Allergies – Your Nose Knows these Symptoms. Do You?

Allergies….It’s actually immune system warfare being waged in your body, but to you, it appears as one or more of these symptoms:

• Sneezing often accompanied by a runny or clogged nose
• Coughing
• Postnasal drip (my favorite)
• Itching eyes, nose, or throat
• Allergic shiners (the dark circles under your eyes staring back at you in the mirror every morning. They are caused by increased blood flow near the sinuses)
• The “allergic salute” (in a young child,  the persistent upward rubbing of the nose that causes a crease mark across the nose and makes the tip nice, red and sore)
• Watering eyes or puffy eyes
• Conjunctivitis (inflammation of the membrane that lines the eyelids, causing red-rimmed, swollen eyes, and crusting of the eyelids).
• Eczema (itchy, dry or thickened skin)
• Wheezing, shortness of breath, or tightness in the chest

The Diagnosis

Time to see the doctor. People with allergy symptoms, such as the runny nose of allergic rhinitis, may at first suspect they have a cold–but the “cold” lingers on and on. It just won’t go away. It is important to see a doctor about any respiratory illness that lasts longer than a week or two. 

If your symptoms include aches or fever, it is probably not an allergy as these are not allergy symptoms. If it appears that the symptoms are caused by an allergy, you should see a doctor who understands the diagnosis and treatment of allergies and asthma. 

Medical specialists in the immune system and allergies are known as allergists and immunologists. There are various test they can run to determine what is triggering your allergic reaction. For people who suffer seasonal or recurring reactions to various trigger substances, allergy testing can be a crucial and necessary step toward receiving proper treatment. Allergy testing is not inexpensive but is necessary in many cases..

If your medical history indicates that the symptoms recur at the same time each year, your primary doctor will probably work under the theory that a seasonal allergen (like pollen) may be the problem. The specialists in your area will recognize the patterns of potential allergens common during local seasons and your symptoms.

Skin Test

Allergists commonly use skin tests to determine whether a patient has IgE antibodies in the skin that react to a specific allergen. Because skin tests challenge the body’s reactions, it is important that you discuss all medications (both prescription and over-the-counter ) you are taking at the time the appointment is made for testing. 

You will be instructed to stop certain medications anywhere from 5 days to the night before testing.  Also, let your doctor know about any antidepressants or medications such as Zantac, Pepcid, or Tagamet you take as these medications can interfere with accurate test results.

In skin (or challenge) testing, the doctor uses diluted extracts from various allergens such as dust mites, pollens, or molds commonly found in your local area. The extract of each allergen is injected under the patient’s skin or is applied to a tiny scratch or puncture made on your arm or back.

I’d be lying if I said it did not hurt just a little bit.  Skin tests are one way of measuring the level of IgE antibody in a person.

With a positive reaction, a small, raised, reddened area (called a wheal) with a surrounding flush (called a flare) will appear at the test site. The size of the wheal gives the doctor an important diagnostic clue, but a positive reaction does not prove that particular pollen is the cause of a patient’s symptoms.

Blood  Test

Although skin testing is the most sensitive and least costly way to identify allergies in patients, some individuals such as those with widespread skin conditions like eczema should not be tested using that method.

There are other diagnostic tests that use a blood sample from the patient to detect levels of IgE antibody to a particular allergen. One such blood test is the Specific IgE test (formerly called the RAST radioallergosorbent test), which can be performed when eczema is present or if a patient has taken medications that interfere with skin testing.

Patch Test

In the case of dermatitis where eczema is not present, your doctor may suspect certain substances that have come in contact with your skin could be the cause of the allergic reaction.  In this instance a patch test will be performed. 

This simple procedure involves direct application of the suspected allergens to the skin.  The allergens to be tested are mixed with a nonreactive base and then place in direct contact with the skin and covered.  The upper back is a common area for this type of testing. 

The patches are left in place for 48 hours. During this time, it is important not to get the tapes wet or to expose them to ultraviolet light. So that means to keep your shirt on and your back out of the shower.  After 48 hours, you will go back to the office, the patches will be removed and the results analyzed. 

This sort of testing is most common for nickel, parabens, formaldehyde, lanolin, and common adhesives and accelerants.

No matter the type of tests performed, once the results have been analyzed you will know your allergy triggers.  The test results along with your medical history will be used by your doctor to complete your diagnosis.  Once the triggers have been identified and the diagnosis has been made you can begin your allergy-free living plan.

Previous Post - Understanding the Immune System

Up Next – Public Enemy #1 Pollen

Till next time

Cheryl