What is an allergy attack

by Richard S. Roberts, M.D.

Do you really own the Hives?

Don’t despair.

What is an allergy attack

You’re not alone. Approximately 20% of the population will own hives (urticaria) at one time or another during their lifetime. First off, are you certain that they’re really hives? True hives are red, itchy, generally raised lesions that look very much love mosquito bites. They are often circular or oval but can be  irregularly shaped. Their size may vary from ¼ inch to several inches in diameter.

What is an allergy attack

They may blend together. Each spot lasts anywhere from 4-36 hours and is surrounded by normal looking skin. As they resolve the skin looks normal, not flaky or rough. While the hives are present one spot will be resolving while another nearby is developing. In about 40% of cases localized swelling (angioedema) of the lips, eyelids, hands, feet or tongue also occurs.
So, if these are really hives they must be from an allergy, right? Well, unfortunately it’s not that simple and modern science doesn’t own every of the answers. The history of how they first appeared and what’s happened to them since can provide significant clues as to what category of hives you own.

But first, what actually is a hive? Everyone’s skin is made up of numerous types of cells. One of these cells is called a mast cell. Everyone’s mast cells make and store histamine.

What is an allergy attack

They also routinely make leukotrienes and other substances that can cause localized inflammation. Mast cells don’t generally release much of these substances into the surrounding skin but if they do, these substances, especially histamine produce localized redness, itch and swelling we recognize as a hive or if it’s slightly deeper, angioedema.

Chronic Hives

So, if acute hives don’t seem to own an allergic cause what else could be going on? One of the more common presumed causes, especially in children is post-infectious hives. During or within a week of viral, strep or other infections hives may happen through poorly understood mechanisms. This often leads to confusion when antibiotics own been given for the infection.

Were the hives from the antibiotic or from the underlying illness? Post-infectious hives can recur for up to 6 weeks. At times, even without infection or any obvious trigger a few hours to a few days of hives happen. These are called acute idiopathic hives. We assume that the immune system is inappropriately activating the skin mast cells but we don’t know why. We don’t ponder that stress is a common cause.

So, your hives own gone on for more than 6 weeks, so they drop into the chronic urticaria category. Now what? Once again you’re not alone. Approximately 3 million Americans of every ages own the same problem.

There are some significant things that you should know. The first is that, unlike acute urticaria, less than 5% of the cases are due to some external cause. Also, unlike acute urticaria, the hives and /or swelling are rarely dangerous. In this form of hive problem various quirks and idiosyncrasies of the immune system, as they relate to mast cells, are the primary cause.

Our understanding of the problem is improving but there are numerous unanswered questions.

The best understood of these idiosyncrasies is called chronic autoimmune urticaria. Approximately 45% of every chronic hives are of this type. In this condition the immune system makes a detectable antibody (for which we own a test) that mistakenly thinks that parts of the mast cell surface are the enemy. This antibody attacks the skin mast cells which leads to the release of histamine, etc. It’s been known for a endless time that if our body makes one autoantibody type of error it’s easier for it to make other autoantibody mistakes. Therefore, it’s not terribly surprising that in chronic autoimmune urticaria approximately 20% of patients, especially women, will also own autoantibodies that target the thyroid gland.

This may lead to Hashimoto’s thyroiditis and periodically blood tests for thyroid function should be checked. Unfortunately, treating this thyroid condition probably does not benefit the hives.

The next most common type of chronic urticaria is chronic idiopathic urticaria. This condition is almost certainly due to the immune system’s interaction with mast cells but the details are unknown. Both chronic autoimmune and chronic idiopathic urticaria may worsen during febrile illnesses, with the use of aspirin family medicines, prior to the monthly menstrual period or with sustained pressure to or rubbing of the skin.

Individual hives that sting more than itch, leave bruises and final 3 or more days may indicate hives due to vasculitis (inflammation of the blood vessels).

Other forms of chronic hives own to do with the immune system’s reaction to physical triggers.

