If you live with allergies, also referred to as allergic rhinitis, you know how annoying the symptoms can be. The itchiness, congestion, trickle in the throat—they can make it difficult to do the things you need, or want, to do.
It can also be difficult to determine the cause of your allergies (allergic rhinitis). For example, you could be allergic to airborne or environmental factors, such as ragweed or something in your home. Or it could be a seasonal condition. Whatever the cause, Alexandra Demeglio, a Physician Assistant in the Department of Otolaryngology at Mount Sinai Doctors – East 85th Street, says patients can get relief.
“Knowing what you are allergic to is helpful because there are ways to manage or eliminate the symptoms you are experiencing,” she says.
To make an appointment with Alexandra Demeglio, PA, call 212-241-9410.
Understanding your airborne and environmental triggers starts with a simple, rapid skin prick (also called a puncture or scratch) test. The test takes about two minutes to administer, and in as little as 15 minutes you can get results that can be used to develop a treatment plan. In this Q&A, she explains how that process works.
What are common allergy (allergic rhinitis) symptoms?
The most common allergy symptoms include:
• Nasal congestion, which may be accompanied by clogged ears
• Itchiness in the eyes, nose, ears, or throat
• Watery eyes or nose
• Post-nasal drip—mucus from your nose or sinuses that drips down your throat
• Red eyes or dry eyelids
• Worsening asthma symptoms
• Fatigue or brain fog
What is causing my allergy symptoms?
Many environmental and seasonal factors can trigger allergy symptoms. These include:
• Pollen (grass and trees in spring and summer; ragweed, pigweed, and mugwort in fall)
• Mold and mold spores
• Pets and other animals
• Pests, such as mice and roaches
• Feathers
• Changes in humidity
• Dust mites
Some causes are not just seasonal but also regional in nature, such as mold, which is relatively common in some states, including New York, but virtually nonexistent in other states, such as Arizona. Also, your home furnishings and décor can contain months—even years—of allergens, so keeping them clean will help to reduce or prevent symptoms.
Should I be concerned about my symptoms?
If over-the-counter medications are not providing relief from allergies and your symptoms are worsening or severe enough that they affect your quality of life, you should see an otolaryngologist about testing and treatment options.
Untreated allergies can lead to conditions such as nasal polyps, eczema, and asthma. To prevent that from happening, it is important to desensitize your immune system to affecting allergens. That starts with getting a better understanding of what you are allergic to.
A consultation with an otolaryngologist usually begins with a review of your medical history and symptoms followed by a nasal endoscopy of your nose and sinuses. Based on the findings, the otolaryngologist may prescribe an over-the-counter medication and lifestyle changes, recommend further consultation with a rhinologist, or refer you for a skin prick test.
What is a skin prick test?
The skin prick test is designed to deliver quick insights about the seasonal or environmental factors that are triggering your allergic symptoms. It is typically performed using the forearm among adults.
Before the test begins, the health professional will clean the forearm skin with alcohol. Using a device with multiple small needles, the professional will make gentle scratches along the skin and apply 40 different allergen extracts, such as pollen, cat hair, and mold. In cases involving suspected food allergies, a referral will be made to an allergist for the skin prick test.
The process typically takes two minutes. During the test, the health professional will apply two other substances to measure patient reactions to the allergens—histamine, which is released by the body during an allergic reaction, and a glycerin saline solution, which typically produces no reaction.
How do I prepare for a skin prick test?
To prepare for a skin prick test, you should:
• Stop taking prescription and over-the-counter antihistamine medications, including sprays, at least one week before the test. This will ensure that the test is accurate in identifying allergies and the degree of severity.
• Discontinue oral acid reflux medications up to three days before the test.
• Delay taking any blood pressure medication until after the test.
Patients who are taking steroid-based nasal sprays or other medications to treat asthma or allergic asthma can continue to do so.
Skin prick tests are not recommended for patients who are not able to suspend medications that can interfere with the outcomes of the test. In these cases, a blood test will be performed. Skin prick tests are also not recommended during pregnancy to prevent the risk of a bad reaction that affects blood flow to the fetus.
What happens after the test?
Once the allergen extracts have been applied to the skin, the health professional will wait 15 minutes and then check the patient’s forearm for reactions. They are looking for anything that resembles a mosquito bite, which is a positive. They will also look at the degree of sensitivity, which they measure using a scale from one to four, with four meaning a large hive. That tells providers what a patient is very allergic to.
The results, which are revealed the day of your appointment, will determine treatment recommendations. Patients who demonstrate a mild reaction are typically prescribed a six-to-eight-week regimen of over-the-counter antihistamines. Patients who demonstrate a severe reaction, or whose symptoms are not controlled, or worsen, during antihistamine treatment, are referred to an allergist or immunologist for further assessment and, in some cases, allergy immunotherapy shots. Patients whose test results are negative despite displaying symptoms will be referred to an allergist for intradermal testing, in which the allergens are injected under the skin.
Ultimately, once you have a better idea of what is causing your symptoms, you have options that can provide relief from allergies. Mount Sinai’s team of otolaryngologists, allergists, and immunologists are available to help you.
“Our otolaryngology program spans everything from head and neck to rhinology,” Ms. Demeglio says. “Our clinicians are on the cutting edge in treating people efficiently and effectively. We know the appropriate treatments, and we can individualize them so that we can improve your quality of life.”