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Overview
What are allergies?
Allergies are your body’s reaction to a substance it views as a harmful “invader.” These substances are called allergens. Common allergens include pollen, animal dander, mold and dust mites.
An “allergic reaction” is the way your body responds to an allergen. If you are prone to allergies, the first time you’re exposed to an allergen, your body responds by producing antibodies to fight it. Your body responds by releasing a chemical mediator called histamine, which causes symptoms of allergy. Nasal allergy symptoms are referred to as “allergic rhinitis.”
Not everyone has allergies. The tendency is inherited. If you have allergies, your child may develop an allergy, but not necessarily to the same allergen.
Common Seasonal Allergens
Pollen
Seasonal allergic rhinitis, or hay fever, is an allergic response to pollen from trees, grasses or weeds. It causes inflammation and swelling of the lining of your nose and of the protective tissue of your eyes (conjunctiva).
Animal dander
Allergic reactions can be caused by the proteins secreted by sweat glands in an animal’s skin, which are shed in dander, and by the proteins in an animal’s saliva.
Molds
Molds are tiny fungi (like Cladosporium, Aspergillus, Penicillium or Alternaria) with spores that float in the air like pollen. Mold can be found indoors in damp areas, such as the basement, kitchen, or bathroom, as well as outdoors in grass, leaf piles, hay, mulch or under mushrooms. Outdoor mold spores reach a peak during hot, humid weather.
Dust mites
Dust mites are tiny organisms that live in dust and in the fibers of household objects, such as pillows, mattresses, carpet and upholstery. They grow in warm, humid areas.
Bee venom
If you get a bee sting, a normal reaction includes pain, swelling and redness around the sting site. A large, local reaction includes swelling that extends beyond the sting site. For example, if you are stung on the ankle, you may see swelling in your leg.
Symptoms of Allergy
Common symptoms
Common symptoms of seasonal allergic rhinitis include sneezing, stuffy nose and itchy, watery eyes, nose and mouth.
Some people experience allergic asthma in response to pollen, molds, dust mites or animal dander. Symptoms of allergic asthma include wheezing, shortness of breath, coughing and/ or chest tightness
The normal reaction to a bee sting includes pain, swelling and redness around the sting site. Swelling may extend beyond the sting site. More serious symptoms may signal a life-threatening reaction that requires emergency treatment.
Diagnosing Allergy
How is allergy diagnosed?
If you think you have allergic rhinitis or asthma related to allergy, don't wait to see if your symptoms go away. When symptoms last longer than a week or two, interfere with work or school or cause sleep disruption, make an appointment with an allergy specialist.
Allergy skin testing may be used to identify the allergens that are causing your symptoms. The test is performed by pricking your skin with allergen extracts, and then checking your skin’s reaction.
If a skin test can’t be performed, blood work may be done.
Treatment
How are allergies treated?
Allergies can’t be cured, but symptoms can be controlled using a combination of avoidance and medications. Sometimes immunotherapy (“allergy shots”) is needed.
Medications
Common medications used to treat allergic rhinitis symptoms include:
- Antihistamines (e.g., Allegra®, Zyrtec®)
- Decongestants (e.g., Sudafed®, Contact®)
- Topical nasal steroids (e.g., Flonase®,Nasonex®)
- Cromolyn sodium
- Topical nasal antihistamines
- A combination of over-the-counter and prescription medications
Medications used to treat asthma symptoms include:
- Inhaled bronchodilators
- Inhaled steroids
- Oral bronchodilators (theophylline)
- Oral anti-leukotrienes (montelukast [Singulair®], zafirlukast [Accolate®], zileuton [Zyflo®])
- Omalizumab (Xolair®), dupilumab (Dupixent®), reslizumab (Cinqair®), benralizumab (Fasenra®) or Mepolizumab (Nucala®)
Other treatments
Immunotherapy for allergic rhinitis or allergic asthma may be recommended if symptoms are not adequately controlled with a combination of avoidance measures and regular medication use. Immunotherapy is recommended after an allergy to bee venom is confirmed.
Saline irrigation can be used to rinse out allergens and decrease the amount of inflammation they cause. Saline rinse kits (e.g., Neilmed®) are sold over-the-counter. To make your own rinse, mix one-half teaspoon non-iodized salt and one-half teaspoon baking soda in 8 ounces of distilled or boiled water.
Treating Specific Allergens
Pollen
To reduce symptoms avoid pollen by staying indoors when pollen counts are high, closing your windows and using air conditioning.
