Skin masters clinic is a specialty clinic for allergy testing and treatment and is a renowned name in North India in the field of allergy treatment. Our director Dr. M L Gera is trained at Patel Chest Institute, New Delhi, best institute in India for respiratory allergy treatment. Dr. M L Gera has more than 40 years of experience in managing allergic disorders.
Dr. Sandeep Gera is a specialist in treating skin allergies. Dr. Sandeep received his training at prestigious AIIMS, New Delhi and Safdarjung Hospital, New Delhi and received two gold medals in his MD final exam. He has many publications in reputed international journals and is a reviewer of international journal of clinical dermatology.
What are Allergies?
An allergy (or allergic reaction) is when the immune system mistakes a harmless substance for dangerous one and produces an antibody called “immunoglobulin E”, more commonly known as “IgE”. IgE is an antibody that protects us from very specific parasitic infections, however, IgE is usually absent (or present at very low levels) in people who do not suffer from allergies.
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What are types of Allergies?
According to body part involved, allergy is classified as:
- Skin Allergy: Urticaria (Hives), Atopic dermatitis, Eczema, contact dermatitis etc
- Nose Allergy: Allergic Rhinitis
- Respiratory allergy : Asthma, Bronchitis
- Others: Organ systems like eyes, gi tract, joints can also show symptoms.
Doctors also classify allergy based on the type of reaction as Type I, II, III and IV hypersensitivity.
What Happens in an Allergy Attack?
When an allergic person is exposed to an allergen, IgE is produced to fight off the specific allergen. For example, if someone is allergic to cats and is exposed to a cat, then an “anti-cat” IgE antibody is produced. If the same person is also allergic to pollen and comes in contact with pollen grains, then an “anti-pollen” IgE antibody will also be produced and so on. Each allergen will have a specific IgE antibody to fight off that specific trigger.
Each time IgE is produced, the IgE molecules attach themselves to mast cells that are found in large numbers in the eyes, nose, lungs, intestines, and immediately beneath the skin. These mast cells contain many chemicals, including a substance called histamine which, when released into the body, can cause itching, hives, wheezing, a runny nose, sneezing and watery eyes. These effects are recognized as allergy symptoms.
In some cases, reactions can occur in several places throughout the body. Welts or hives may appear, spasm in the lungs may cause coughing or wheezing, the throat, and tongue may swell – even anaphylaxis may occur.
Can Allergies be Controlled?
Avoidance is the best defense against allergies. But if you are unable to avoid the bothersome allergens, medication may be taken to relieve symptoms. Medications may help relieve symptoms, but they do not alter the allergy immune response. If symptoms cannot be controlled by medication, allergy shots may be prescribed. Allergy shots can put your allergies into remission over time and are a good alternative for people who don’t want to take medicine regularly.
What is allergy skin testing?
Skin testing is the most reliable form of allergy testing. Because mast cells are located in high numbers just under the skin, results of skin testing have proven to be more accurate than blood testing in diagnosing allergies.
The allergy testing procedure
Skin testing is a simple series of tiny pricks made on your forearm. Staff uses a small instrument similar to a plastic toothpick, which contains trace amounts of a single allergen, such as mold, pollen, dust mite, and pet dander to perform the allergy test. When the results are positive, a small reaction on the skin occurs, usually within 20 minutes. This reaction is generally a small bump, similar to a mosquito bite, and may cause some itchiness. A bump or reaction indicates that you are allergic to that specific trigger.
What medications should be stopped before testing?
You should stop taking certain medications that contain antihistamines anywhere from three (3) to five (5) days prior to testing.
Do not stop taking any inhaled asthma medications or routine medications that treat high blood pressure, heart problems, diabetes, etc.
Test Results from Allergy Testing:
Our doctors also take a medical history in addition to the allergy test to determine what allergens are bothersome and diagnose an allergy. Patients will be made aware during their initial visit what allergens they have tested positive to. Based on the test results of your allergy skin test, our allergists determine the best treatment options for your allergies and their symptoms.
Immunotherapy (Allergy Shots)
While avoidance is the best defense, it is often impossible to avoid allergens that can trigger your allergies. To relieve the suffering of allergy symptoms, for most inhalant allergies (dust mite cockroach, cat, pollen, mold) and stinging insect (bees, wasps) allergies, you can get allergy shots.
Allergy shots are also known as “immunotherapy.” Recent research has clearly shown the effectiveness of allergen vaccine immunotherapy for allergies. In fact, allergy shots are the ONLY way to suppress the underlying allergy response for long-term relief.
How Do Allergy Shots Work?
An allergy occurs when your immune system mistakes a harmless substance for a dangerous one and triggers the release of chemicals into your body. Allergy shots increase your tolerance to the harmful allergen. By injecting gradually increasing doses of the offending allergen extract, the immune system builds up a tolerance to that allergen. Allergy shots slow down and reduce the production of the IgE antibody. You can think of each shot as adding a brick to the “wall of protection” against things that trigger your allergies.
