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Certain allergies require more preparation because of the danger of anaphylaxis.
InteliHealth/Harvard Medical Content
The best way to prevent anaphylaxis
is to avoid exposure to the medications or foods that you are allergic to. In the case of dyes used for radiology tests, a type of dye that is less likely to provoke an allergy reaction can be used, and you may be given antihistamines and corticosteroids before and after the tests to prevent a reaction. In the case of anaphylaxis from insect venom, an allergy specialist is likely to recommend allergy shots (immunotherapy)
to prevent future reactions. Immunotherapy shifts the way that your immune system reacts against the allergen, so that anaphylaxis or other allergy symptoms do not occur after you are exposed.
Being Prepared For Anaphylaxis
Certain allergies require more preparation because of the danger of anaphylaxis. Anyone who has had an anaphylactic reaction can have anaphylaxis again in the future, after exposure to the same trigger. A person who has had a rash or allergic reaction of any kind to penicillin, cephalosporins, sulfa drugs, latex, insect stings, peanuts, shellfish, or dye used in radiology tests might experience anaphylaxis at the time of a second exposure.
- Keep emergency medications together in a kit. Examples include the antihistamine diphenhydramine (Benadryl), your short-acting inhaler if you have asthma, and an EpiPen (epinephrine) if your health-care provider prescribes it. Have these items readily available at home, at work, in the car, in your sports bag, on trips, etc.
- Consider wearing a Medic-Alert bracelet or necklace. Thus, anyone who finds you unconscious or unable to speak can quickly identify that you need treatment for an allergic reaction. A Medic-Alert bracelet or necklace can also prevent you from being given a medication you are allergic to if you are unable to communicate to medical personnel during an emergency.
- Keep emergency numbers posted next to the phone and programmed into your cell phone.
- Teach all family members, including children, what to do in an emergency.
- Family members should learn cardiopulmonary resuscitation (CPR).
Controlling Your Exposure To Allergens
If you have hay fever or seasonal allergies, you need to limit your exposure to outdoor allergens.
To prevent or diminish allergic reactions during your peak allergy season:
- Keep the windows closed and invest in an air conditioner to refresh the indoor air.
- Avoid going outside in the morning hours, when the pollen count is at its highest.
- Do not dry your laundry outside, as pollen can collect on your clothes. Change your clothes after you have been outside for an extended time. Launder your recently worn clothing quickly, and keep your laundry hamper somewhere other than your bedroom.
- Consider an evening shower with a thorough rinse of your hair prior to going to bed.
- Pay attention to pollen reports in the news so you can consider taking allergy medications before your symptoms begin.
Mold allergies can be triggered both indoors and outdoors. Look for places that are dark and damp and have little airflow. Raking moldy leaves in the spring can trigger a mold allergy. Mold grows indoors in carpets, in dark corners, inside humidifiers and in the basement and garage, particularly during the winter months.
If you have indoor allergies, common culprits include dust mites, animal dander, mold and cockroaches. Eliminate triggers in the bedroom first. People spend a significant part of a 24-hour day in bed. Dust mites live and proliferate in the mattress, mattress cover, pillows, blankets and sheets.
You can reduce your exposure to dust mites by following these simple steps:
- Encase your pillows, mattresses and box springs in allergen-proof materials.
- Wash your sheets at least once a week and use hot water, not warm or cold.
- Wash your blankets regularly (this may preclude the use of wool blankets).
- Remove rugs and stuffed animals from the bedroom, unless they can be regularly washed.
- Consider keeping a bedspread on the bed that can prevent dust from accumulating on blankets below. Carefully remove this bedspread from your room (without shaking it) before you go to bed.
- Use a dehumidifier to keep humidity below 50 percent as a means of reducing dust mites and mold allergens.
- Someone who is not allergic should frequently vacuum upholstered furniture, curtains, mattresses and rugs to eliminate dust mites and animal dander. It may be helpful to use a vacuum cleaner with a HEPA (high-efficiency particulate air) filter if possible.
- Frequently clean hard surfaces, including frames around pictures, mirrors and windows.
- Don't leave food out overnight, and keep food stored in sealed containers to avoid attracting cockroaches. Empty your garbage each evening.
- Quickly repair leaky pipes, as standing water can attract roaches.
- In some cases, it is appropriate to use an asthma prevention medicine (such as a corticosteroid inhaler or a cromolyn inhaler) before you meet your allergy triggers, if you know you will have an exposure.