What is an allergy attack

Hives produced by stroking of the skin is called dermographism. Some people’s hives are triggered just by freezing, heat, skin pressure, vibration, exercise, sun or even water. These conditions are fairly rare. Some exercise induced patients can either react just to exercise while others react only if their exercise follows the consumption of a food to which they are mildly allergic, most commonly wheat, celery and shellfish. These exercise reactions can produce anaphylaxis and may be dangerous.

What is an allergy attack

Another dangerous condition, this one involving angioedema and never hives, is called hereditary angioedema. In these patients swelling of the upper airway can be fatal. Such patients also generally own pronounced abdominal pain from swelling of their intestines. Treatment is available.

So, now that you’ve put your hives into a category how are they treated? For acute hives and rare cases of chronic hives avoidance of triggers is the key. If the acute hives are already present antihistamines and if severe, a short course of oral steroid is used. For chronic hives daily preventative antihistamines are essential. Doses higher than those used for nasal allergy treatment are often needed.

If maximum antihistamine dosing has been reached without control, addition of an H2 blocker (e.g. Tagamet) and/or a leukotriene blocker (e.g. Singulair) may be tried. Maximizing the above therapy should minimize the need for oral steroid. Relying on recurrent courses of oral steroids (prednisone) especially without full antihistamine, H2 blocker and anti-leukotriene support is to be discouraged. In rare cases cyclosporin or other immunomodulatory medicines may be added. Once control has been achieved medicines should be continued for several weeks or longer past the final symptoms.

Slow tapering can then be attempted.

Allergy Hives

So, why are my mast cells releasing histamine and other things when they shouldn’t? The first question that needs to be asked is for how endless own you had hives? Hives that own been present intermittently or daily for less than 6 weeks are called acute hives, and if longer, chronic hives. Amongst the numerous possible causes of acute hives those due to allergic reactions get the most attention. In allergic patients the mast cells are coated with an allergy antibody, called IgE, that recognizes a extremely specific target (peanut, penicillin, yellow jacket, etc.).

When that substance, such as peanut, becomes attached to that allergy antibody a chain reaction occurs that activates the mast cell which results in the release of histamine and other inflammatory substances. A hive is born! For food allergy reactions, there are 3 useful rules to consider:

  1. First, the reaction begins quickly, within 5-30 minutes of eating the food; on rare occasions up to an hour but almost never longer.
  2. Second, it goes away within a few hours or at the most within a day or two. Therefore, you never get hives for a week from one serving of peanut butter.
  3. Third, the reaction is reproducible, meaning that if hives were caused by eating 4 peanuts on a Monday, eating 4 peanuts the following week will almost always cause the same problem.

    Despite favorite belief, artificial food colorings and food additives almost NEVER cause hives.

Hives from antibiotics is a diverse situation. The hive reaction can start anywhere from a few minutes after the first dose to 10 days after finishing the course. Antibiotic related hives can persist for up to approximately 2 weeks.

Allergic hives from stinging insects are generally obvious but occasionally they can be sneaky by occurring while you’re asleep or distracted.

They start quickly after the sting and resolve in a few hours to a few days. In the U.S. spiders, flies and mosquitoes almost never cause hives although rare cases own been reported.

Almost any medicine or herbal product can potentially cause hives but one of the most common medicines implicated is the aspirin family (aspirin, ibuprofen, naproxen, etc.). Isolated swelling without hives is a unique side effect of the ACE inhibitor blood pressure medicines.

What is an allergy attack

Soaps, detergents, fabric softeners almost never cause hives but if they do, the hives happen only where the skin is touched. Airborne allergy to pollen, dust, etc. almost never causes hives unless the person is in the midst of a massive hay fever attack. In an allergic person, direct skin contact with a potent allergic substance love animal saliva or latex can cause hives at the site. Every categories of allergic hives are potentially dangerous while chronic hives are generally not.

Conclusion

So, what’s my prognosis Doc?

As noted above:

  1. •Loss of smell or taste. Frequent throat clearing. Hoarseness. Coughing or wheezing.

  2. •Sulfites (additives in wine and some foods).

  3. •Cold air.

    Temperature and humidity changes.

  4. •Wheezing.

