- What is an allergist?
- Why should I see an allergist?
- Allergy appointments:
- Help! I think my child has allergies!
- Useful links for allergy sufferers
Allergists specialise in the treatment of allergic diseases. This includes the diagnosis and treatment of allergic rhinitis (hayfever), asthma, allergic eye diseases, atopic eczema and urticaria (hives). Allergists also see patients with food allergy, medication allergy, bee sting allergy and latex allergy.
An allergist provides expert medical advice and treatment in the evaluation and management of people with allergic diseases. This includes performing and interpreting allergy tests, expertise in treating complex allergic diseases and asthma, as well as the ability to prescribe allergen immunotherapy .
The following is a list of reasons which may warrant an evaluation by an allergist:
- Asthma that causes frequent symptoms, affects school/work/sleep/exercise, or leads to frequent doctor or emergency room visits.
- Any asthma attack that has led to being hospitalized.
- Frequent allergic rhinitis symptoms that affect a person's lifestyle or lead to recurrent sinus infections.
- Medications (over-the-counter or prescribed) are not helpful in treating allergic rhinitis or asthma, or cause unwanted side effects.
- Frequent or recurrent skin rashes, especially those that itch or may be related to allergies.
- Any food allergy, mild or severe.
- Any severe reaction to a bee sting or other insect sting.
- Hives (urticaria) or swelling (angioedema).
- Moderate to severe atopic dermatitis.
- The desire to reduce the need for medications and improve and possibly cure allergic rhinitis and asthma through treatment with allergen immunotherapy.
- How to prepare
- Please let the receptionist know that you are booking an allergy consultation, this allows for the extra time required for this consultation. On average the consultation is 40 minutes.
- Stop taking any antihistamines for 5 days prior to your appointment (texa, zyrtec, allergex, xyzal, clarityne, deselex, allecet, telfast etc). Nasal sprays, asthma inhalers and oral asthma medication such as singulair may be continued.
- What to expect
- In many cases, allergy tests (skin prick tests) can be done at the first appointment and the results will be available on the same day.
- There are approximately 30 different tests available, however usually only 10-15 are performed at a time, specifically tailored to your symptoms.
- In cases of severe eczema where there is no unaffected skin available, blood tests may be done instead. Alternatively, skin prick tests will be deferred until the skin is clear.
- If blood tests are required, the results may take a few days.
- What to bring
- Bring copies of all previous tests done.
- If your allergy is suspected to be as a result of a fresh food, please bring a small amount of that particular food with you for the appointment. e.g. cashew nuts, banana, avocado, lentils.
- If the reaction was due to another kind of food or drug, please bring the container in which the food was purchased in order for the complete list of ingredients to be investigated.
- Skin prick test procedure
- Skin prick tests are performed by placing a minute drop of the allergen extract on your skin, usually on the forearm. The skin is then pricked gently through the drop, allowing some of the extract to penetrate the skin. After 15 minutes the result can be read.
- This test is very safe both in adults and children of all ages with virtually no side-effects.
- Skin prick tests may be performed in children from the age of 4 months.
- Patch tests can be performed for suspected contact dermatitis e.g. for skin rashes due to topical ointments
- A tiny aluminum plate is filled with the suspected allergen and placed on the skin for 24 hours. It is then removed.
- The reaction to the allergen is read 72 hours later.
What is an allergy?
An allergy is an immune reaction to a substance in the environment called an allergen.
When a child with allergies comes into contact with an allergen - either by touching it, breathing it, eating it, or having it injected - her body mistakenly views it as a dangerous invader and releases histamines and other chemicals to fight it off.
These chemicals irritate the body and cause symptoms such as a runny nose, sneezing, itching, and coughing.
Symptoms can be mild or more severe, intermittent (seasonal, for example) or ongoing because of constant exposure to the allergen.
In some cases, an allergen can cause a severe reaction, called anaphylaxis. This is a medical emergency, as the symptoms — including breathing difficulty and swelling — can be life-threatening.
What are examples of allergens?
