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Biologic Medications in Allergy, Asthma, and Immunology

Thu, 06 Aug 2026 19:54:39 GMT

Biologic medications are a type of treatment used for certain allergic and immune-related conditions. They are also called monoclonal antibodies . These medicines are made from proteins and are designed to work with the body’s immune system in a very targeted way. At Asthma & Allergy Physicians (AAP), biologics are an important option for patients whose symptoms are not well controlled with standard treatments.

Traditional medications, such as inhalers, pills, or creams, often treat symptoms but do not always address the cause of inflammation. Biologics work differently. They target specific signals in the immune system that cause swelling, irritation, and allergic reactions. By blocking these signals, biologics help calm the immune system and reduce long-term inflammation.

Biologic medications are usually given as an injection under the skin. Some are given every two weeks, while others are given once a month or even less often. Depending on the medication, injections may be given at home or in the office. These treatments are meant to be taken long-term and are carefully monitored by your provider at AAP.

Conditions We Treat with Biologic Medications

Moderate to Severe Asthma
Biologics are often used for patients with moderate to severe asthma who continue to have symptoms despite daily inhalers. These medications can reduce asthma attacks, improve breathing, and decrease the need for oral steroids such as prednisone. Many patients also notice fewer emergency visits and a better quality of life. This is available to patients 6 years and older.

Atopic Dermatitis (Eczema)
For patients with moderate to severe eczema, biologics can reduce itching, redness, and skin inflammation. This can lead to better sleep, fewer skin infections, and improved comfort when topical treatments alone are not enough. This treatment is available to patients 6 months of age and older.

Chronic Sinus Disease With Nasal Polyps
Some patients have long-lasting sinus inflammation that leads to nasal polyps. These polyps can cause congestion, sinus pressure, and loss of smell. Biologics help reduce inflammation and shrink polyps, which may improve breathing and decrease sinus infections. This treatment is available to patients 12 years and older.

Eosinophilic Esophagitis (EoE)
Eosinophilic esophagitis is a chronic allergic condition of the esophagus. It can cause difficulty swallowing, food getting stuck, chest pain, and feeding problems in children and affects patients of all ages. Biologic medications can reduce eosinophils and inflammation in the esophagus, helping protect the esophagus and improve symptoms. This treatment is available for patients one year and older.

Chronic Hives (Chronic Spontaneous Urticaria)
Chronic hives cause daily or frequent itching and swelling, often without a known trigger. Biologics can help control the immune response that leads to hives and can greatly reduce itching and flare-ups when antihistamines are not enough. This treatment is available for patients 12 years and older.

Hypereosinophilic Syndrome (HES)
HES is a very rare condition where the body makes too many eosinophils, which can damage organs over time. Biologics can lower eosinophil levels and help prevent complications from ongoing inflammation. This treatment is available to patients 12 years and older.

Food Allergy
In certain patients, biologics may be used to help reduce allergic reactions to foods. These medications can lower the risk of severe reactions and may be used along with other treatments under close medical supervision. At AAP we also use biologics to help aid us in successful oral immunotherapy desensitization. This treatment is available to patients one year and older.

Common Biologic Medications

Some biologic medications commonly used in allergy and asthma care include Dupixent, Tezspire, Xolair, Nucala, Fasenra, Cinqair, Adbry, Ebglyss and Nemluvio. Each medication works in a slightly different way, and not every biologic is right for every condition. Your provider will help choose the best option based on your symptoms, test results, and medical history. As new biologic medications are approved each year, healthcare providers have more options to provide precise, personalized care for patients.

Safety and Monitoring

Biologic medications have been studied in large clinical trials and are considered safe and effective for many patients. The most common side effects are mild, such as redness or soreness at the injection site. Patients are followed closely by our team to make sure the medication is working well and to monitor for side effects. Your provider will review all of the potential side effects prior to starting therapy to make sure this treatment is right for you. Biologics have no drug-to-drug interactions and are not processed through the kidney or liver.

Is a Biologic Right for You?

Biologics are usually recommended when symptoms are not well controlled with standard therapies. At Asthma & Allergy Physicians, we take time to review your condition, testing, and treatment goals to decide if a biologic medication is appropriate for you. Our goal is to reduce symptoms, prevent flares, and help you live a healthier, more comfortable life. If you would like to learn more about biologic therapy, please speak with your provider at your next visit.

Biologic Medications in Allergy, Asthma, and Immunology

Could a Tick Bite Make You Allergic to Red Meat?

Thu, 06 Aug 2026 19:54:37 GMT

As an allergy practice, one of the most common reactions we see when discussing Alpha-Gal Syndrome with patients is disbelief. “I’ve eaten hamburgers my entire life. How can I suddenly become allergic now?” It’s a fair question, and one that many Massachusetts residents are beginning to ask as awareness of this unusual condition continues to grow.

Most of us are familiar with Lyme disease and other infections that can be transmitted by ticks. What surprises many people is that certain tick bites can also trigger a food allergy. Known as Alpha-Gal Syndrome (AGS) , this condition can develop in adults who have never had food allergies before and may cause reactions after eating beef, pork, lamb, venison, or other mammalian products.

One of the things that makes Alpha-Gal Syndrome so difficult to recognize is that symptoms are often delayed. Unlike peanut or shellfish allergy, where symptoms usually occur within minutes, people with AGS may not develop hives, swelling, stomach pain, diarrhea, or even anaphylaxis until three to eight hours after eating. We have seen patients who wake up in the middle of the night covered in hives and have no idea that the steak they ate for dinner could be the culprit.

