What is dust allergy and its innovative remedies?
Dust is a very fine particulate material produced from soil and cement or any other particulate material. It reaches you as particles float in the air and gain entry to your respiratory tract when you breathe.
Many people have an adverse immune response when they breathe in dust. This is called a dust allergy.
What is dust allergy?
In an earlier post we have described an allergic reaction. Dust allergy is a form of allergy in which a person suffering from it gets allergic symptoms or allergic reaction when they breath in pollen.
So pollen allergy is induced by aeroallergen that is allergen coming through air and entering inside your system when you breathe.
Many people have this problem and they experience the allergic symptoms when they are exposed to the dust in windy season or when construction activity is going on near their home.
At what age does dust allergy start?
At first exposure to dust your body gets primed to them. Usually it takes 2-3 seasons of pollination for priming.
Priming can be described as an introduction to the immune system. In this phase the antigens here dust is introduced to your immune system. Your immune system recognizes that dust as foreign particles and it attacks against them. First 1-2 seasons this attack is mild.
After this priming when you come in contact with allergen this attack by immunity is more stronger and you also experience its effect on your own body.
So dust allergy usually becomes symptomatic at age 2-3 years of life after getting exposed to dust for 2-3 seasons. It is likely to continue for years and becomes annoying for the sufferer.
What are the symptoms of dust allergy?
Dust usually enters our body when we breathe, So first symptoms to appear are usually respiratory tract symptoms. They are symptoms like hay fever or may be more severe symptoms than hay fever.
Dust allergy signs and symptoms can include:
- Runny nose and nasal congestion
- Watery, itchy, red eyes (allergic conjunctivitis)
- Sneezing
- Cough
- Itchy nose, roof of mouth or throat
- Swollen, blue-colored skin under the eyes (allergic shiners)
- Postnasal drip
- Fatigue
- Fever
- Headache
- Ear pain
- Breathlessness
Now let’s see the details of symptoms as you would like to know about your condition.
Runny nose and nasal congestion
One of the most annoying complaints you may experience is runny nose. This runny nose may affect your day to day function.
The nasal discharge from runny nose of allergic rhinitis is watery thin and profuse. It is more annoying when a person is sitting or standing.
Literally those who have pollen allergy need to clean their nose every few minutes. It affects the concentration and working capabilities.
The people working in public or going to school or class may feel ashamed and they may be blamed by others as they disturb the entire class while cleaning their noses.
Nasal congestion may be associated with the condition. It may occur in night time too to disturb the sleep of the patient.
Watery, itchy, red eyes
Other common complaints associated with running a runny congested nose is itching of eyes.
There is a feeling of itching in the eyes and there is a strong urge to rub the eyes. Person is found vigorously cleaning his nose and rubbing his eyes
Eyes become red called conjunctival congestion. Sometimes sticky eye discharge may be found with eyelids sticking together..
Eyes typically as if they have got conjunctivitis. As there is no infection causing conjunctivitis in these cases so they are called as allergic conjunctivitis.
Sneezing
Sneezing is typically present in allergic rhinitis. The characteristic of sneezes is identifiable and generally similar in pollen allergy.
The person with pollen allergy usually has loud explosive sneezes and that come in rapid succession like a machine gun.
You may experience episodes of anywhere 4-5 sneezes or may be as many as 25-30 sneezes. Additionally there are many such episodes present.
Cough
Cough may be present in patients with pollen allergy. The cough may be dry or with expectoration.
The cough may be because of post nasal drip or may be because of irritation in nose and throat.
Sometimes pollen allergy may be associated with asthmatic attacks too. In such cases cough may indeed be a prominent symptom with difficulty in breathing and wheezing sound from the chest.
Patients with pollen allergy are more likely to get asthmatic symptoms and vice versa is true.
Itchy nose, roof of mouth and throat
With the above symptoms already the person is annoyed and more to that there is an uncomfortable feeling of itching of nose, roof of mouth and throat.
Because of this itching sensation which is uncomfortable the person looks annoyed and keeps on rubbing his nose vigorously. This act of rubbing the nose frequently with an annoyed face is called an allergic salute.
This itching affects the working capability of the students and they feel annoyed and disabled.
Post nasal drip
If you have pollen allergy the nasal secretions may come out from the nose as seen by you externally.
These secretions are so profuse and large that they also drip into the pharynx from the back side of the nose.
This secretion can be viewed when the patient opens the mouth with tongue out and depressed with tongue depressor. This visible flow at the back was of oropharynx is called as post nasal drip.
This is typically very common in children.
Fatigue
With these ongoing symptoms you feel fatigue.