Possible allergens include food, drugs, insects, animal dander (pets), dust mites, mould, and pollen. Allergens can cause respiratory symptoms, as in nasal allergies or allergic rhinitis, skin symptoms like eczema, or intestinal problems — from food allergies, for example.
What causes nasal allergies?
- Dust mites — microscopic organisms that thrive on human skin flakes. Nearly 85 percent of allergy sufferers are allergic to dust mites.
- Animal dander — from cats, dogs, birds, hamsters, horses etc
- Mould — fungi found in wet, damp places such as bathrooms and basements
Some children are allergic to feather pillows or wool blankets. And remember cigarette smoke can make allergy symptoms worse.
How can I tell if my toddler has nasal allergies or just a cold?
Because the symptoms of nasal allergies are much like cold symptoms — runny nose, watery eyes, cough, nasal congestion, sneezing — it can be tough to tell the difference. There are some telltale signs of allergies, though. Ask yourself the following questions:
- Does it seem like your toddler always has a cold? Colds usually wind down in a week to ten days; allergies don't.
- Is your toddler's nose always stuffy or running?
- Is she constantly wiggling, wiping, or pushing her nose up in what doctors call the allergic salute?
- Is the mucus that drains from her nose clear and thin (as opposed to yellow or greenish and thick)?
- Does she seem to sneeze a lot?
- Are her eyes itchy, red, and watery?
- Does the skin under her eyes look dark or purple or blue — what doctors call allergic shiners?
- Does she breathe through her mouth?
- Does she have a dry cough?
- Is her skin irritated or broken out in an itchy red rash?
If you answered yes to one or more of these questions, there's a good chance your toddler is allergic to something in her environment. Kids with nasal allergies are also more prone to ear infections, asthma, and sinus infections.
Are allergies inherited?
A child inherits the tendency to be allergic but not necessarily the specific allergies. For example, if one of your child's parents has hay fever or pet allergies, there's a 40 to 50 percent chance that your child will have some sort of allergy as well. That probability jumps to 75 to 80 percent when both biological parents have allergies. Family members may differ widely in the kinds of things they are allergic to.
If my toddler is allergic, when will I know?
It can take time for an allergy to develop. Each allergic person has a threshold that must be reached before an allergen causes a reaction, and this can take several months.
Seasonal allergies to things such as pollen and grass usually don't rear their ugly (and stuffy) head until a child is about 3 to 4 years old. That's because the exposure to each individual pollen is only for a few weeks each year.
How can I figure out what my child is allergic to?
It takes some careful detective work and sometimes the help of medical tests to pinpoint the cause of an allergy. One clue may be when the allergy attacks occur.
Mould allergies usually develop during damp or rainy weather and can be hard to distinguish from colds. Dust mites or pet allergies often cause morning congestion throughout the year. Pollen-related allergies are more common in spring, summer, and autumn.
Sending the cat or dog away for a few days won't tell you whether your toddler has a pet allergy. It can take more than a year after a cat is no longer around for cat dander to degrade to the point that it doesn't bother allergic people.
On the other hand, if you take your toddler away from your pet (on holiday, for example) and she seems much better, then you have a good — but by no means conclusive — lead. You'd also want to consider that your toddler might be allergic to something else in your house.
If your own detective work doesn't give you the answer, it's time to see the doctor. He'll examine your toddler and ask lots of questions. If he believes the problem is allergies, he may refer you directly to an allergic specialist or he may suggest a blood test to measure levels of IgE (allergy) antibodies in your toddler's blood.
Blood tests may be less accurate than skin tests. So if the blood test does suggest an allergy, the next step is a skin test. You'll need to see an allergist for that.
During a skin test, an allergist applies small amounts of common allergens to your child's skin. If your toddler is allergic to a substance, she'll have a reaction similar to a mosquito bite on that spot.
Keep in mind that testing tells you what your child is allergic to at that point, but it may change as your child gets older. If your toddler has a negative skin test but continues to have allergy symptoms, have her reevaluated in six to 12 months.
How can I protect my toddler from allergens?
Here are the best ways to reduce your toddler's exposure to the most common allergens:
Dust mites live in fabrics and carpets and are common in every room of the house but children are usually exposed to the most dust mites in the bedroom, where mattresses and pillows are veritable dust-mite condominiums.