The discovery of Alpha-Gal Syndrome is one of the most fascinating stories in modern allergy medicine. In the early 2000s, Dr. Thomas Platts-Mills and his colleagues at the University of Virginia were investigating why some patients experienced severe allergic reactions to a cancer medication called cetuximab. Their research led them to a sugar molecule called alpha-gal and eventually to an unexpected connection: many of the affected patients had a history of tick bites and delayed reactions after eating red meat. Their work revealed an entirely new type of food allergy and changed the way allergists think about allergy development.

Most cases in the United States have been linked to bites from the Lone Star tick. While these ticks were once considered primarily a southern species, they have become increasingly common in parts of Massachusetts, including Martha’s Vineyard and Nantucket. As tick populations expand, more cases of Alpha-Gal Syndrome are being recognized throughout New England.

Many people are surprised to learn that Alpha-Gal Syndrome can involve more than food. Alpha-gal is a sugar molecule found in mammals, and some medications, vaccines, and medical products contain mammalian-derived ingredients. Most patients with AGS tolerate medications without difficulty, but certain individuals may require special consideration before receiving specific treatments or undergoing medical procedures. This is one reason why evaluation by an allergy specialist can be helpful.

Diagnosis typically involves a careful review of symptoms, a history of tick exposure, and a blood test that measures antibodies to alpha-gal. It’s important to understand that a positive blood test does not automatically mean someone has Alpha-Gal Syndrome . Like many allergy tests, results must be interpreted in the context of a patient’s symptoms and medical history.

The good news is that there are practical steps people can take to reduce their risk. When spending time outdoors, use tick repellents, stay on cleared trails when possible, wear protective clothing, and perform thorough tick checks after being outside. Pets can also bring ticks into the home, so they should be checked regularly as well. If you find a tick attached to your skin, remove it promptly with tweezers and clean the area with soap and water. Unlike Lyme disease, we do not yet know how long a tick must be attached to trigger Alpha-Gal Syndrome , so early removal is always recommended.

For most people, a tick bite is nothing more than an unpleasant nuisance. But if you’ve experienced unexplained allergic reactions, especially several hours after eating red meat, it may be worth discussing Alpha-Gal Syndrome with your healthcare provider. As awareness grows in Massachusetts, recognizing the signs of this unusual allergy may help patients find answers that have been hiding in plain sight.

Could a Tick Bite Make You Allergic to Red Meat? Understanding Alpha-Gal Syndrome

New Advances in Food Allergy Treatment: Beyond Avoidance

Mon, 20 Jul 2026 22:23:17 GMT

For many years, the standard approach to managing food allergies was simple but challenging: avoid the allergen completely and always carry an epinephrine auto-injector in case of accidental exposure. While this remains an essential part of food allergy management, exciting advances in treatment are giving patients and families new options—and new hope.

Oral Immunotherapy (OIT): Building Food Tolerance

One of the most significant developments in food allergy care is Oral Immunotherapy (OIT) . This treatment works by introducing extremely small amounts of the allergenic food and gradually increasing the dose over several months under the supervision of an allergy specialist.

The goal of OIT is to help the immune system become more tolerant of the allergen, reducing the risk of a severe reaction if accidental exposure occurs. While OIT is not considered a cure, it can significantly improve safety and quality of life for many individuals living with food allergies.

Biologic Therapy: A New Generation of Allergy Treatment

Another promising advancement is the use of biologic medications . These treatments work differently from OIT by targeting and blocking the antibodies responsible for triggering allergic reactions.

Studies have shown that biologic therapy can reduce allergic responses by as much as 98% , dramatically lowering the severity of reactions from accidental exposure. For some patients, biologics can be used as a standalone treatment to provide added protection, while others may benefit from combining biologic therapy with oral immunotherapy to improve safety during treatment—particularly those with severe food allergies.

Looking Ahead

Research into food allergy treatments continues to advance rapidly. Additional biologic medications and other innovative therapies are currently in development, offering the potential for even more effective and personalized treatment options in the future.

If you or your child has a food allergy, it's important to consult with a board-certified allergist to determine whether newer therapies such as oral immunotherapy or biologic treatment may be appropriate. As medical research progresses, managing food allergies is becoming safer, more effective, and increasingly focused on improving everyday quality of life.

Article based on information provided by Ralph Cahaly, MD.

Oral immunotherapy is commonly used for allergies to:

Peanuts
Tree nuts
Milk
Eggs
Wheat
Soy
Sesame

House Dust Allergies Common Even in Clean Homes

Thu, 23 Apr 2026 04:33:15 GMT

House dust is the major cause of year-round runny or stuffy nose, itchy, watery eyes, and sneezing for allergy sufferers. Dust can also make people with asthma suffer attacks or wheezing, coughing and shortness of breath.

Why does house dust cause allergic reactions?

House dust is a mixture of many kinds of waste materials. Its content varies from home to home, depending on the type of furniture, building materials used, presence of pets and other factors. A speck of dust may contain fabric fibers, human skin particles, animal dander, microscopic creatures called mites, bacteria, parts of cockroaches. mold spores, food particles and other debris. A person may be allergic to one or more of these substances, and, if exposed to the dust, will have an allergic reaction.

Is dust allergy a sign of a dirty house?

No, a dirty house can make a house-dust allergy problem worse, but in all likelihood, normal housekeeping procedures may not be enough to relieve house-dust allergy symptoms. Tiny creatures called house dust mites seem to be the major allergen (cause of allergic reactions) in house dust. A recent study in England showed that 10 percent of the general population and 90 percent of people with allergic asthma have positive skin tests for allergy to dust mites. Recent studies in the U.S. suggest that at least 45 percent of young people with asthma are allergic to dust mites.

