Allergy relief: How to use the 3-step approach

Allergies can affect your daily life and lead on to other health problems, physical and mental, especially if your symptoms are poorly controlled.¹ So why wait? Get a diagnosis and work with your doctor to find an effective combination of avoidance, short-term symptom relief and long-term allergy relief with immunotherapy.²

This article describes the typical 3-step approach to allergy relief. There are ways you can try to prevent an allergic reaction starting and we explain the different kinds of allergy treatment. That might be drug-free remedies or medications for symptom relief. Learn how these short-term solutions differ from long-term allergy relief and what might be available for your trigger or allergen. We also look at side effects. 

Step 1: Prevention as allergy relief

Your doctor will advise you how to minimise contact with your allergens. It can be tricky; for instance, pollen is in the air around you during hay fever season and almost every home has tiny dust mites.² So some symptoms are likely, especially as there can be contributing factors like air pollution.³

Avoidance is critical with allergies to food, drugs, latex or stinging insects, which can cause life-threatening anaphylactic reactions.² It’s more effective too. Apart from accidental contact, avoidance results in a complete disappearance of symptoms.³ Make sure these allergies are noted in your medical records.

How to avoid pollen

Check the daily pollen forecast and close windows at home and in the car during high counts. Dry laundry indoors too. Wear wraparound sunglasses if you go out – or a face mask if you have bad hay fever.⁴ Shower and change clothes after being outdoors in pollen season.

How to avoid dust mites

Keep humidity in your home to 35-50% with good ventilation and maybe a dehumidifier. Use mite-proof covers on pillows and mattresses. Wash bedding weekly at 60C. Reduce clutter and choose hard flooring over carpets. Use a vacuum with a HEPA filter and damp-dust surfaces often.⁵

How to avoid pet dander

Limit direct contact and wash hands after stroking an animal. There’s no such thing as a hypoallergenic cat or dog⁶ so if you choose to have one, groom them often – or ask someone else to help. Choose hard flooring over carpets and vacuum regularly to minimise allergen build-up. Keep pets out of bedrooms.

How to avoid food allergy triggers

Always read food labels carefully and ask about allergens when eating out. At home, consider having separate plates, cutlery, cooking utensils and storage to avoid cross-contamination. Ask allergic kids not to share snacks. Educate friends, family and carers about your allergy.

How to avoid insect stings

Know where wasp nests or bee hives are and steer clear. Keep food and drinks covered outside so as not to attract insects. Also avoid bright clothes or strong perfumes, and wear shoes to walk on grass. Never swat bees and wasps – try to stay calm. 

Drug-free allergy relief

Complementary drug-free remedies may help relieve symptoms and mean you need less allergy relief medication.⁷ They’re not a substitute for medical treatment in more severe cases.

1. Nasal irrigation: Saline is simple inexpensive allergy relief for the nasal symptoms of hay fever. Rinsing the nose regularly during pollen season can reduce medication use by about 30%.⁷

2. Water vapour: A hot shower or steam from a bowl of boiled water can help ease nasal congestion by loosening mucus. It also seems to suppress the immune response in the nose and calm the nasal lining. ⁸

3. Yoga: One-hour sessions, three times a week for eight weeks significantly improved hay fever symptoms in the 2019 study Effect of Hatha yoga training on rhinitis symptoms and cytokines in allergic rhinitis patients.⁹

4. Cold compresses: Recommended by the National Institute for Health and Care Excellence (NICE) as eye allergy relief if you have conjunctivitis. Apply for 5-10 minutes twice a day.¹⁰ Also to help reduce allergic inflammation after an insect sting.¹¹ 

5. Colloidal oats: An ancient treatment for skin health and effective in managing atopic dermatitis (eczema). Look for emollients that contain colloidal oats¹² or add the powder to your bath.¹³ You can also make it into a paste.¹³

Allergy relief medications

Short-term allergy relief means antihistamines, corticosteroids and other types that help control symptoms until the drug clears from your body.² Some are available over the counter, others on prescription. And you may find combination therapy, using two or more of these medications, is most effective for you.²

Always follow the instructions or your doctor’s advice, especially for children as doses can vary with age and weight. For young kids, liquids and chewable medications may be easier to take.