The following steps may seem like a lot of work, but they really help. Parents who take these steps may expect some improvement in their child's allergies and this could cut down the level of medication needed for the problem.
Encase your toddler's mattress and pillow in an impenetrable cover especially made for allergic children. Unlike plastic covers, these provide a barrier that's breathable and not crinkly. Avoid big, fluffy duvets and use blankets instead.
Wash bedding once a week in hot water to kill dust mites. Set your washing machine at 55-60 degrees. Expose mattresses to sunlight when possible for a few hours a week. Avoid piling up stuffed animals in your child's room. Wash the few favourites your toddler can't live without in hot water weekly or stick them in the freezer for an overnight killing frost.
Dust and vacuum weekly or every other week, but make sure your child isn't in the room when you do it. Dusting and vacuuming stir up residual dust-mite particles in the room. Wet mopping can help prevent this. Consider investing in a vacuum cleaner with a HEPA (high efficiency particulate arresting) filter, which traps even microscopic particles that pass right through ordinary vacuum cleaners. If your toddler has a severe dust mite allergy, consider replacing carpeting with a smooth floor like wood or vinyl and replacing curtains with blinds. Clean or replace filters on your fireplace and air conditioners during seasons they're in use.
If your child is allergic to a pet, the only solution is to give the animal away. That's not an easy decision to make, of course, and, understandably, you'll want to consider it only as a last resort.
Wash your pet frequently. You can find shampoos that reduce dander in the pet store. Try to keep your pet mostly outside, but if not, keep your pet off the furniture and never allow the pet into your child's room.
Use a dehumidifier and air conditioner when the weather is warm and moist, especially in a wet basement or other areas of your home where mould growth is a problem.
Clean your bathroom regularly with mould-inhibiting disinfectants, such as a little bleach and water or a natural solution like tea tree oil and water. And consider investing in a better ventilation system.
Avoid steaming up the bathroom at bathtime by keeping the windows open as much as possible.
Use the extractor fan when cooking (or open windows).
Limit the amount of indoor plants.
Empty and clean rubbish bins frequently.
Do not store firewood inside.
Mould can often be found growing in cupboards, attics, cellars, plants, fridges, showers, dustbins and under carpets.
Even a fake Christmas tree can harbor mould.
Outdoors, mould is found in sandpits, rotting vegetation, hay, compost heaps and piles of dead leaves.
Pollen is nearly impossible to avoid completely.
Avoid being outside on hot, windy days or when grass has just been cut.
Wear sunglasses and a bit of Vaseline on the nostrils.
Flush eyes with sterile saline solution to remove pollen.
Close bedroom windows on windy days.
Are there any medications that can help my toddler?
Yes, but don't give over-the-counter allergy medicine without talking to your doctor first. Your doctor may suggest antihistamines and offer you a prescription. Many of the newer allergy medicines have fewer side effects than other products on the market.
What can I do to prevent my toddler from getting allergies in the first place?
At this point, there's lots of conflicting information about preventing or delaying allergies by postponing — or accelerating — a child's exposure to potential allergens.
Someday we'll be able to look at genetics and really know what a child is destined to be allergic to and what to do about it. But right now there is nothing that can predictably help.
And keeping your home — in particular your toddler's room — clean and as free of mould and dust mites as possible is a good idea, regardless of whether your child has allergies.
- The Allergy Society of South Africa – www.allergysa.org.za
This national organization aims to advance the knowledge and practice of allergy and immunology through publications, meetings, and conferences and to foster the education of medical professionals as well as the public.
- American Academy of Allergy, Asthma and Immunology - www.aaaai.org
This site offers a channel for patients and consumers providing information on all types of allergies, including prevention, treatment and management.
- Pollen Sampling in Cape Town - www.pollensa.co.za
- Food Allergy and Anaphylaxis Network – www.foodallergy.org
Provides education and support for parents dealing with food allergies
- National eczema association- www.nationaleczema.org
Provides education and support for adults and children with eczema
The pollen and fungal spore count is measured in Cape Town over a 24hour period. Find out which pollens are present in the air at any given time.