People allergic to dust mites react to proteins in the bodies and digestive waste (feces) of the mites. These waste particles are so tiny and light that they float easily into the air when anyone walks on the carpet or disturbs bedding. When allergic people inhale these particles. they suffer symptoms.

No matter how vigorously you dust or vacuum. you will not reduce the number of dust mites present deep within carpeting and mattresses. In fact, usual cleaning methods actually put more dust into the air, making symptoms worse.

Dust mites belong to the family of 8-legged creatures called Arachnids. This family also includes spiders. chiggers and ticks. Dust mites - which can only be seen with a microscope - are hardy creatures that live well and multiply easily in warm, humid places. They prefer temperatures at or above 70°F. with relative humidity at 75-80 percent. Mites die when the humidity falls below 40-50 percent and are rarely found in very dry climates.

As many as 18,875 dust mites can live in one gram of dust, but the usual population is about 100 to 500 mites per gram. (A gram is about the weight of a paper clip). Each mite produces about 10-20 waste particles each day and lives for 30 days. Egg-laying females can add 25-30 new mites to the population.

Mites eat particles of skin and dander and thrive in bedding. carpeting, upholstered furniture, clothing. closets and automobile seats – all likely to contain skin particles. Dust mites don't bite, cannot spread diseases and never live on people, only in the environment. They are harmful only to people who become allergic to them. While usual household insecticides have no effect on dust mites, a new product (described later) is now available to kill mites and help remove them from carpeting.

What are dust mites?

Are house dust allergies seasonal?

In the U.S., mite populations appear to peak in July and August, and allergen levels stay high through December. Allergen levels are lowest in April and May. Although dust mite populations decrease during winter in areas where the climate is cold and dry, some sensitive people report that their symptoms get worse at that time! That's because mite fecal particles and pieces of dead mites, both of which trigger dust mite allergy, are still present. Forced-air heating systems blow these panicles up into the air, and, as dust dries out over time, even more of the particles become airborne. People may get fewer symptoms in the summer because they spend more time outdoors and need not run the furnace indoors.

How do I know if I have dust mite allergy?

If you think you may have an allergy to house dust mites, consult an allergist. To pinpoint the cause of your symptoms, the allergist may ask questions about your work and home environments, eating habits, family medical history, frequency and severity of symptoms, exposure to pets and a variety of other questions. Your allergist may employ skin testing, observing your body's reaction to various possible allergens placed under the skin. A positive reaction (a raised welt with redness around it) shows that you are allergic to that allergen. Skin testing is the easiest, most sensitive and least expensive way to identify an allergy. In some cases, however, skin lest results may be unclear and your allergist may require a RAST test – analysis of a small blood sample – to confirm the diagnosis.

What can I do to relieve dust mite allergy symptoms?

The three basic treatments for dust mite allergy are:

Dust mite avoidance
Prescription medication
Allergy shots

Dust mite avoidance works best to relieve symptoms.

How do I avoid dust mites?

Dust mites are difficult to remo ve completely from your home. However, you can follow certain anti-mite procedures that will reduce mite populations and your exposure to them, thereby reducing your symptoms. Some of these procedures are expensive, and you may not need to do them all. Ask your allergist which ones will be most helpful for your situation.

Reduce Surface Dust

Clean your home thoroughly, on a regular basis. Vacuum frequently and dust with a damp or oiled cloth. Ideally, someone other than the dust-sensitive person should clean, but if this is impossible, wear a dust mask.
Get rid of carpeting, especially in the bedroom. Carpeting is a breeding ground for dust mites. If you must have carpeting, select a type with low pile. Scatter rugs that can be washed each week are a better alternative, Wood floors, seamless vinyl or linoleum floor coverings are best because they can be cleaned easily and thoroughly, and mites don't like to live on uncarpeted floors.
Remove from your home any items that tend to collect or hold dust and replace them with easy-to-clean items. Use wooden, leather or plastic-covered sofas and chairs instead of upholstered furniture (particularly older furniture stuffed with cotton, kapok, feathers and down, or animal hairs). Select closed bookcases and curio cabinets instead of open shelves. Books and knickknacks are dust collectors. Use washable curtains or window shades instead of venetian blinds and heavy draperies. Choose furniture with simple, clean designs instead of ornately carved pieces. Select easily cleaned decorations instead of dried-flower arrangements, wall hangings and straw baskets

Reduce Dust in the Air

Use air conditioning to keep inside humidity at 50 percent or lower to slow down mite growth during warm weather months. A sling hygrometer or wet-dry thermometer may help monitor humidity

Change or clean air conditioner and furnace filters often. Consider using an HEPA (high energy particulate air) air cleaner on your heating system.

Pay Special Attention to Bedrooms

On average, people spend one-third of their lives in the bedroom, and studies have shown that, of all the rooms in the home, the bedroom often contains the most dust mites. Concentrate efforts in the bedroom of the dust-sensitive person, following all the steps above, plus:

Install a room air conditioner and dehumidifier in the bedroom if the home does not have central air conditioning
Place a filter made of cheesecloth under the faceplate of the bedroom heating vent to help prevent recirculating of dust into the bedroom air
Select nonallergic, washable bedding materials. Rather than pillows stuffed with feathers, down, kapok or foam rubber, use pillows stuffed with dacron or other synthetic materials. Nonallergic plastic casings that zip around mattresses, box: springs and pillows will help keep mites under control. Cover the zippers of these casings with adhesive tape to make a better barrier. Avoid comforters and chenille bedspreads.
Use washable blankets and spreads, and wash all bedding (including pillows without cases) every week to 10 days, using hot water.
Hang clothes in a closet and keep the closet door closed, or put them into dresser drawers.
Get rid of stuffed animals; they collect dust mites.
Never allow pets in the bedroom.

