Allergy Treatments

What to Expect

You can expect different things from different treatment options:

Avoidance

An allergic reaction is a unique immune response to a substance (usually a protein) where a very specific antibody called immunoglobulin E (IgE) is created against that substance. The best way to prevent your child from having an allergic reaction is to avoid the allergen.

Avoidance means keeping your child away from his or her allergy triggers, such as foods, medicines and any other allergens. For things like mold, dust mites and animal dander, avoidance may mean using environmental control.

When avoiding an allergen is not possible, there are several different treatments and therapies that can help manage allergy symptoms.

Allergy Medicines

Allergy medicines may include:

• Over-the-counter medications. Over-the-counter allergy medicines include antihistamines, nasal sprays, eye drops, steroid ointments and moisturizers. These medicines do not require a prescription. You can try different types to see if they help your child’s symptoms.
• Prescription medications. An allergist can prescribe prescription allergy medicines if over-the-counter options are not helping. Types of prescription allergy medicines include:
  • Stronger versions of over-the-counter medicines
  • Epinephrine for severe reactions like anaphylaxis
  • Asthma medicines, including quick-relief and long-term controller medicines
  • Oral steroids, which can treat a wide variety of allergic reactions 
• Immunotherapy. Allergy immunotherapy treatments can be given by injection or by mouth:
  • Injections. Allergy injections or shots are one of the most common treatments for allergies. Allergy shots involve injecting a small amount of your child's specific allergen just under the skin.
  • Oral immunotherapy. Oral immunotherapy is available for grass and ragweed allergy. These products may have specific age and sensitivity requirements for their use.

For some allergy medicines, the allergist will give you a prescription to fill at your pharmacy. Your child may need to take a medication at regular times and/or when symptoms appear. Ask your child’s allergist for detailed instructions about when and how to take the medication. Some allergy medicines, including allergy shots, are only given at the doctor’s office.

Immune Modulation

Immune modulation is a treatment that involves taking specialized medicines to adjust the immune system. Immune modulation can use anti-IgE medicine or other specialized immune modulators:

• Anti-IgE medicine. Omalizumab is a specialized injection that targets IgE. IgE is a type of antibody that the immune system creates in response to an allergen. These antibodies are responsible for triggering an allergic reaction. Omalizumab treats allergy-related asthma. It is available for children aged 6 years and up who show sensitization to perennial allergens such as pet dander or dust mites and have a total IgE level within a specific range. It is also available to treat chronic idiopathic urticaria or hives.
• Other specialized immune modulators. Mepolizumab is another specialized injection that is approved for ages 12 and up. It targets another part of the immune system that can also help individuals with certain types of asthma.

Both of these medicines are monoclonal antibodies. That means they are highly specific antibody injections that target specific aspects of the immune system that contribute to the allergic response.

The schedules for receiving these injections, monitoring their progress and length of treatment are different for each patient. Many other types of monoclonal antibody injections to treat asthma and allergies are in development. Ask your child's allergist for more information.

More on Allergy Shots

Treatment with allergy shots begins by injecting a small amount of highly diluted allergen into the upper arm just under the skin. Your child will receive increasing amounts of the allergen each week—first by increasing the dose and then by increasing the concentration. This continues until your child reaches a top dose, which is either the strongest dose available or the highest amount he or she can tolerate.

Once your child reaches the top dose, weekly injections continue at that level for maintenance. As treatment continues, your child should experience some relief of his or her allergy symptoms. He or she may be able to lower the dosage on other medicines used to control symptoms.

Depending on how your child is doing, the interval between shots can be stretched to every two, three and, eventually, four weeks. Reactions to the shots may require slowing down the program or even going backwards a few steps. The goal is to achieve a maximum safe dose with no side effects and excellent control of symptoms.

Your child may miss allergy shots due to illness or vacation. His or her doctor will make an adjustment in the dose and schedule depending on the situation. You should cancel or reschedule an allergy shot if your child has a fever or the flu or if he or she is wheezing.

Your child may continue to receive allergy shots for many weeks or months. Many allergy shot treatment programs last for three to five years. If your child has been on a four-week schedule for at least a year and is only taking shots to treat the allergy, then you may consider stopping the allergy shots. There is no way to know when to stop the allergy shot program other than by monitoring your child’s progress and reactions to treatment. Please give the program at least one year before deciding if it has worked for your child.

Allergy shots work best for life-threatening bee sting reactions and for nasal allergy. They may also be used to treat allergic asthma, but they may not work for children with severe or poorly controlled allergic asthma. For these children, immune modulation treatments may help.