occur.

Acute Sinusitis

Acute sinusitis refers to sinusitis symptoms lasting less than four weeks. Most cases begin as a common cold. Symptoms often go away within a week to 10 days; but in some people, a bacterial infection develops.

Chronic Sinusitis

Chronic sinusitis, also referred to as chronic rhinosinusitis, is often diagnosed when symptoms have gone on for more than 12 weeks, despite medical treatment.

People with allergic rhinitis or asthma are more likely to suffer from chronic sinusitis. This is because the airways are more likely to become inflamed when allergic rhinitis or asthma are present. Sinusitis may also be caused by an infection, a fungus, deviated nasal septum, nasal polyps or in rare cases an immune system deficiency.


Sinusitis symptoms, whether acute or chronic, frequently develop after a cold or during times of severe or ongoing allergic rhinitis symptoms. The most obvious sign of sinusitis is a painful pressure in the cheeks and forehead. Other symptoms include:
•    Thick yellow-green nasal discharge
•    Postnasal drip, often with a bad taste
•    Cough
•    Congestion
•    Toothache
In cases of acute sinusitis, a fever may develop.

Allergy testing performed by an allergist / immunologist can identify what allergic triggers might be behind your chronic or reoccurring sinus infections.

In chronic or severe cases, your doctor may also examine your nasal passages using a technique called rhinoscopy or nasal endoscopy. In this procedure, a thin, flexible instrument is inserted up the nostril to view the sinus passages and look for blockages.

If you come in to see us, we may order an MRI or CT scan to look for abnormalities in the sinuses – narrow drainage passages, polyps or a deviated septum.

Make an appointment with us right away if you have: a fever, pain or swelling in the face or eye, redness on the cheek or around the eye, severe headaches, confusion or a stiff neck.