What products are available to get rid of dust mites?

Many people may not want to get rid of carpeting to avoid dust mites, but until recently. there were no other alternatives. New products, available today, remove dust mites or their allergen from carpet fibers. One product, tannic acid, breaks down mite allergen but does not kill the mites. Another product, benzyl benzoate dry foam, actually kills mites and helps remove them and their waste products from carpet.

Tannic acid can be sprayed on carpets or upholstered furniture to break down allergen from mites or cat dander. When the allergen is inactivated, it can no longer cause allergy symptoms. Tannic acid works fast and is easy to use, but its effects do not last long because mites remain and allergen continues to build up. requiring frequent application of the product, Also, some people have complained it may stain some carpets and upholstery fabrics.

To kill mites, benzyl benzoate moist powder can be brushed into carpets, allowed to dry for 8 to 12 hours, and vacuumed up. The Environmental Protection Agency (EPA) has approved this product as safe for home use, and it will not usually stain carpets. Unlike tannic acid, benzyl benzoate's effect is long-lasting. After one or two initial applications. you can keep mites and your symptoms under control by using it only once or twice a year.

What if avoiding dust mites doesn't work for me?

If you follow these procedures to reduce your exposure to dust mites but allergy symptoms persist, your alIergist may recommend other treatment methods, such as medication or allergy shot treatments. Consult your allergist to determine the most effective treatment method for you, and you can gain control of your dust mite allergy and achieve relief from allergy symptoms.

What is Rhinitis?

Thu, 23 Apr 2026 04:27:14 GMT

Rhinitis is not a disease: it is simply a term describing the symptoms produced by nasal irritation or inflammation. Symptoms of rhinitis include runny nose (rhinorrhea), itching (pruritus), sneezing and stuffy nose (blockage or congestion). These symptoms are the nose's natural response to inflammation and irritation.

The nose normally produces mucus, which traps substances like dust, pollen, pollution and germs such as bacteria and viruses. Mucus flows from the front of the nose to the back and is swallowed, but when mucus production is excessive, it can flow from the front (runny nose) or become noticeable from the back (post-nasal drip). Nasal mucus, normally a thin, clear liquid, can become thick or colored, perhaps due to dryness, infection, or pollution. When post-nasal drip is excessive, thick, or contains irritating substances, cough is the natural response for clearing the throat.

Itching and sneezing are also natural responses to irritation caused by allergic reactions, chemical exposures (like cigarette smoke), temperature changes, infections and other factors.

The nasal tissues congest and decongest periodically. In most people, nasal congestion switches back and forth from side to side of the nose in a cycle several hours long. Some people, especially those with narrow nasal passages, notice this nasal cycle more than others. Strenuous exercise or changes in head position can affect nasal congestion. Nasal congestion is also the natural response to irritation and inflammation. Severe congestion can result in facial pressure and pain, as well as dark circles under the eyes.

So, what is sinusitis?

Sinusitis is inflammation or infection of any of the four groups of air sinus cavities in the skull, which open into the nasal passages. Sinusitis is not the same as rhinitis, although the two may be associated and their symptoms may be similar. The terms "sinus trouble" or "sinus congestion" are sometimes wrongly used to mean congestion of the nasal passage itself. Most cases of nasal congestion, though, are not associated with sinusitis.

What causes rhinitis?

Arbitrarily, rhinitis lasting less than six weeks is called acute rhinitis, and persistent symptoms are called chronic rhinitis. Acute rhinitis is usually caused by infections or chemical irritation. Chronic rhinitis may be caused by allergy or a variety of other factors.

The symptoms of allergic rhinitis (called "hay fever" sometimes, but not caused by hay and not associated with fever) are caused by exposure to substances (allergens) to which the patient has become allergic. Common allergens are tree, grass, and weed pollens, molds, animal hair and dander, and house dust mites.

How is rhinitis treated?

Nasal surgery will usually cure or improve symptoms caused by mechanical blockage or chronic sinusitis not responsive to prolonged antibiotics and nasal steroid sprays. Stopping the use of offending medications will cure rhinitis medicamentosa, providing that there is no underlying disorder. When no specific cure is available, options are ignoring your symptoms, avoiding or decreasing exposure to irritants or allergens to the extent practical, and taking medications for symptom relief.

Antihistamines are the most inexpensive and commonly used treatment for rhinitis. They dry excess secretions and reduce itching and sneezing, but may not do much for nasal congestion. There are dozens of different antihistamines and wide variations in how individual patients respond to them. Some are available over the counter and others require a prescription. Generally, they work well and produce only minor side effects. Persons with nasal dryness or thick nasal mucus should avoid taking antihistamines without consulting a physician. Contact your physician for advice if an antihistamine causes drowsiness or other side effects.

In general, pollen (and sometimes mold) allergy causes symptoms at certain times of the year, while mold, animal dander and dust mites cause symptoms year round. People with allergies have developed antibodies to these allergens. These antibodies circulate in the blood stream, but localize in the tissues of the nose and in the skin. This makes it possible to demonstrate presence of these antibodies by skin testing, or less commonly, by a special blood test. A positive skin test mirrors the type of reaction going on in the nose. Not everyone with symptoms of rhinitis has allergies, and not everyone with allergies has rhinitis.

