Allergy treatment: Are medications or allergy shots right for you?

Allergy symptoms are all-too-common. More than 50 million Americans experience them each year. Allergens, sadly, are almost everywhere—from your pets to your yard to your workplace.

But there’s good news, too: allergies can be treated by physicians in a wide array of specialties. The most common specialties offering allergy treatments are family practice, pediatrics, internal medicine, obstetrics and gynecology, allergy and immunology, and otolaryngology (ear, nose and throat). No matter what kind of physician you see, allergies are generally treated in the same way.

Avoiding allergens and using saline spray and other irrigation methods have long been useful in preventing allergy symptoms. But if you need further treatment, allergy management is usually taken in two steps—medication and immunotherapy. Here’s what you need to know about each.

1. Medications to reduce allergy symptoms

For people with inhalant allergies, like pollen or pet dander, topical nasal antihistamines are the standard first line of treatment. There are several antihistamine sprays in the market that your physician could recommend.

“These medications offer the same effects as oral antihistamines in terms of decreasing runny nose and post-nasal drip,” said Ewen Tseng, MD, an otolaryngologist on the medical staff at Baylor Scott & White Medical Center – Frisco. “They also help relieve congestion without being an actual decongestant.”

Dr. Tseng said he generally recommends topical medications since they usually have significantly fewer side effects in comparison to oral medications. In oral medications, very little of the medication is absorbed into the body, so topicals tend to have a greater localized effect.

Other classes of allergy medications can be added with topical antihistamines as needed, such as topical nasal steroid sprays and leukotriene inhibitors.

2. Immunotherapy (allergy shots)

If you do not respond well to medication or are unable to tolerate medications, your physician will typically prescribe immunotherapy—which looks like an intimidating word, but in this instance represents some very familiar treatments.

Immunotherapy can come in the form of injections, or allergy shots, given once or twice a week, or topical immunotherapy in the form of drops under the tongue.

“About 85 percent of the patients we place on immunotherapy feel better,” Dr. Tseng said.

He added that the effectiveness of both the drops and injections are statistically equivalent and that the serums in both forms are FDA approved.

The American Academy of Allergy, Asthma, and Immunology (AAAAI) notes that while allergy shots are effective for both children and adults, they’re not generally recommended for children younger than 5 years old. Also, you should know that shots are not a method of treating food allergies—the solution there is to avoid the foods that cause an allergic reaction.

You should also be aware that immunotherapy for allergies is a two-step process. The first phase gradually raises your immunity by giving you slowly increasing doses of the allergen once or twice a week over several months. Once an effective dose is reached, your doctor will switch to maintenance, with shots of that dose happening less frequently, usually every two to four weeks.

Maintenance treatment is generally continued for several years. And, of course, you should consult with your doctor before ending an allergy treatment.

Are you or someone in your family dealing with allergies? Find allergy care near you.