  5. •Ingesting allergens (e.g., food and medicines). Common food allergens are milk, fish, nuts, wheat, corn, and eggs. Common medicine allergens are penicillin and aspirin.

  6. •Some medicines, such as aspirin.

  7. •Itchy, irritated, or red skin (e.g., skin rash).

  8. •Allergens that come in contact with the skin. Examples are cosmetics, latex, poison ivy, and metals. These can result in skin rashes love eczema, contact dermatitis, and hives.

  9. •Breathing allergens from animal dander; dust; grass; weed and tree pollen; mold spores, etc.

  10. •A cough lasts more than a week.

    Coughing may be the only symptom. It may happen during the night or after exercising.

  11. •Cool, moist skin or sudden onset of pale skin and sweating.

  12. •Strong feelings, including laughing and crying.

  13. •Severe swelling every over or of the face, lips, tongue, and/or throat.

  14. •Prolonged shortness of breath. Breathing gets harder and may hurt. It is harder to breathe out than in.

  15. •Repeated ear and sinus infections.

  16. •Feeling dizzy, feeble, and/or numb.

    Fainting. Decreasing level of awareness.

  17. If you own chronic hives that aren’t of the “physical” type at least 50% will resolve in less than a year and another 20% will resolve over the next several years. The “physical” hives tend to be more endless lasting.
  18. •Runny, stuffy, or itchy nose. Sneezing. Burning, itchy, or watery eyes. Dark circles under the eyes.

  19. •Shortness of breath. A hard time breathing or swallowing. Wheezing.

  20. •Exercise, especially outdoors in freezing air.

  21. •Chest tightness or pain.

  22. •Pale or bluish lips, skin, and/or fingernails.

  23. Acute hives resolve spontaneously.
  24. •Colds, flu, bronchitis, and sinus infections.

  25. •Breathing an allergen (e.g., pollen, dust, mold, dander, etc.) or an irritant (e.g., tobacco smoke, air pollution, fumes, perfumes, etc.).

  26. Less than 30% of idiopathic acute hives will go on to be chronic.
  27. •Hormone changes with menstrual periods, etc.

Research is ongoing in every of these areas.

So hold your chin up, take your antihistamine, and get the necessary attention to the type of hives that you have.

Allergies & Asthma

Treat your symptoms before they get out of control. Don’t feel too proud to get treatment. Know your limits! Remember to follow every of your doctor’s instructions and don’t be afraid to enquire questions.”

– Dave S., University of Michigan

Allergies and asthma can be triggered by the same substances, but they are two diverse conditions.

With an allergy, the immune system reacts to a substance (allergen) that is normally harmless.

An allergen can be inhaled, swallowed, or come in contact with the skin. Allergies refer to numerous conditions, such as eczema, hay fever, and a serious condition called anaphylaxis. This sudden, severe allergic reaction occurs within minutes of exposure. It is a medical emergency.

Asthma is one condition – a chronic, lower respiratory disease that affects the bronchial tubes (the main air passages in the lungs).

A person can own allergies without asthma; asthma with few or no allergies; or both.

About 80% of asthma in children and about half of asthma in adults may be related to allergies.

Signs & Symptoms

For Common Allergies

  • •Runny, stuffy, or itchy nose. Sneezing. Burning, itchy, or watery eyes. Dark circles under the eyes.

  • •Loss of smell or taste. Frequent throat clearing. Hoarseness. Coughing or wheezing.

  • •Itchy, irritated, or red skin (e.g., skin rash).

  • •Repeated ear and sinus infections.

For a Severe Allergic Reaction

For a Severe Allergic Reaction

  • •Shortness of breath.

    A hard time breathing or swallowing. Wheezing.

  • •Cool, moist skin or sudden onset of pale skin and sweating.

  • •Pale or bluish lips, skin, and/or fingernails.

  • •Severe swelling every over or of the face, lips, tongue, and/or throat.

  • •Feeling dizzy, feeble, and/or numb. Fainting. Decreasing level of awareness.

For Asthma

For Asthma

  • •A cough lasts more than a week. Coughing may be the only symptom. It may happen during the night or after exercising.