Treatment options include over-the-counter and prescription oral antihistamines, anti-leukotrienes, nasal steroids, nasal antihistamines and nasal cromolyn.
If these measures do not relieve your symptoms of allergic rhinitis or asthma, talk with your healthcare provider about immunotherapy (“allergy shots”).
Animal dander
Avoidance measures don’t work as well as removing the pet from your home. If this is not an option, keep your pet out of your bedroom, use air cleaners with HEPA filters and washing your pet frequently.
Medications may help control your nasal, eye or chest symptoms.
Immunotherapy may be recommended if your symptoms are not adequately controlled with avoidance methods and medications.
Molds
Treatment may include medications to control your nasal, eye and chest symptoms.
Immunotherapy may be recommended if your symptoms are not adequately controlled with avoidance and medications.
Dust mites
To help manage dust mite allergy, try placing airtight plastic or polyurethane covers over pillows, mattresses and box springs. Remove carpeting or vacuum frequently with a high-efficiency filter vacuum cleaner.
Medications may by used to control your nasal, eye and chest symptoms.
Immunotherapy may be recommended if your symptoms of allergic rhinitis or asthma are not adequately controlled with avoidance methods and medications.
Bee venom
Normal reactions to bee stings only require avoiding bees. In some individuals, however, a bee sting can provoke a serious allergic reaction known as anaphylaxis. This is a life-threatening emergency that requires immediate medical attention. Symptoms may include:
- Widespread hives that appear as a red, itchy rash that spreads outside the area that was stung
- Swelling not only around the sting, but also in the face, throat or mouth
- Wheezing, sensation of throat constriction or difficulty swallowing
- Restlessness and anxiety
- Shortness of breath, chest tightness, abdominal pain, cramps, vomiting, diarrhea
- Rapid pulse
- Dizziness, mental confusion or a sharp drop in blood pressure
An anaphylactic reaction is treated with epinephrine (adrenaline).
If you have experienced a reaction like this, the next sting can be life-threatening. See a board-certified allergist/immunologist. If your allergy to bee venom is confirmed, immunotherapy is recommended. It will dramatically reduce the likelihood of having a serious reaction if you are ever stung again.
Patient Services
MyChart
Cleveland Clinic MyChart® is a secure, online personal healthcare management tool that connects patients to their medical record. Patients can register for MyChart through their physician’s office or online.
Parents and caregivers of children under age 18 can view test results, renew prescriptions, review past appointments and request new ones using Cleveland Clinic MyChart. This secure online healthcare management tool connects parents and legal guardians to portions of a child’s medical record at any time, day or night.
Medical Concierge
For complimentary assistance for out-of-state patients and families, please call 800.223.2273, ext. 55580, or email medicalconcierge@ccf.org.
Appointments
Make an Appointment
To schedule an appointment with an adult allergy specialist, please call 216.444.6503. For more information, please visit Cleveland Clinic’s Allergy and Clinical Immunology Department
To schedule an appointment with a pediatric allergy specialist, please call 216.444.5437. For more information, please visit Cleveland Clinic Children’s Allergy and Immunology Department.
Virtual Second Opinions
If you cannot travel to Cleveland Clinic, help is available. You can connect with Cleveland Clinic specialists from any location in the world via a phone, tablet, or computer, eliminating the burden of travel time and other obstacles.
If you’re facing a significant medical condition or treatment such as surgery, this program provides virtual access to a Cleveland Clinic physician who will review the diagnosis and treatment plan. Following a comprehensive evaluation of medical records and labs, you’ll receive an educational second opinion from an expert in their medical condition covering diagnosis, treatment options or alternatives as well as recommendations regarding future therapeutic considerations. You’ll also have the unique opportunity to speak with the physician expert directly to address questions or concerns.
Why Choose Us?
Choosing Your Care
Experts at Cleveland Clinic’s Respiratory Institute and Cleveland Clinic Children’s are committed to excellence in patient care, research, education and advocacy.
We offer comprehensive and evidence-based diagnosis and management for adults and children with conditions within the spectrum of allergic/immunology disorders, offering a broad range of treatment options including medications, biologic agents, immunoglobulin replacement, drug desensitization and allergen immunotherapy.
Being part of Cleveland Clinic and Cleveland Clinic Children’s also means you have easy access to any of our other specialists to manage any related conditions, such as asthma. Cleveland Clinic is consistently ranked as one of the nation's top hospitals by U.S. News & World Report.
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