Rhinitis may result from many causes other than allergic reaction. In fact, the most common condition causing rhinitis is the common cold. Colds can be caused by any of more than 200 viruses. Children, particularly young children in school or day care centers, may have from 8-12 colds each year. Fortunately, the frequency of colds lessens after immunity has been produced from exposure to many viruses.

Colds usually begin with a sensation of decongestion, rapidly followed by runny nose and sneezing. Over the next few days, congestion becomes more prominent, the nasal mucus may become colored, and there may be a slight fever and cough. Cold symptoms resolve within a couple of weeks although a cough may sometimes persist. Cold symptoms that last longer may be due to other causes of chronic rhinitis or to sinusitis.

Not all symptoms in the nasal passage are caused by allergy or infection. Similar symptoms can be caused by mechanical blockage, use of certain medications, irritants, temperature changes or other physical factors. Rhinitis can also be a feature of other diseases and medical conditions.

Drug-induced nasal congestion, called "rhinitis medicamentosa “ can be caused by birth control pills and other female hormone preparations, certain blood pressure medications (beta blockers and vasodilators), and prolonged use of decongestant nasal sprays.

Decongestant nasal sprays work quickly and effectively, but they alter normal nasal physiology. After a few weeks of use, nasal tissues swell after the medication wears off. The only thing that seems to relieve the obstruction is more of the medicine, and the medication's effect lasts shorter lengths of time. Permanent damage to the nasal tissues may result. Consultation with a physician to "get off' the medication is often necessary.

Cocaine also alters normal physiology, causing a condition identical to that produced by decongestant nasal sprays. If you use cocaine, it is important to tell your physician so that appropriate therapy can be prescribed.

"Vasomotor rhinitis" is a term used to describe a group of poorly understood causes of rhinitis, with symptoms not caused by infection or allergy. Many people have recurrent nasal congestion, excess mucus production, itching, and other nasal symptoms similar to those of allergic rhinitis, but the disorder is not caused by allergy.

What are other causes of rhinitis?

Nonprescription decongestant nasal sprays work within minutes and last for hours, but can't be used for more than a few days at a time without a physician's order. Oral decongestants are found in many over the counter and prescription medications, and may be the treatment of choice for nasal congestion. They don't cause rhinitis medicamentosa, but need to be avoided by some patients with high blood pressure. If you have high blood pressure, you should check with your physician before using them. Using an over the counter saline spray will help counteract symptoms of dry nasal passages or thick nasal mucus. Unlike decongestant nose sprays, a saline nose spray can be used as often as needed. Sometimes, your physician may recommend washing (douching) of the nasal passage.

Corticosteroids counteract the inflammation caused by release of allergic mediators, as well as that caused by other nonallergic factors. Thus, they generally work for many causes of rhinitis symptoms and are sometimes useful for chronic sinusitis. Corticosteroids are sometimes injected or taken orally, but usually on a short term basis for extremely severe symptoms. Physicians warn that injected or oral steroids may produce severe side effects when used for long periods or used repeatedly and, for this reason, they should be used with extreme caution. In rhinitis, a corticosteroid is much safer when used topically by spraying it into the nose. Cromolyn is a medication that blocks the release of chemical mediators. It does not work in all patients. It must be used at least four times daily, and improvement may take several weeks to occur.

Atropine and the related drug ipratropium bromide are sometimes used to relieve symptoms of rhinitis: in fact, most antihistamines have a slight atropine-like effect. Atropine can be taken orally, and it is a component of some antihistamine decongestant preparations. Atropine and ipratropium are not yet commercially available as nasal sprays.

Antibiotics are for the treatment of bacterial infections. They do not affect the course of uncomplicated viral upper respiratory infections (common colds), and are of no benefit for non-infectious rhinitis, including allergic rhinitis. In chronic sinusitis, antibiotics may help only temporarily, and surgery may be needed.

One or more of the above medications, accompanied by appropriate avoidance measures, will usually control most symptoms of nasal allergy. If not, immunotherapy (allergy shots, desensitization) may provide additional relief. The treatment program consists of injections of a diluted extract, administered frequently in increasing doses until a maintenance dose is reached. Then, the injection schedule is changed so that the same dose is given with longer intervals between injections. Immunotherapy helps the body build resistance to the effects of the allergen, reduces the intensity of symptoms provoked by allergen exposure, and sometimes can actually make skin test reactions disappear. As resistance develops, symptoms should improve, but the improvement from immunotherapy will take several months to occur. Immunotherapy does not help the symptoms produced by nonallergic rhinitis

What triggers vasomotor rhinitis?

Irritants that can trigger vasomotor rhinitis include cigarette smoke, strong odors and fumes (perfume, hair spray, other cosmetics, laundry detergents, cleaning solutions, pool chlorine, car exhaust, and other air pollution). Spices used in cooking can cause nasal irritation, producing a condition called "gustatory rhinitis."

Other things that can aggravate vasomotor rhinitis are alcoholic beverages (particularly beer and wine), aspirin, and certain blood pressure medications, such as reserpine and propranolol. Some people are very sensitive to abrupt changes in weather or temperature. Skiers often develop a runny nose -"skier's nose" - but in some people any cold exposure may cause a runny nose. Others start sneezing when leaving a cold, air-conditioned room. These agents are not allergens, do not induce formation of allergic antibodies, and do not produce positive skin test reactions. Occasionally, one or two positive skin tests may be observed, but they do not correlate with the history and are not relevant or significant.