  • •Prolonged shortness of breath. Breathing gets harder and may hurt. It is harder to breathe out than in.

  • •Wheezing.

  • •Chest tightness or pain.

Causes & Risk Factors

In both allergies and asthma, the immune system releases chemicals that cause swelling.

With asthma, the swelling is in the breathing tubes.

What is an allergy attack

With allergies, the inflammatory response can affect the eyes, nasal passages, the skin, etc.

For Allergies

Causes & Risk Factors

In both allergies and asthma, the immune system releases chemicals that cause swelling. With asthma, the swelling is in the breathing tubes.

What is an allergy attack

With allergies, the inflammatory response can affect the eyes, nasal passages, the skin, etc.

For Allergies

  • •Breathing allergens from animal dander; dust; grass; weed and tree pollen; mold spores, etc.

  • •Ingesting allergens (e.g., food and medicines). Common food allergens are milk, fish, nuts, wheat, corn, and eggs. Common medicine allergens are penicillin and aspirin.

  • •Allergens that come in contact with the skin. Examples are cosmetics, latex, poison ivy, and metals. These can result in skin rashes love eczema, contact dermatitis, and hives.

{Note: Insect stings, nuts, penicillin, and shellfish are common causes of a severe allergic reaction.}

For Asthma

The exact cause for asthma is not known.

A family history of it and/or having allergies increases the risk for asthma. It is also more common in children who live in houses with pets and/or tobacco smoke.

Asthma Attack Triggers

{Note: Insect stings, nuts, penicillin, and shellfish are common causes of a severe allergic reaction.}

For Asthma

The exact cause for asthma is not known. A family history of it and/or having allergies increases the risk for asthma.

It is also more common in children who live in houses with pets and/or tobacco smoke.

Asthma Attack Triggers

  • •Colds, flu, bronchitis, and sinus infections.

  • •Some medicines, such as aspirin.

  • •Strong feelings, including laughing and crying.

  • •Cold air. Temperature and humidity changes.

  • •Exercise, especially outdoors in freezing air.

  • •Sulfites (additives in wine and some foods).

  • •Breathing an allergen (e.g., pollen, dust, mold, dander, etc.) or an irritant (e.g., tobacco smoke, air pollution, fumes, perfumes, etc.).

  • •Hormone changes with menstrual periods, etc.

Treatment

For Allergies

Avoid the allergen(s).

Skin tests can identify allergens. Allergy shots may be prescribed. Medications can prevent and relieve symptoms. Medicine (e.g., an EpiPen), can be prescribed to use for a severe reaction before emergency care is given.

For Asthma

Asthma is too complicated to treat with over-the-counter products. A doctor should diagnose and monitor asthma. He or she may prescribe one or more medicines. Some kinds are to be taken with an asthma attack. Other kinds are taken daily (or as prescribed) to assist prevent asthma attacks.

A annually flu vaccine is advised.

Regular doctor visits are needed to detect any problems and assess your use of medicines.

Allergy & Asthma Centers S.C.

Greenfield Location

4811 S. 76th St, Suite 400
Greenfield, WI 53220
414-281-0404

Hours of Operation
Monday: 9:00 AM – 5:30 PM
Tuesday: 9:00 AM – 5:30 PM
Wednesday: 9:00 AM – 6:00 PM
Thursday: 9:00 AM – 8:00 PM
Friday: 9:00 AM – 5:30 PM

Allergy Shot Hours
Monday: 9:00 AM – 11:30 AM; 1:30 PM – 5:00 PM
Tuesday: 1:30 PM – 5:00 PM
Wednesday: 9:00 AM – 11:30 AM; 1:30 PM – 5:30 PM
Thursday: 1:30 PM – 8:00 PM
Friday: 9:00 AM – 11:30 AM; 1:30 PM – 5:00 PM

Wauwatosa Location

2500 N.

Mayfair Road, Suite 220
Wauwatosa, WI 53226
414-475-9101

Hours of Operation
Monday: 9:00 AM – 5:30 PM
Tuesday: 9:00 AM – 5:30 PM
Wednesday: 9:00 AM – 8:00 PM
Thursday: 9:00 AM – 4:00 PM
Friday: 9:00 AM – 5:30 PM

Allergy Shot Hours:
Monday: 9:00 AM – 12:00 PM; 1:30 PM – 5:30 PM
Tuesday: 1:30 PM – 5:00 PM
Wednesday: 9:00 AM – 8:00 PM
Thursday: 9:00 AM – 11:30 AM
Friday: 9:00 AM – 12:00 PM; 1:30 PM – 5:00 PM

If you purchase something through a link on this sheet, we may earn a little commission.