Being Prepared For Allergic Rhinitis, Allergic Reactions in the Eyes, or Asthma
Preparing to act at the earliest signs of symptoms is important for any allergy, but this is especially important for asthma. Asthma that is not treated quickly can become dangerous. Keep an immediate-acting inhaler handy (at work, in your purse, in the car, in your garden tool cart). Inhalers, usually albuterol (Ventolin), provide immediate relief for wheezing and other asthma symptoms. If you are having asthma as a consequence of allergy or any other trigger, be in contact with your doctor's office so that medicines may be adjusted so your symptoms an be brought under control quickly.
If you anticipate nose or eye allergy symptoms because you expect to encounter your allergy trigger, be sure to have an over-the-counter, immediate-acting antihistamine close at hand. Examples of inexpensive antihistamines include diphenhydramine (Benadryl), clemastine (Tavist) and chlorpheniramine (Chlor-Trimeton). Chlorpheniramine is the least sedating of the three. Loratidine (Claritin) is an antihistamine that causes less sedation than other over-the-counter medicines in the antihistamine group, but it is expensive and it may require several hours before it begins providing optimum allergy relief. Several additional antihistamines are available by prescription.
Cromolyn-based nose spray (Nasalcrom) can be used to limit nasal symptoms before an expected allergy trigger exposure. Short-acting decongestants such as phenylephrine(Sudafed PE) also relieve congestion and runny nose quickly. Nasal corticosteroids sprays are excellent prevention medicines if you can plan well ahead, but they need to be used for at least a week before they can prevent symptoms.
For itchy and red eyes, the most useful eye drops for allergy prevention are those that contain an antihistamine without other active ingredients, such as astelazine (Optivar) or levocabastine (Livostin). Some eye drops contain cromolyn or other mast cell stabilizers, without other active ingredients. These drops must be used prior to exposure or used at regular intervals through the day in order to keep allergy symptoms away. They include olopatadine (Patanol), nedocromil (Alocril), cromolyn (Crolom, Opticrom), and others.
A combination antihistamine/decongestant eye drop such as naphazoline (Naphcon-A, Opcon-A) can be helpful for reducing redness that comes with an eye allergy reaction, but it is not recommended that you repeatedly use drops that contain a decongestant. If you use a decongestant eye drop repeatedly, then your eye may have rebound red discoloration for a while after you discontinue the treatment.
Allergic skin rashes (hives, eczema, atopic dermatitis, contact dermatitis) are characterized by an itch-scratch-itch cycle that is difficult to break. When you react to an allergen, histamines are released. These histamines cause itching. Scratching activates additional mast cells and releases more histamines, so your itching gets worse. Histamines also activate more inflammation, so your rash gets worse. There are two parts to breaking the so-called itch-scratch-itch cycle and preventing allergic skin rashes:
- Control the itch with antihistamines.
- Prevent dryness and inflammation with moisturizers such as Cetaphil, Eucerin and Keri lotion. A prescription moisturizer is also available.
Moisturizers are important because dry skin is more likely to get cracked and inflamed. Having dry, cracked skin can permit allergy triggers to get below the skin surface, which can stimulate your immune system to cause an eczema rash. Antihistamines can prevent or treat hives, and can reduce itching from many different rash types.
These additional simple steps are especially helpful for people with eczema and atopic dermatitis:
- Avoid anything that can dry the skin too harshly, such as sudden or extreme changes in temperature and exercise that causes sweating.
- Wear soft, lightweight clothing made of natural fabrics that won't irritate your skin.
- Avoid using hot water and harsh soaps when bathing. Many mild soaps are available and affordable, such as Dove, Oil of Olay and Cetaphil.
- Pat rather than rub yourself dry and apply moisturizer when your skin is still slightly damp. If you must wash your hands frequently or expose your skin to water frequently as part of your job, moisturizing after each exposure is especially important.
- Use a humidifier during the winter to help keep your skin from becoming too dry.
Contact dermatitis is more likely to become weepy than dry. As blisters can develop and break open, the area must be kept clean and dry to prevent infection. Preventive measures may involve recruiting help to rid your yard of poison ivy or oak. In addition, you should take care to isolate and wash any clothing you wear or equipment you use in your yard. If you know you have been exposed, washing your skin with rubbing alcohol followed by water is an effective way to clear your skin of the plant oils that trigger allergy.
If you have a history of food allergies, your child is at very high risk of developing food allergies. If you are pregnant or have just had a baby, consider the following suggestions that may reduce the chance that food allergies will occur in your children.