The cause of vasomotor rhinitis is not well understood. In a sufficiently high concentration, many odors will cause nasal irritation in almost anyone. Some people, though, are unusually sensitive to irritation, and will have significant nasal symptoms even when exposed to low concentrations of irritants. Thus, vasomotor rhinitis seems to be an exaggeration of the normal nasal response to irritation, occurring at levels of exposure which don’t bother most people. It occurs more often in smokers and older individuals. As is the case with allergic rhinitis, vasomotor rhinitis often can't be cured. Fortunately, symptoms can be kept under control by avoiding or reducing exposure to substances that cause symptoms, and by taking medications when needed. Patients with vasomotor rhinitis should not smoke or permit smoking in their homes.

Dryness of the nasal tissues can be a normal effect of aging, or a characteristic of "rhinitis sicca," which may be associated with a foul smelling nasal discharge. Rhinitis can also be a feature of endocrine disease like hypothyroidism or can occur during pregnancy. Rhinitis can be made worse or even improved during pregnancy. Alcoholic beverages can cause the blood vessels in the nose to enlarge temporarily and produce significant nasal congestion.

How do you know what kind of rhinitis you have?

Consult your physician. Sometimes several of the above conditions can coexist in the same person. In a single individual, allergic rhinitis could be complicated by vasomotor rhinitis, septal deviation (curvature of the bone separating the two sides of the nose) or nasal polyps. Use of spray decongestants because of chronic sinusitis, septal deviation or vasomotor rhinitis may cause rhinitis medicamentosa. Any of these conditions will be made worse by catching a cold. Nasal symptoms caused by more than one problem can be difficult to treat, often requiring the collaboration of an allergist and an otolaryngologist (ear, nose and throat specialist).

Types of Molds

Thu, 23 Apr 2026 04:17:45 GMT

Alternaria

This mold is commonly found in the air from late spring into fall. It is at its daily peak from noon until 3 P.M. It grows in the soil and on the leaves, stems, flowers and fruit of many vegetables, cereal grains. and flowering plants. For example, it is found on tomato plants, beans, cabbage and chrysanthemums.

Aspergillis

This is commonly found in the soil. It also grows on food stored under damp conditions. One type is common on wet surfaces in bathrooms and in drip pans of refrigerators and other appliances. This is commonly called mildew.

Cladosporium

(Hormodendrium) The spores of this mold are very common in large numbers in the air. The highest levels occur from midsummer through December. The daily peak is from 11 A.M. to 3 P.M. This mold grows in the soil, on dead leaves and may even be found on the leaves of some living plants.

Fusariuim

This mold is often produced in a slimy mass and requires water splashing to get into the air. For this reason, it is most common in the air after rain. Many types of this are found on vegetable and field crops. This mold can be released into the air from infected grasses, cereals and stored fruits and vegetables (ex. tomatoes, potatoes and cucumbers).

Penicillium

Groups of this mold are often blue or green in color and may be seen on citrus fruits, jams, bread, apples and leather in the home. This mold is plentiful inside houses during winter. It peaks around 2 P.M. IT SHOULD BE NOTED THAT AN ALLERGY TO THIS MOLD DOES NOT INDICATE AN ALLERGY TO THE MEDICATION PENICILLIN

Your First Injection Visit

Thu, 23 Apr 2026 04:12:24 GMT

Purpose

Your doctor has recommended immunotherapy as part of your allergy care. The purpose of injection therapy is to help your body produce blocking antibodies to reduce your symptoms. It will not "cure" the allergy. The process of building up these antibodies is slow and you may not begin to see the positive effects for six months or more. immunotherapy is a commitment of at least three years with many patients electing to remain on injection therapy for the long term management of their allergies.

Procedure

Your serum consists of four bottles of extract that contain the same main ingredients. The difference is in the concentration. We start with the weakest solution and work up to the most concentrated, or undiluted solution. In the initial building up phase injections are given weekly, for about seventeen to twenty weeks. At this point you will make an appointment for a serum evaluation. This is an office visit where we review the past few months, make any further adjustments in medications or serum, and check to see that your physical findings correlate to how you are feeling. If you have reached your maintenance, you will now come every two weeks until the completion of your first year. An office visit will again be scheduled for another comprehensive review and the series continues every three weeks for one year and then every four weeks for the third year.

This type of schedule is a guide, not necessarily a promise, and adjustments will be made based on your individual needs. Not every patient will reach the fourth, or undiluted bottle of extract. That means that your maintenance, the dose that will help produce blocking antibodies occurs at a lower level. The goal is to reach the highest level that you can tolerate without producing an unwanted reaction.

Reactions

Since you are receiving injections of the allergens to which you are allergic, it is possible to have a reaction from the extract. Serious reactions are rare; however, it is for your safety that you wait thirty minutes following each injection. If you take antihistamines as part of your regular routine, you may continue to do so on the day of your injection. You should not take any medication for the purpose of trying to prevent itching or swelling as this could possibly mask symptoms that warn the dose is getting too high.

Reactions may be local with redness, heat and itching at the site of the injection. Any discomfort can be relieved by applying ice and taking an oral antihistamine. Any swelling, known as the wheal, should be measured, comparing the size of the swelling to a dime, nickel, quarter or half dollar. If you have any reaction, one of the professional staff must be notified at your next appointment and they will determine if any adjustment is needed in your dosage. Often for swelling of about a quarter the same dose will be administered until you no longer have such a reaction. For swelling larger than a half dollar, your dosage may be reduced by one half the previous injection. Any symptom that occurs regularly after receiving an injection should be reported. Delayed reactions can occur eight to twenty-four hours later, although the longer the time lapse usually the less severe the reaction.