The fatigue comes as part of the condition itself or as a consequence of symptoms.
If the person with pollen allergy experiences the symptoms at the time of the sleep and is not able to sleep may feel fatigue at the workplace. There is a feeling of the decreased energy and decreased capacity to work.
With this fatigue you may experience pain in limbs. You want to take rest but you are unable to do so due to symptoms.
Fever
All the above symptoms can be associated with mild grade fever. The fever is typically mild grade and is felt when there are other symptoms.
The fever is associated with feeling of fatigue and feeling of loss of energy too.
Headache
Above all symptoms are usually associated with feeling mild headaches.
This headache occurs when you are fatigued with symptoms. It is typically mild grade and in the frontal region above your nose.
If you have sinusitis along with pollen allergy the headache in this condition is worsened to moderate grade. The headache is relieved typically when symptoms are decreased.
Breathlessness
Some people may feel breathless when there is a nose block. This is especially the case in small children and infants.
Some have a tendency to get bronchospasm like asthma when they have symptoms of hay fever and they may get wheezing and difficulty breathing needing immediate intervention.
If the symptoms like breathlessness are severe, it can become life threatening and a person severely allergic to pollen may die if not treated.
How to diagnose dust allergy?
Your doctor can easily diagnose dust allergy. Your doctor asks you a detailed history of symptoms and timing of the year it occurs.
History and physical examination helps to diagnose the pollen allergy.
Further tests are useful for the confirmation of the diagnosis.
Skin prick test is useful for the diagnosis and allergist perform this test on you.
Additionally detecting IgE levels and eosinophil levels also hints at the diagnosis.
What is treatment for dust allergy?
Treatment of the dust allergy depends on what the symptoms are and how often they make you suffer.
You should take your doctor’s opinion rather than using over the counter medicines again and again.
Acute management
Acute management is aimed at reducing the current symptoms in those suffering from allergic rhinitis. Current symptoms may range from mild to severe.
When the current symptoms are affecting day to day function of the person they should be treated. Following are the treatment options available in this condition
Antihistamines
Antihistamines are antiallergic in nature. They reduce the secretion of histamines by the histamine secreting cells and histamine is the main allergy inducing agent that causes symptoms of the allergy.
Antihistamines show effects in hours depending on which drug was used. Antihistamines are classified according to the time they were invented. Older generation antihistamines cause more sedation and newer ones are comparatively less sedating.
Hydroxyzine and promethazine and chlorpheniramine are amongst older antihistamines.
Loratadine, fexofenadine, cetirizine and levocetirizine and bilastine are among newer ones.
Antihistamines can be used orally or locally as a nasal spray like azelastine nasal spray.
These agents though are many available OTC should be used cautiously as they may cause addictions if used in the wrong way and also dangerous if given in overdose.
Some of them like hydroxyzine and fexofenadine may cause arrhythmia in some patients.
The anticholinergic effects which they have helps
- Dry up the nasal and pharyngeal mucosa
- Reduce the stuffiness of the nose
- Itching sensation
Sedating antihistamines is a drug choice in children where sleep disturbance is there along with nasal secretion and stuffiness symptoms.
Adults who need to drive or work at places where attention is needed should be given newer antihistamines which cause less sedation. You should keep in mind though newer antihistamines too may cause decreased alertness with other medications.
Phenylephrine
This is the drug that causes the constriction of blood vessels in the nasal mucosa. Due to this constriction of the blood vessels in nasal mucosa the blood flow to nasal mucosa is decreased.
The secretions on nasal mucosa are decreased and dried up. It gives relief from symptoms of nasal secretions and stuffiness.
This is given usually orally in combination with antihistamines. Many OTC cough cold medications contain phenylephrine as a content.
This should be given in proper dosages and with advice of the doctor as overdoses are dangerous and it may cause high blood pressure.
This drug is not safe to use in pregnant ladies and infants and small children. It can be dangerous in older adults too.
Oral steroids
Steroids are known for their antiallergic and antiinflammatory effects. They do reduce the symptoms of allergy in pollen allergy..
Oral steroids can be given orally or by injection or by nasal spray. They show their effect in a few hours and are safe given by doctor’s advice.
Some of the examples are prednisolone for oral use and dexamethasone for injection and fluticasone and mometasone as nasal spray.
Used for prolonged periods these may cause hypertension, diabetes and cataract and kidney failure. They should always be used with the advice of a doctor.
Used in the wrong manner they may cause severe immunosuppression and that can be dangerous to the person. In the long run these can weaken your bone altering your calcium metabolism.
Antiinflammatory drugs
Antiinflammatory drugs reduce the pain and inflammation. Pollen allergy may be associated with headache and bodyache and feeling of tiredness.