To help prevent food allergies in your child:
- A pregnant woman does not need to avoid allergenic foods (unless she is allergic to them).
Breastfeed your baby until he or she is at least 1 year of age. Eliminating foods such as milk, peanuts, or egg in your diet while breastfeeding has not been proven to noticeably reduce the risk for allergy in children. If your baby has already been diagnosed with a serious food allergy, you should avoid eating that food if you are breastfeeding. If breastfeeding isn't possible, discuss formula choices with your child's pediatrician. If your baby needs to be formula fed, you may be able to delay or prevent allergic eczema by using hydrolyzed formulas. They don't contain cow's milk. Other options, such as soy-based formula, don't have a proven benefit.
- Exclusive breastfeeding is a good idea for the first four months. This means that the baby would get no formula containing cow's milk protein and no solid foods. This appears to limit eczema and cow's milk allergy during a baby's first two years.
- When introducing new foods, start with small portions of only one new food at a time. Watch for possible reactions (such as gas, vomiting, diarrhea, fussiness or a rash) for several days before introducing the next new food.
- After the baby is 4 months old, diet restrictions don't appear to lower allergy risk during childhood. Or at least they don't appear to lower the risk very much. Before 2008, milk, seafood, eggs, peanuts and other nuts were held out of an infant's diet until age 1 or older. Now, the American Association of Pediatrics says it's fair to feed these foods to your baby after age 4 months.
- Of course, you should avoid a food if your baby has shown an allergy to it. And remember to avoid foods your baby could choke on.
Preparing For Food Allergies
If your child does develop a food allergy, or if you yourself have a food allergy:
- Read food labels carefully, watching for both the food allergen and related food products. For example, people allergic to milk may react to casein, caseinate, whey or milk solids.
- Ask specific questions when ordering food in restaurants.
- Teach your child about which foods he or she must avoid and why.
- Teach any adult who supervises your child about your child's allergy and what to do in an emergency.
- Communicate with cafeteria personnel and the school nurse about your child's food allergy and any special diet that may be necessary.
- If your child has had a potentially life-threatening reaction in the past, you should discuss with your health-care provider whether or not you should have an EpiPen (a device that injects epinephrine).
If you ever have a side effect or reaction to a medication, make sure you clarify with your health-care provider if it is an allergy. Then, make sure you inform any health-care provider you see about your allergy. Most providers ask this question every time they prescribe a medication, just to be sure. Some people with allergies to multiple antibiotics keep a list of what medications they can take safely.
Consider wearing a Medic-Alert bracelet or necklace. Anyone who finds you unconscious or unable to speak will know about your allergy right away. This is especially important if you have ever had anaphylaxis to a medication. At the very least, make sure that your spouse or family members know about your medication allergy.
If you have had an allergic reaction to insects in the past, hire a professional to remove hornet's nests or beehives from your yard and the eaves of your house if you find them. Do not attempt this yourself. When outside, be careful when you drink anything out of a soda can or partially closed container. Drink out of an open cup instead to be sure no bee or wasp is caught inside.
If you do get stung or bitten, preventive measures are available. The first reaction to a bee sting or insect venom is usually a significant welt around the sting or bite. If you take an antihistamine right away, you can help minimize this reaction. Don't wait until the rash gets bigger, because it is harder to reverse the reaction than it is to prevent it. Keep diphenhydramine (Benadryl) tablets or liquid handy at all times. Taking this medication right away will begin to dull the allergic reaction. See a health care professional the same day if you're having a large local reaction or any allergy symptoms along with your local swelling, or if you have a history of a previous severe allergy reaction.
Even if you do not have anaphylaxis symptoms, a large local reaction to an insect sting may be enough of a reason to have allergy tests done, several weeks or months after your insect sting. A large reaction means you received a large dose of venom with your sting, and a large venom exposure is more likely to sensitize you (make you allergic to future stings). Allergy shots (immunotherapy) should be considered for any person with anaphylaxis, or for any person with a large local reaction who also has a positive skin test reaction. These injections can prevent anaphylaxis from a future sting.
Talk to your health care professional about carrying an EpiPen. This medication (epinephrine) is formulated in a self-injectable syringe and can save your life during an anaphylactic reaction. For older people and people with known heart disease, any emergency medications should be administered by a health care professional or an emergency medical technician, who can provide appropriate monitoring.
Last updated December 16, 2011
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