When allergies attack

By Laura Roberson

Robert never had any allergies – not a sniffle or a wheeze his entire life. Then he met his sister’s new dog, a spaniel named Finn. On a recent visit, Finn’s copious dander ambushed the 39-year-old, causing sniffling, wheezing, runny eyes, a scratchy throat and sneezing fits. “I’d never had reactions to any animals,” says Robert. “Now I won’t come in the door without drugging myself up.”

Allergists and immunologists are seeing more men like Robert, who’ve been blindsided by new allergies.

“We used to think you couldn’t develop allergies later in life,” says immunologist Dr Donata Vercelli, of the University of Arizona. “They usually arrived when you were young, and you typically outgrew them.”

Adult-onset allergies may be part of a broader phenomenon. Scientists call it the hygiene hypothesis: the less you’ve been exposed to allergens in your life, the more likely you may be to develop allergies as an adult. The theory is that when your system is out of practice, it becomes sloppy, says Vercelli.

Instead of idly standing by, it launches all-out attacks against harmless dander and pollen, leaving you congested, itchy and inflamed.

To hone your body’s defences, read on.

FROM THE AIR
The next time your boss blames your productivity dip on slacking, tell him it may be something in the air. Allergic rhinitis – a reaction that occurs inside the nasal passages and upper airways – costs employers millions in lost productivity and absenteeism each year. Often mistaken for bronchitis because both conditions cause coughing, it’s actually triggered by pollen, pet dander or dust mites.

When you’re confronted with these invaders, a flood of chemicals – including histamine, bradykinin and leukotrienes – dilates your mucous membranes, inflames your nose and throat, and causes your eyes to itch. Taking antihistamines (eg, Zyrtec or Claratyne, or in generic form, cetirizine hydrochloride or loratadine, respectively) can help prevent allergic rhinitis symptoms in most people – as long as they take the medicine early in the day and not just when the symptoms appear.

But these drugs target only one part of your reaction, histamine, says pulmonologist Dr Paul Enright, a professor of medicine at the University of Arizona. This may not be enough to clear you up.

Your strategies When your throat starts to itch, raid the spice rack. “Hot pepper, especially cayenne pepper, turns on mucous production,” says integrative-medicine expert Dr James Dillard. “So if you have pollen sitting there, you may be able to rinse it out just by adding some pepper to your dish.”

For persistent problems, ask your doctor about allergen-specific immunotherapy, which can shift your system to a non-allergic immune response. Immunotherapy is available either in injection form or sublingually, where drops or tablets of allergen extract are placed under the tongue.

At home, turn down the thermostat. Warm indoor temperatures in winter can bring on a stuffy nose, irritated eyes and wheezing, according to a recent US Government study. Make sure your house stays below 23ºC, the temperature at which the symptoms began in study participants.

When it comes to pets, if you have an allergy and will be visiting a pet-friendly home, start using a nasal steroid spray (eg, Rhinocort or Beconase Allergy) five days beforehand, says Dr George Pyrgos, an allergy and immunology fellow at Johns Hopkins University in the US. These products help prevent the inflammation caused by pet dander.

FROM YOUR FOOD
Most likely you’re not allergic to food. Only about four per cent of adults are, and their reactions are generally limited to fish, shellfish and nuts. But being among the other 96 per cent doesn’t mean you’re entirely off the hook. Certain fish, when they’re mishandled (inadequately refrigerated, for example) can release histamine, the same inflammatory chemical released by your immune system’s “mast” cells. “Some people eat fish and get a reaction that appears almost identical to a food allergic reaction,” says Dr Anju Peters, an associate professor of allergy and immunology at Northwestern University in the US.

Additionally, if your mouth itches every time you eat fruit, you may have oral allergy syndrome, a condition that adults with pollen allergies can develop. That’s because some types of pollen have proteins that are similar in structure to those of specific fruits. Such pairings include ragweed and melons, tree pollen and apples, and grass pollen and tomatoes. “The similarities trick your immune system into thinking the trigger is one of these pollens, when it’s actually the fruit,” says Pyrgos.

Your strategies If you’re uncertain whether you’re allergic to a specific food, consider requesting an allergen-detecting blood test called an ImmunoCAP. It’s 95-98 per cent accurate, according to a recent Journal of Allergy and Clinical Immunology study. In the case of oral allergy syndrome, Pyrgos recommends avoiding the fruits or eating them skinless when your pollen sensitivity is high.

THROUGH YOUR SKIN
The winter complexion you probably attribute to cold, dry air could actually be atopic dermatitis, also known as eczema. It causes red, itchy skin and is triggered by unknown allergens. If you have it, you’ll see tiny cracks in your skin. These fissures let in additional allergens and the natural bacteria on your skin (such as staphylococcus), giving them easy access to the immune cells waiting just below the surface. Or you may have contact dermatitis, in which one of almost 3000 triggers – such as nickel in a belt buckle or wristwatch – causes a similar reaction.

Your strategies For eczema, apply a liberal layer of petroleum jelly to irritated areas after a shower to seal in moisture. Use only fragrance-free soaps, shampoos and shaving products to avoid further irritation. For a persistent rash, apply hydrocortisone cream.

Because contact dermatitis symptoms don’t show up for 24-72 hours, it may be difficult to pinpoint the cause. Identify the source with a patch test, where various test substances are applied to the back under adhesive strips. The area is examined after two and four days. A positive result shows as redness or blisters at the site of a particular substance.

A positive result appears more quickly, usually within 20 minutes, with a skin-prick test. Here, selected allergens are applied to the forearm or the back with a dropper, and the skin gently pricked with a needle. If skin-prick testing is inconclusive, a RAST test can be carried out. Here, a blood sample is taken and the level of an immunoglobulin associated with allergic reaction (allergen-specific IgE) is measured.

ALLERGIC TO SEX?

As if. But there are ways a little intimacy can cause the kind of reactions you weren’t gunning for.

Whether it’s her lingering scent or a lingering itch from a latex condom, you can thwart these romantic gremlins

COITUS INTER-OUCH!
Some women develop allergies to proteins in their partners’ semen, which can easily be misdiagnosed as vaginal itch. If she has other allergies, it may be worth being tested for it. Once diagnosed, you can use a condom.

NASAL NIGHTMARE
If her perfume makes you wheeze, you may have non-allergic rhinitis, says otolaryngologist Dr Michael Benninger, of the Cleveland Clinic in the US. “True perfume allergies are rare, but the symptoms are the same – nasal obstruction and runny nose,” he says. He suggests using an intranasal antihistamine 90 minutes beforeyour date.

KISS OF DEATH
Never treat a goodnight kiss lightly – especially if you have food allergies. Particles can linger in your date’s saliva, which may mean itchy, swollen lips or even dangerous anaphylaxis, according to a study by Mount Sinai School of Medicine in the US. Offer her a piece of chewing gum after dinner, and then wait an hour to make your move. This combo eliminates 99 per cent of food residue.

BURNING RUBBERS
Latex allergies can be as unpleasant for women as they are for men. Either can break out in hives, have trouble breathing or develop a rash, says Dr Anju Peters, a professor of allergy and immunology at Northwestern University in the US. If she’s allergic, use a polyurethane condom, such as Durex Avanti – they are as effective as latex, according to a recent Cochrane review.