Antiinflammatory drugs help to reduce those symptoms. They also reduce the fever if present.
Some of the examples are paracetamol and ibuprofen. Many OTC cough cold medications contain combinations of antihistamines and phenylephrine plus paracetamol. They may have added caffeine to reduce the side effect of sedation.
Nasal sprays of oxymetazoline
Oxymetazoline and xylometazoline give immediate relief of symptoms when sprayed into the nose. They act by constricting the blood vessels in the nasal mucosa.
Oxymetazoline give symptomatic relief from the symptoms of nasal secretion and nasal stuffiness. They show their effect within a few seconds.
These medicines though many times available as OTC should not be used for more than 5-7 days as they have habit forming potential.
They do cause sleepiness and feeling fatigue. They may give you a stingy sensation in your nose.
Those with hypertension and older adults should not use these medicines as they are not safe in this age group.
Additionally these drugs are to be avoided for those below 12 years of age as they are not safe to use in this age group.
Long term management:
As this problem occurs repeatedly and above mentioned drugs give temporary relief we need to do intervention that acts to prevent the symptoms.
Patients suffering symptoms and then treating those is an annoying process. It is better if we stop symptoms from occurring.
So following are strategies that are useful for this purpose.
Steroid nasal spray
Used with medical advice these are useful for keeping the check on symptoms. They drastically reduce the symptoms.
Steroid nasal spray contain a very minute amount of steroids. They act locally and do not get absorbed into blood. So these cause very minimal or no side effects systemically.
They contain steroid doses which are 10-100 times less than oral or injectable steroids. When oral steroids are given they do get absorbed in blood and then reach to intended areas. So they have more side effects. This side effect is solved in case of local steroids.
The thing is these are to be used for prolonged periods and they are administered by nasal sprays so are easy to take.
Some side effects like nasal bleeding and feeling of nasal dryness and stingy nasal sensation can occur in some people.
Those who have vasomotor rhinitis and nasal polyps and respond to this therapy very effectively.
Steroid nasal sprays also help to reduce the frequency and severity of bronchospasm in patients who have asthma symptoms with allergic rhinitis.
Mometasone and fluticasone are some examples of the steroid nasal sprays.
Montelukast
Montelukast is a membrane stabilizer. It reduces the secretion of allergy inducing agents by the cells.
These drugs are useful in chronic allergies and allergic rhinitis. These drugs are useful in allergic rhinitis and Pollen allergy too.
You can take it orally once or twice. Initially doctors prescribe it for 14 days with antihistaminic then as mono drug therapy or in combination with steroid nasal spray.
This also helps to reduce other allergic and asthma symptoms apart from allergic rhinitis.
Antihistamine nasal sprays
Antihistamine nasal sprays are newer in this category and they have all benefits of oral antihistamines with lesser side effects.
Newer antihistamines like azelastine are useful by this route.
Combination nasal sprays
These are steroid plus local antihistamines are good for initial control without need of oral medicines.
Combination of mometasone and azelastine is available for this purpose. They combine the benefits of both steroids and antihistamines.
How to prevent Dust allergy?
Best way of preventing dust allergy is avoiding contact. Following are the general guidelines to prevent pollen allergy.
Stay indoor
Staying indoor during the dusty season can protect you from dust allergy. It helps to reduce the exposure to an environment containing pollen in air.
Masks
Masks can protect you from exposure to dust particles. It helps to reduce the symptoms. Use clean and washed mask.
Doors and windows
Keep the windows and doors closed during the season of dust and stay indoor.
Vacuum cleaners
While cleaning your house you come in contact with the dust and you can avoid this by using vacuum cleaners.
Curtains
Curtains in your house attract a lot of dust and when you or your children move them they release this dust in the air. You should use washable curtains and wash them once in 2 weeks in hot water.
Bed
Your bed may absorb a lot of dust and when you sleep at night it may get released in air, affecting you by allergy. Cover your bed and pillows with anti allergic covers.
Blankets
Your blankets accumulate and release a lot of dust and fibres which are particles the size of air. You should cover it with cotton cloth and also wash it regularly.
Change the house or workplace
If your house or workplace is located in a area where dust cannot be avoided you should change the house or workplace and possibly occupation.
What are allergy shots?
Allergy shot is a form of treatment for the allergy. It is desensitization treatment of the allergy.
Your allergist can give you this treatment if needed. It is useful for the known allergen.
In this treatment you are exposed to increasing levels of allergen sequentially and your body learns to tolerate the allergen and you are free of allergy.
It is a form of immunotherapy.
