A “How To” series by Dr Tan & Partners
Have you been caught up with the whole Marie Kondo craze recently, discovering long lost items buried beneath heaps of other stuff that do not spark joy? Or simply packing and repacking your house because the festivities are around the corner?
But wait, as you happily get into your rhythm of packing and cleaning, you find that your nose starts to tickle, you take a few deep breaths and before you know it, a loud uncontrollable “Ah-Choo!” You wipe away the mucus and continue packing but the sneezing does not seem to stop at all.
Apart from the possibility of someone constantly thinking about you, you start to wonder whether you have caught the flu. Or worse still, developed an allergy, an allergy to cleaning!
Could It Be Possible That You’ve Developed An Allergy to Cleaning?
Does An Allergy to Cleaning Even Exist?
What is An Allergy?
Allergy is a common condition that can happen at any age, where the person’s own immune system overreacts with substances that are usually harmless for most people.
These allergens include anything from house dust mites, pollen, moulds (fungi), pet danders, insect sting/bites, a certain type of medicines and foods.
Allergy is, however, more common in people with atopy ( genetic / hereditary tendency for allergy), family and personal history of allergic rhinitis (sensitive nose), eczema (sensitive skin) and asthma (sensitive airways).
When exposed to allergens, the immune reaction is triggered! Subsequently, the allergic person produces antibodies called IgE antibodies, which results in the release of a chemical known as histamine. This chemical histamine is then responsible for the various inflammatory symptoms that can be uncomfortable and distressing such as
- Rashes ( eg. eczema flare ups),
- Swelling of face/ lips/around the eyes,
- Throat and tongue,
- Runny or blocked nose,
- Itchy watery eyes,
- Abdominal pain,
- Vomiting, and diarrhoea,
- and even difficulty in breathing.
These IgE mediated allergy symptoms typically appear within 1-2 hours after exposure to the particular allergens.
Sometimes, allergic reactions can be very serious and potentially life threatening, condition known as anaphylaxis. Patients with history of anaphylaxis, especially due to food allergy, are usually prescribed an emergency adrenaline injection, known as Epipen Injection, as delayed intervention can be fatal. These patients are also educated on how to use the injection and the importance of carrying it with them all the time.
Hence, It is very crucial to identify the potential allergy so that we can try avoid and reduce exposure to the particular allergens.
“So Yes I hear you about the whole allergy thing and how one may die from it but you have not told me how to stop sneezing yet!”
Yes my discerning reader, we are getting on to that in just a bit, bear with me, i’ll first have to cover this bit on testing for allergy. It is always better to know what we are dealing with rather than fight in the dark.
How Do We Test For Allergy?
An allergy can be diagnosed with these 2 commonly used methods – an IgE blood test or a skin prick test. They can test for both food and non food allergies.
Wait what a skin prick test? That sounds painful!
1. Skin Prick Test :
Hold on there, before you start worrying about anything which might be painful.. From our own personal experience (yes this writer has done the test on himself), apart from the mild discomfort, it is a procedure that i personally, and most patients tolerate well. There will certainly be no bleeding during the procedure.
For patients with sensitivity to the particular allergen, i.e a positive result, they will likely experience some itch and mild irritation over the test area.
This is a simple, quick and accurate test to diagnose allergy and the results can be known on the same day within 15-20mins !
How this Skin prick test is usually done is that small markings will be drawn on skin and tiny drops of allergens applied onto the skin. The allergens are introduced into the skin via tiny lancets that barely penetrates the skin surface.
This skin prick test is done on the inner forearm or upper back ( small children). After which, the doctor will look for a specific skin reaction, that appear as red, raised and itchy bumps, known as wheals. Size of the wheals will be measured and measurements more than 3mm is indicative of an allergic reaction.
Another caveat also is to avoid oral antihistamines at least 1 week before the test.
Skin prick test is generally very safe as only tiny amounts of the allergens are introduced into the skin. However, there are situations where skin prick test may not be suitable, such as :
- Patients who are unable to come off oral antihistamines/ steroids prior to the test
- Those who have severe eczema/ skin rash over the forearms/ back
- Those with previous history of life threatening anaphylatic reaction.
2. IgE Blood Test :
As mentioned before, for persons with atopy, the immune system produces IgE antibodies against certain allergens. Therefore we can detect these specific IgE antibodies in a blood test.
A wide range of allergens can be tested via a single blood test in one setting. It usually takes about 1 week for results to be ready. No special preparation is necessary prior to blood test.
Sometimes, both IgE blood test and skin prick tests are done in a complementary fashion as useful parameters in the prediction and diagnosis for allergy.
So if you have patiently read all this way till now, let me fill you in on what you’ve been waiting for.
How Do I Stop Sneezing !!
There are several ways we can deal with allergy :
We can try our best to avoid the offending allergen, however, most times, it is just not feasible to avoid certain allergens especially inhalant allergens. Avoidance alone is usually inefficient.
2) Anti allergic drugs
Medications like oral antihistamines, oral decongestants, nasal sprays and corticosteroids can help ease or reduce symptoms caused by allergy as long as the symptoms are not serious or life threatening. However, they do not treat the allergy condition.
This means symptoms typically appear again when you stop taking the drugs.
For example, dust mites allergy is very common in those with allergic rhinitis. It is almost impossible to avoid dust mites completely, hence, patients will usually have to be on long term medications for symptom control.
3) Sublingual immunotherapy (SLIT)
Immunotherapy is the only treatment that is capable of treating the root cause of the allergy.
This therapy works by desensitizing and downregulating the body’s reaction towards a specific allergen that is responsible for producing symptoms. Hence, gradually modifying the body’s allergic responses over time.
This is accomplished by intentional regular exposure of the specific allergens administered via under the tongue ( sublingual spray).
Sublingual immunotherapy significantly improves quality of life, reduces consumption of medications, and also reduces risk of developing asthma and new allergies in the future.
Clinical papers show success rates of SLIT up to 80% especially for inhaled allergens.
Improvement of symptoms can be seen as early as 2-3 months from start of the therapy. It is recommended duration of treatment is 3-5 years, hence, a firm commitment from the patient is necessary to help determine the success of treatment. Persistent effects from immunotherapy have been documented to last up to 10 years.
Symptoms can relapse if treatment is stopped prematurely.
How Do I Use SLIT?
2 sprays under the tongue daily is all that is needed. Generally we advise patients to avoid eating or drinking in the first 15 minutes after the spray to allow maximum efficacy of the treatment on the administered area. It has a pleasant pineapple taste.
How Safe is SLIT?
Sublingual immunotherapy is safe for children as young as 2 years old. Only about 1% of patients report temporary mild itching/ tingling under the tongue which resolves within 1 week.
SLIT is strongly recommended in World Allergy Organization (WAO) clinical studies.
So my dear reader, our 3As approach is what we advocate to acing your allergies. If you feel that it is time to act to alleviate your symptoms, speak to us already so that we can accompany you to ameliorate your sneezing. Okay with all these A words, you get the point of our 3 As – Avoidance, Anti-allergic medications, A novel therapy in Sublingual Immuotherapy
If you are interested to have an Allergy Testing, Skin Prick Test or Allergy Treatment, please drop us an email for appointment firstname.lastname@example.org.
Stay Safe and May Your Cleaning Always Be a Joyful One!