A patient journey for allergies

Around one in four people in the UK develop an allergy at some point in their lives. These can increase or decrease over time and it's possible to suddenly develop an allergy to something you weren't allergic to before. Allergies are particularly prevalent in children.

Substances that create an abnormal reaction in people are known as allergens. When the body's immune system comes into contact with an allergen, it produces antibodies (proteins used by the body to combat viruses and bacteria) that trigger the release of inflammatory chemicals such as histamine. These chemicals can produce a range of symptoms - from mild itching to anaphylaxis (a life-threatening condition which includes symptoms such as swelling of the eyes, lips, mouth, or extremities, severe itching and most importantly, difficulty breathing). Anaphylaxis is a medical emergency and medical help should be sought immediately. 

Symptoms depend very much on the substance involved and vary from person to person.

Common allergies include:

• Food allergies - the most common are nuts, cow’s milk, shellfish, and fruit
• Grass and tree pollen - also known as hayfever
• Medication - such as Ibuprofen, aspirin, some antibiotics
• Latex - found in some disposable gloves, balloons, and condoms
• Mould
• Dust mites
• Some animals - most common are cats and dogs
• Household chemicals - such as cleaning products and hair dye. Read more about an allergy to hair dye

What to expect at the GP

If you suspect that you may be allergic to a substance, you should make an appointment to see your doctor.

Your doctor will begin by asking you about your symptoms: when they began, any factors that make the symptoms better or worse, whether you have pets, what medications you take, what treatments you have tried for the symptoms and whether there is any family history of allergy.

It is helpful if you keep a diary of your symptoms and possible trigger factors, and show this to your doctor. Your doctor will usually also examine you (for skin rashes, for example) and may recommend a specialist allergy test, such as a blood test, a skin test or both. These are usually carried out by allergy specialists. In the case of a suspected food allergy, the doctor is likely to suggest removing it from your diet before reintroducing it to see if it triggers your symptoms. If your symptoms are severe or if there is any history of anaphylactic reaction, you'll be referred to a specialist.

In cases of anaphylaxis, the doctor may give you an emergency adrenaline injector to carry with you at all times. This is an auto-injector pen that has clear instructions on the side to inform others how to operate. If you do have a history of severe allergic reactions (especially if they require the use of an auto-injector/ medical alert bracelet/necklace, it's a good idea to tell the people you live and work with. 

Treating allergies

There are various forms of treatments that can be used to help manage an allergy. These include avoidance of the allergen, various medications, and immunotherapy.

• Emollients - lotions and creams prescribed for the treatment of dry skin conditions. They work by creating a protective barrier on the skin which locks in water. Emollients will not cure dry skin conditions but they can help to relieve symptoms such as itching and allow the skin time to heal. Read more about emollients and moisturisers here.
• Decongestants - these can be used to relieve a blocked nose caused by an allergy. They should only be used for a short period of time as long term use can cause your symptoms to become worse. They usually come in an oral tablet or capsule, a nasal spray or a liquid.
• Steroids - corticosteroids are almost identical to the natural hormone cortisol (which we all produce). Corticosteroids should not be confused with anabolic steroids - those are the kind abused by sportspeople. Corticosteriods work by reducing inflammation and are come as topical creams, inhalers or tablets.
• Antihistamines - are a well-known type of allergy medication used to relieve symptoms. They are available from a pharmacy and do not usually require a prescription. Antihistamines are categorised by generation (first, second and third). The most common types of antihistamine contain the ingredients cetirizine or loratadine, and they won't make you feel drowsy - unlike first-generation antihistamines which contain diphenhydramine or chlorphenamine. Antihistamines tend to come as a tablet, topical cream or a liquid (which is useful for children). You can also find eye drops and nasal sprays which provide soothing relief for allergies of the eyes and nose.  Read more about antihistamines.

Another form of treatment for allergies is immunotherapy (also known as desensitisation). The aim of this treatment is to help your body get used to an allergen by introducing small amounts to your body over a period of time. The allergen is given occasionally in the form of drops or tablets (under the tongue) or through injections. The treatment can last several years and should provide some relief from allergy symptoms rather than a cure.

talkhealth suggests three allergy-related charities and support groups: Allergy UK, Action Against Allergy, and Allergy Academy.

Chat with other allergy patients on our talkallergy forum and visit our allergy blog to keep up-to-date with the latest news and opinions on allergy-related issues.

Sources used in writing this article are available on request.

_{Last revised: 15 May 2020}

_{Next review: 15 May 2023}