A more serious reaction can be hives, generalized itching, shortness of breath, dizziness, wheezing or tightness of the throat. As a rule of thumb any symptom which develops immediately after receiving your injection should be reported before you leave the office. If a severe reaction should occur within one to two hours after your injection you should return to the office or go to the nearest emergency room.

Summary

Injection therapy is a commitment. You will not experience immediate results, and may continue to need supplementary medications. The professional staff is available to help and offer ongoing evaluations. The office is generally open Monday thru Friday from 9 a.m. to 5 p.m. We will be happy to answer any questions or refill prescriptions during this time. There is always a medical staff member on call nights and weekends. This is for emergencies, since you do not have your medical records at home. Any medication that you may need can be reviewed before Friday afternoon. Time has been set aside on Monday morning for a follow-up office visit on every patient that requires emergency help over the weekend, your well-being is our primary concern.

Allergic Reactions to Stings from Hornets, Wasps, Bees & Yellow Jackets

Thu, 23 Apr 2026 04:09:59 GMT

What Happened?

You were stung by an insect and reacted very severely to the venom that it injected.This response, called "Anaphylaxis‎," is the most severe form of an allergic reaction and can result in any combination of these symptoms:

Dizziness
Weakness or unconsciousness
Throat tightness or difficulty breathing
Itching
Hives of the skin
Generalized swelling

The reaction usually starts minutes after the sting and can be life-threatening and occasionally fatal.

Your reaction. while severe, is not unusual. Two to five million Americans have experienced similar reactions as a result of such stings.

It's important that you know that your reaction can reoccur if you're stung again. but it can be prevented with proper medical care.

What Should I Do Now

Consult an allergist If you’ve had a frightening reaction to an insect sting, it's important to talk to an allergist, a doctor who is a specialist in diagnosing and treating allergic disease. If the allergist determines that you are allergic to insect stings, there is a 60% chance you will have another severe reaction if re-stung. But it is important to know that serious anaphylactic reactions to insect stings can be prevented from occurring by a treatment known as venom immunotherapy.

Immunotherapy

Immunotherapy (preventive immunization) to insect stings involves administering gradually increasing doses of venom that stimulates the immune system to become resistant to the allergic reaction. In a matter of weeks, people who previously lived under the constant threat of severe reactions to insect stings can go about leading normal lives.

Venom immunotherapy is an effective treatment for stinging insect allergy, but individual patients should be carefully evaluated by an allergist before a decision for treatment is reached. Some reactions are not allergic in nature at all, and in those cases immunotherapy is not indicated.

Avoidance

If you arc allergic to any of the stinging insects, your doctor can explain preventive steps to protect yourself from locations, situations, and clothing that attract these insects. In general, good common sense on avoidance measures can reduce the incidence of an insect sting.

Epinephrine

Before the immunotherapy takes effect, your doctor may instruct you (to carry a form of epinephrine for self administration. You would be instructed on how to inject this material into an appropriate site, such as your thigh, in emergencies. It is often effective in slowing or stopping the reaction, but is not always enough. In some cases, intravenous fluids, oxygen, and other treatments are necessary. The epinephrine might also be ineffective in combination with certain other medications, and over time many patients tend to forget to carry it with them. For these reasons, epinephrine should not be seen as an alternative for venom immunotherapy. D

Conclusion

While stinging insect allergy is a major problem, much of the risk and fear of a reoccurrence can be eliminated with immunotherapy treatment and basic avoidance measures. Patients who have had a severe reaction to a sting should be evaluated by an allergist for correct diagnosis and treatment of the allergic condition.

You and Your Allergens

Thu, 23 Apr 2026 04:04:17 GMT

What is an Allergy?

An allergy is an abnormal or exaggerated reaction to an otherwise harmless substance. Itches, coughs, sneezes, and wheezes are some of the trademarks of allergic misery. The allergy producing substance, called the allergen, may enter your body by inhalation through the nose or lungs, by eating or drinking, by direct skin contact, or by insect stings.

As an allergic person, you may be sensitive to more than one allergen, which may be confirmed by your skin test. It is possible to have one or more manifestations at different times of your life. For example, you may have eczema as an infant, asthma as a child, and rhinitis as an adult. Your tendency to develop an allergy is inherited and remains with you throughout your life. However, you may have dormant periods with no apparent symptoms. It is most doubtful that you can "outgrow" an allergy.

Since allergic persons are usually sensitive in varying degrees to certain allergens, we speak of the Allergic Load. A major goal at Asthma & Allergy Physicians is to lighten the load as much as possible by:

Environmental controls
Medications to control symjnoms
lmmunotherapy

Although you are born with a tendency to develop allergies, your symptoms are best controlled by your Allergist. You will lead a more comfortable and productive life by following yow doctors prescribed treatment.

The following is a list of allergens that are commonly found in your environment. You have reacted with a positive skin test to the following allergens as indicated by a checkmark. Please keep this list for your reference. We are always happy to discuss any concerns about these allergens, or we'll suggest how to avoid them.

Trees:

Pollinating season begins at the end of March and continues through May.

ASH
BIRCH
ELM
HICKORY
MAPLE
OAK
PINE
WILLOW
POPLAR

Grasses:

Pollination begins in mid-May, peaks in June, and ends in mid-July.

JUNE
ORCHARD
REDTOP
TIMOTHY

Weeds:

Pollinating season for Plantain begins with the grasses and continues through the fall. Ragweed is the most prolific weed that begins its season by August 15th, peaks in September, and continues until the first frost, along with the other weeds.

