Comprehensive management of allergic rhinitis, allergic asthma, and accompanying conjunctivitis-sinusitis through trigger control, intranasal corticosteroids, antihistamines, and, when appropriate, allergen immunotherapy.
Indication
- Seasonal or year-round allergic rhinitis (sneezing, runny nose, congestion, itching)
- Allergic conjunctivitis (eye itching, redness, watering)
- Mild, moderate, or severe persistent asthma triggered by allergens
- Recurrent acute sinusitis or tendency for nasal polyps in the setting of allergic rhinitis
- Respiratory symptoms due to pollen, dust mites, animal dander, mold, or occupational allergen exposure
- Exercise-induced bronchoconstriction and coexistence with atopic dermatitis
- Candidates for immunotherapy when high-dose pharmacotherapy fails to control symptoms or causes side effects
Preparation
- A detailed allergy history, symptom diary, and family history are evaluated
- Allergen sensitivity is identified by skin prick test and/or serum specific IgE
- When asthma is suspected, spirometry, bronchodilator reversibility, and exhaled nitric oxide test (FeNO) are performed
- Nasal examination and, if needed, nasal endoscopy and sinus imaging
- Identification of environmental triggers (house dust mites, pets, pollen calendar)
How it's performed
- Hygiene measures, mite-proof bedding covers, and ventilation recommendations are provided to avoid trigger allergens
- Intranasal corticosteroids (e.g., mometasone, fluticasone) are prescribed as first-line regular therapy for allergic rhinitis
- Second-generation antihistamines (oral or nasal) and eye drops are added as needed
- For asthma, controller medications (inhaled corticosteroid ± long-acting beta-2 agonist) and reliever medications (short-acting beta-2 agonist or ICS-formoterol) are planned according to GINA stepwise treatment
- Correct inhaler technique is taught under supervision; a spacer device is recommended when needed
- In suitable cases, subcutaneous or sublingual allergen immunotherapy (a 3-5 year program) is considered; biologic therapies (anti-IgE, anti-IL5) are evaluated for severe eosinophilic or allergic asthma
Post-procedure
- Assessment of medication response and adherence after the first 2-4 weeks
- For asthma patients, follow-up every 3-6 months with spirometry and the Asthma Control Test (ACT) when possible
- Proactive treatment plan before pollen season, with school/workplace recommendations
- Monitoring of monthly injections or daily sublingual doses during allergen immunotherapy, with anaphylaxis surveillance
- Management of additional factors such as smoking, air pollution, occupational exposure, and obesity
Risks
- Nasal dryness, bleeding, and rarely septal ulceration related to intranasal corticosteroids
- Drowsiness, dry mouth, and cognitive slowing from antihistamines (especially first-generation drugs)
- Oral thrush, hoarseness, and at high doses, effects on bone metabolism from inhaled corticosteroids
- Local reactions and rarely systemic anaphylaxis during allergen immunotherapy
- Risk of life-threatening exacerbation if asthma remains uncontrolled
FAQ
Does allergy treatment completely eliminate the allergy?
Treatments largely control symptoms and improve quality of life. Allergen immunotherapy can provide long-term reduction in some cases; however, no 'definitive cure' can be promised.
Do I need to use medications continuously?
Seasonal use may be sufficient in mild cases, while moderate-to-severe persistent cases may require regular long-term use. The decision is based on symptom severity and test results.
If my child has allergic rhinitis, will asthma develop?
Allergic rhinitis is a risk factor for asthma; however, not every patient develops asthma. Early diagnosis, trigger control, and regular follow-up may reduce the risk.
Are natural methods sufficient?
Saline nasal rinsing, mite-proof covers, humidifiers, and filtration support treatment. However, in moderate-to-severe symptoms, they cannot replace medical therapy.
Related Information
Related Medical Services
Other services in the same specialty or with similar indications you may want to explore.
Asthma Evaluation and Treatment
Pulmonology
Asthma diagnosis, control assessment, and stepwise treatment management based on the GINA guidelines.
Nebulizer Therapy
Pulmonology
Nebulizer therapy — bronchodilator and anti-inflammatory treatment delivered via inhaled medication.
Pneumonia Treatment
Pulmonology
Pneumonia treatment — management of bacterial, viral, or fungal lung infection.
Skin Prick Test
Pulmonology
Skin prick test — rapid detection of sensitivity to airborne and food allergens.
Spirometry
Pulmonology
A core test that measures the breathing capacity of the lungs and distinguishes obstructive from restrictive diseases.
Pulmonary Function Tests
Pulmonology
Comprehensive evaluation of lung volumes, flows, and gas exchange with PFT.
COPD Evaluation and Treatment
Pulmonology
Diagnosis, classification and individualized management of COPD according to GOLD guidelines.
Oxygen Therapy
Pulmonology
Oxygen therapy — long-term home and in-hospital supportive treatment for chronic respiratory failure.