How this works.

Treatment

For Allergies

Avoid the allergen(s). Skin tests can identify allergens. Allergy shots may be prescribed. Medications can prevent and relieve symptoms. Medicine (e.g., an EpiPen), can be prescribed to use for a severe reaction before emergency care is given.

For Asthma

Asthma is too complicated to treat with over-the-counter products. A doctor should diagnose and monitor asthma. He or she may prescribe one or more medicines.

Some kinds are to be taken with an asthma attack. Other kinds are taken daily (or as prescribed) to assist prevent asthma attacks.

A annually flu vaccine is advised. Regular doctor visits are needed to detect any problems and assess your use of medicines.

Allergy & Asthma Centers S.C.

Greenfield Location

4811 S. 76th St, Suite 400
Greenfield, WI 53220
414-281-0404

Hours of Operation
Monday: 9:00 AM – 5:30 PM
Tuesday: 9:00 AM – 5:30 PM
Wednesday: 9:00 AM – 6:00 PM
Thursday: 9:00 AM – 8:00 PM
Friday: 9:00 AM – 5:30 PM

Allergy Shot Hours
Monday: 9:00 AM – 11:30 AM; 1:30 PM – 5:00 PM
Tuesday: 1:30 PM – 5:00 PM
Wednesday: 9:00 AM – 11:30 AM; 1:30 PM – 5:30 PM
Thursday: 1:30 PM – 8:00 PM
Friday: 9:00 AM – 11:30 AM; 1:30 PM – 5:00 PM

Wauwatosa Location

2500 N.

Mayfair Road, Suite 220
Wauwatosa, WI 53226
414-475-9101

Hours of Operation
Monday: 9:00 AM – 5:30 PM
Tuesday: 9:00 AM – 5:30 PM
Wednesday: 9:00 AM – 8:00 PM
Thursday: 9:00 AM – 4:00 PM
Friday: 9:00 AM – 5:30 PM

Allergy Shot Hours:
Monday: 9:00 AM – 12:00 PM; 1:30 PM – 5:30 PM
Tuesday: 1:30 PM – 5:00 PM
Wednesday: 9:00 AM – 8:00 PM
Thursday: 9:00 AM – 11:30 AM
Friday: 9:00 AM – 12:00 PM; 1:30 PM – 5:00 PM

If you purchase something through a link on this sheet, we may earn a little commission.

How this works.


Causes of seasonal allergies

Hay fever happens when your immune system identifies an airborne substance that’s generally harmless as dangerous. It responds to that substance, or allergen, by releasing histamines and other chemicals into your bloodstream. Those chemicals produce the symptoms of an allergic reaction.

Common triggers of hay fever vary from one season to another.

Spring

Trees are responsible for most springtime seasonal allergies. Birch is one of the most common offenders in northern latitudes, where numerous people with hay fever react to its pollen.

Other allergenic trees in North America include cedar, alder, horse chestnut, willow, and poplar.

Fall

Autumn is ragweed season. The genus name for ragweed is Ambrosia, and it includes more than 40 species worldwide. Most of them grow in temperate regions of North and South America. They’re invasive plants that are hard to control. Their pollen is a extremely common allergen, and the symptoms of ragweed allergy can be especially severe.

Other plants that drop their pollen in the drop include nettles, mugworts, sorrels, fat hens, and plantains.

Summer

Hay fever gets its name from hay-cutting season, which is traditionally in the summer months.

But the genuine culprits of summertime seasonal allergies are grasses, such as ryegrass and timothy grass, as well as certain weeds. According to the Asthma and Allergy Foundation of America, grasses are the most common trigger for people with hay fever.