COCKLEBUR
LAMB'S QUARTER
MARSH ELDER
PLANTAIN
RAGWEED

The Bucket Theory of Allergy

If you are sneezing, wheezing, or itching, it may help to think of your allergies according to the Bucket Theory. Pretend that your body is a three gallon empty bucket. On any given day the bucket is loaded-up with the things that cause you to react including pollen, mites, food, or others. This is fine as long as it's not more than three gallons worth.

When you have more than three gallons worth of sensitizing materials and only a three gallon container, you have overloaded your capacity. The results are your allergy symptoms.

Your bucket can get sabotaged. There are certain factors that seem to lower the brim, leading your bucket to overflow before it holds the entire three gallons. These factors include weather and temperature changes, fatigue, emotions, strong odors, chemicals, exertion, and infection. When some or all of these factors are at work, you may experience allergy symptoms, even when nothing else in your environment has changed.

The goal of allergy therapy is to reduce your allergic load. Your doctor will outline measures to both reduce the number of items that get dumped into your bucket and to reduce your sensitivity to the things that do. Can you think of anything that you can do to lighten the load or raise the brim?

Molds:

Found in the air outdoors except when there is a ground cover of snow; may be found in damp places and spoiled food.

ALTERNARIA
ASPERGILLUS
CLADOSPORIUM
FUSARIUM
PENICILLIUM

Environmental Allergens:

These have no particular season and are present year-round. They appear more troublesome with high humidity and during the heating season.

COCKROACH
MITES

Pets and Animals:

These allergens are not season specific.

CAT
DOG
FEATHER
OTHER: _______________

Rhinitis Pamphlet

Thu, 23 Apr 2026 03:53:56 GMT

Allergic Rhinitis

Rhinitis, nicknamed "hayfever" or "sinus trouble" is a medical term that refers to inflammation of the membranes that line the nose. Frequently, there is inflammation of the surrounding membranes -- sinuses, throat, eyes, and ears. As a result of this, you may end up with one or several familiar symptoms such as a runny or blocked nose, itchy eyes, sinus congestion, sneezing, headache, fluid in the ears and ear infections, and postnasal drip leading to frequent sore throats, cough, or clearing of your throat.

One of the more common types of rhinitis is called allergic rhinitis, which is made up of two distinct types:

Seasonal, typically known as hayfever, occurring only at certain times of the year.
Perennial, occurring year-round.

Allergic rhinitis symptoms are the result of exposure to inhaled allergens such as animal danders, hair and saliva, pollen from trees, grass and weeds, molds, mites, or dust. These allergens then come in contact with sensitizing antibodies (proteins of immune system) located on the surface of specialized cells (mast cells), in which there are granules of chemicals called histamine. When the allergen and the antibody come in contact, the histamine is released from the cells which then cause stuffy or runny nose, itchy ears or throat, sinus congestions, sneezing, headaches, and/or watery red eyes.

If you are diagnosed with allergic rhinitis, your treatment may include avoidance of the off ending allergen, oral medications such as antihistamines and decongestants, or topical medications depending on your medical history. You may also benefit from immunotherapy -- typically called allergy shots, where you receive injections of specific allergens.

Non-allergic Rhinitis

Another form of rhinitis is called vasomotor rhinitis, also known as nonallergic rhinitis. We can make this diagnosis following your skin test, when the specific allergens you were tested for did not elicit a sizable skin reaction. In most cases the patient diagnosed with vasomotor rhinitis has symptoms similar to the allergic rhinitis patient. However, the vasomotor rhinitis patient has no allergies and no sensitivities to the specific allergens.

The likely cause of these symptoms is direct contact with irritants such as smoke, fumes, odors, or changes in the atmosphere. If you are diagnosed with vasomotor rhinitis, your treatment may include limiting exposure to offending irritants, prescribed decongestants, or topical medications depending on your medical history. Allergy shots are not effective in treating this form of rhinitis.

Chemical Rhinitis

Chemical rhinitis is also called rhinitis medicamentosa or drug-induced rhinitis. Over-the-counter topical decongestants (nasal sprays) used to treat allergies are the cause of chemical rhinitis. Some examples of these decongestants are Afrin, NeoSynephrine, and Duration.

The over-the-counter nose sprays do give immediate relief by constricting, or narrowing the vessels in your nose. However, "rebound" swelling of the lining of the nose occurs and worsens the discomfort. The more you spray, the less the response, and the more you need to spray. The over-the-counter nasal sprays should not be confused with physician prescribed nose sprays. These sprays requires more regular use over a longer period, usually 1-3 weeks. These sprays do not cause the undesirable "rebound" effect.

Allergic Rhinitis

Ultimately, what most allergy sufferers seek is long-term relief. There are treatments that successfully control reactions to and symptoms of these allergies. The three most effective measures for controlling an allergic condition are:

Environmental control (avoiding the offending agent)
Medications to control the symptoms
injection therapy (also known as immunotherapy)

Environmental control, means that you change or eliminate the offending agent in your home and work area. Our staff can share with you a number of ways to control your environment based on your own circumstances.

Additionally, medication may also be included in your therapy if your skin test results, evaluation, and medical history demonstrate the need. The range of medications can be quite numerous, depending on what condition you may have. We closely monitor your medications throughout your treatment to ensure the best follow through for your condition.

And of course, injection therapy can prove an effective treatment. This is the series of shots prescribed to build-up blocking antibodies in your system and reduce the severity of your symptoms over the long-term. It is the only way known to alter the allergic state of the patient. Your progress is monitored very closely by our team of physicians, physician assistants, nurses, and medical assistants to ensure that you have the best possible care.