Who are the Best Candidates for Allergy Shots?
If you are able to avoid the trigger of your allergies or if usual doses of medications control your symptoms, then immunotherapy might not be needed. If any of the following applies to you, then you may be a candidate for allergy shots:
- If the medications to control your symptoms (i.e., antihistamines, decongestants), do not work.
- If the medication used to control your symptoms produces too many side effects.
- If complications (i.e., sinus infections, ear infections) develop.
- If you have asthma triggered by allergies.
- If medications control your symptoms, but your symptoms flare back up every time you try to reduce your medications.
- If you can’t effectively avoid things that trigger your allergies.
- If you would rather take a series of allergy shots than daily medications.
- If you would rather treat the actual problem rather than just use medications to control symptoms.
- If the cost of the medications is a burden, allergy shots are very cost effective compared to the use of daily prescription medications over several years.
How Often Do I Need Allergy Shots?
At the beginning, allergy shots are usually administered two to three times per week. With this build-up, improvement can occur within three to four months and will usually be at its full benefit within the first year to 18 months. In a typical treatment schedule, shots are tapered to weekly intervals once the maintenance phase is reached (usually at three to six months) then to every two weeks at 12 months, then every three to four weeks after 18 to 24 months. Most people can come off their shots after about three years.
Are Allergy Shots Expensive?
Studies have shown that allergy shots are a very cost-effective way to treat allergies. They have been shown to reduce medication requirements and improve the quality of life in those patients who take them. They are the only long-term way to bring symptoms under control in those patients who have a significant allergic disease.
Alternatives to Allergy Shots
Sublingual Immunotherapy is often referred to as allergy drops. The antigens used in allergy drops are the same ones that are used in allergy shots, they are just taken orally versus having them injected into the arm. Research has shown allergy drops to be less effective than allergy shots in the treatment of allergies and drops pose some additional challenges to patients who are allergic to multiple items.
Currently, allergy drops are NOT approved by the FDA, though their usage is fairly common and completely legal. Even so, for some patients, allergy drops will still make sense and we are glad to discuss the pros and cons of allergy drops so you can make an informed decision.
Are you really allergic to certain foods?
Food allergy is when the body mistakes a certain food as “dangerous” and produces an antibody called immunoglobulin E (IgE). This IgE antibody reacts with the allergen (i.e., dangerous food item) and chemicals are released into the body causing an allergic reaction. Symptoms of a food allergy reaction may be mild (rashes, hives, itching, swelling) or severe (trouble breathing, wheezing, loss of consciousness). A food allergy can potentially be fatal.
Avoidance is the only treatment for food allergy. There is no cure. Neither desensitization nor shots have proven to be a safe or an effective way of reducing food allergy reactions.
Food Allergy vs. Adverse Food Reaction
Food allergies are often confused with adverse food reactions. Lactose intolerance is an example of an adverse food reaction. A person who is lactose intolerant lacks the proper enzymes to digest the sugar found in milk and dairy products properly. This affects the digestive system and a person may have symptoms of diarrhea and stomach cramping if he/she ingests a milk or dairy product. The severity of symptoms is generally related to the amount of food ingested.
A food allergy, on the other hand, involves the immune system. While the symptoms of a minor food allergy and adverse food reactions may be similar, the biology is different.
Less than 5 percent of the population has a true food allergy. This small number, though, and should not minimize the importance of recognizing and treating a food allergy.
What to Do if You Suspect a Food Allergy
Our allergy specialists can help identify to which foods you are allergic. Often the food causing the allergic reaction is obvious. If a food allergy is suspected, but the offending food is not obvious then allergy skin testing will help in its identification.
Here are some things to keep in mind:
- Know what you are eating. If you are eating out, ask the waiter what ingredients are being used and be very clear with him or her what you can or cannot eat. If the waiter is unsure, ask him/her to check with the chef. In the market, carefully read the labels before you buy.
- Birthday parties can be a challenge to a child with a food allergy. Be sure that the host parents know that your child has allergies. Educate your child, so he or she knows which foods are okay and not okay to eat. Alert teachers or childcare workers of the food allergy and the potential symptoms of an allergic reaction.
What is Patch test?
A patch test is a method used to determine whether a specific substance causes allergic reaction to a patient’s skin. Patch test should be done when any allergic contact dermatitis or atopic dermatitis is noticed in any patient.
Patch test might help in identifying the allergic element if the allergic response is not immediate in the patient. Generally, blood test and needle prick test fails in identifying the allergen. This is when patch test can be helpful in the identification of allergen.
In patch test we deliberately try to produce a local allergic reaction on a small area of the patient’s back, where the diluted chemicals were planted. These diluted chemical are probable allergens. The chemicals included in the patch test kit are the offenders in approximately 85–90 percent of contact allergic eczema.
The patch test works really well in finding allergies caused by metals (e.g., nickel), rubber, leather, formaldehyde, lanolin, fragrance, toiletries, hair dyes, medicine, pharmaceutical items, food, drink, preservative, and other additives.