Winter

By winter, most outdoor allergens lie dormant. As a result, freezing weather brings relief to numerous people with hay fever. But it also means that more folks are spending time indoors. If you’re prone to seasonal allergies, you may also react to indoor allergens, such as mold, pet dander, dust mites, or cockroaches.

Indoor allergens are often easier to remove from your environment than outdoor pollens. Here are a few tips for ridding your home of common allergens:

  1. Cover your bedding and pillows with allergen-proof covers.
  2. Clean moldy surfaces and any places that mold may form, including humidifiers, swamp coolers, air conditioners, and refrigerators.
  3. Fix water leaks and clean up water damage that can assist mold and pests flourish.
  4. Get rid of carpets and upholstered furniture.
  5. Remove stuffed toys from your children’s bedrooms.
  6. Wash your bedding in extremely boiling water at least once a week.
  7. Use a dehumidifier to reduce excess moisture.


Diagnosing seasonal allergies

Hay fever is generally easier to diagnose than other allergies.

If you own allergic symptoms that only happen at certain times of the year, it’s a sign that you own seasonal allergic rhinitis. Your doctor may also check your ears, nose, and throat to make a diagnosis.

Allergy testing generally isn’t necessary. Your treatment for allergic rhinitis will likely be the same, no matter what type of allergen you react to.


Overview

An allergy (allergic rhinitis) that occurs in a specific season is more commonly known as hay fever. About 8 percent of Americans experience it, reports the American Academy of Allergy, Asthma & Immunology.

Hay fever occurs when your immune system overreacts to an outdoor allergen, such as pollen.

An allergen is something that triggers an allergic response. The most common allergens are pollens from wind-pollenated plants, such as trees, grasses, and weeds. The pollens from insect-pollinated plants are too heavy to remain airborne for endless, and they’re less likely to trigger an allergic reaction.

Hay fever comes by its name from hay-cutting season. Historically, this activity occurred in the summer months, around the same time numerous people experienced symptoms.

Seasonal allergies are less common during the winter, but it’s possible to experience allergic rhinitis year-round.

Diverse plants emit their respective pollens at diverse times of year. Depending on your allergy triggers and where you live, you may experience hay fever in more than one season. You may also react to indoor allergens, such as mold or pet dander.


Symptoms of seasonal allergies

Symptoms of seasonal allergies range from mild to severe. The most common include:

Less common symptoms include:

Many people with hay fever also own asthma.

If you own both hay fever and asthma, your seasonal allergens may trigger an asthma attack.


Treating seasonal allergies

The best medicine for hay fever and year-round allergic rhinitis is avoidance of allergens that trigger symptoms for you. Medications are also available to treat symptoms of hay fever. Some people also attempt alternative treatments.

Avoidance

Take steps to avoid seasonal allergens. For instance, use an air conditioner with a HEPA filter to cool your home in summer, rather than ceiling fans. Check your local weather network for pollen forecasts, and attempt to stay indoors when pollen counts are high.

At times of year when your hay fever is active:

  1. keep your windows shut
  2. limit your time outdoors
  3. consider wearing a dust mask when you’re exterior, especially on windy days

It’s also significant to avoid cigarette smoke, which can aggravate hay fever symptoms.

Medication

When you can’t avoid your allergens, other treatments are available, including:

In severe cases, your doctor may recommend allergy shots.

They’re a type of immunotherapy that can assist desensitize your immune system to allergens.

Some allergy medications may own unwanted side effects, such as drowsiness, dizziness, and confusion.

Shop for over-the-counter decongestants and antihistamines online.

Alternative treatments

Few studies own been done on alternative treatments for hay fever. Some people believe the following alternative treatments may provide relief:

  1. quercetin, a flavonoid that gives fruits and vegetables color
  2. spirulina, a type of blue-green algae
  3. Lactobacillus acidophilus, the “friendly” bacteria found in yogurt
  4. vitamin C, which has some antihistamine properties

More research is needed to study if these alternative treatments are effective.


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