Antihistamine: the original allergy medicine

Antihistamine helps people manage allergy symptoms like a runny nose, itchy, watery eyes and itchy skin.² It works by blocking the effects of histamine, one of the chemicals released in your body during an allergic reaction.² Antihistamines come in many forms, including tablets, liquids, nasal sprays, eye drops and creams.

Use of antihistamine for allergy relief began in the 1940s.¹⁴ Older types tend to cause drowsiness so carry warnings not to drive or operate heavy machinery while taking them.¹⁵ Doctors tend to prefer second generation antihistamines like cetirizine, fexofenadine and loratadine.² Just ask for “non-drowsy” in the pharmacy.

Some antihistamines can relieve symptoms in 30 minutes. You might take your allergy treatment just before leaving the house to help control your hay fever. Timed-release antihistamines need 3 or 4 days to be fully effective.¹⁵

Corticosteroids: Sprays and creams for allergy relief

Corticosteroids can help with hay fever symptoms and asthma, and are a second line treatment for atopic and contact dermatitis.² They mimic a hormone made in your body and treat the inflammation that’s part of an allergic reaction.¹⁶ Topical forms are generally preferred, with prescription tablets and injections reserved for severe allergy relief.²

Used regularly, corticosteroid nasal sprays are the single most effective form of relief for allergic rhinitis, particularly congestion or a stuffy nose.² They can also treat allergic eye conditions like itching and watering, which tend to be part of hay fever.^2,17

Corticosteroid nasal sprays may start working after about 7-8 hours but can take up to 2 weeks to reach full effectiveness.¹⁷

Other medications for allergy relief

• Decongestants can unblock a stuffy nose but aren’t effective for an itchy runny nose or sneezing.¹⁷ The advice is only to use them for a few days, otherwise decongestants may actually make symptoms of nasal allergies worse. ¹⁷
• Leukotriene modifiers can ease asthma symptoms such as wheezing and shortness of breath.^3,17 If you have asthma, the GP can prescribe it as allergy relief for hay fever.¹⁸ Leukotrienes are another chemical released by the body when the immune system detects an allergen.²
• Adrenaline is the emergency allergy treatment for anaphylaxis. If the doctor thinks you’re at risk of having a sudden severe allergic reaction, they may prescribe an adrenaline device just in case. You must carry two devices (one spare) with you at all times.¹⁹

Short-term vs long-term allergy relief

All the medications we’ve mentioned so far give temporary relief without addressing the underlying cause. People often keep taking them as long as their allergy is active. The third step or aspect of allergy treatment is immunotherapy, which aims to alter the course of the disease and provide long-term relief.²

One aim of immunotherapy for allergic rhinitis is to reduce the need for regular short-term allergy treatment. For insect venom and peanut it’s to lower the risk of anaphylaxis, which is a life-threatening allergic reaction.^2,20 

Allergy immunotherapy

Allergy immunotherapy is a course of treatment to help the immune system learn to react more naturally. It involves repeated doses of your trigger given as tablets, drops or injections. You may notice fewer symptoms within six months and the goal is for that effect to last after treatment.²⁰

Also known as desensitisation, this allergy treatment targets the cause of the disease and embedding the change takes 3-5 years.^2,20 You take the first dose of tablets and drops under medical supervision and then are free to manage the medication yourself. First doses of peanut oral immunotherapy powder, and dose increases, are supervised. Allergy injections are always at the doctor’s office.²⁰

Is allergy relief available for my trigger?

Short-term symptom relief medications such as antihistamines and corticosteroids¹⁶ could be helpful whatever your trigger. The best type will depend on which part of your body is affected and how severely. Immunotherapy tackles triggers rather than symptoms and is available in the UK for the following:²¹

• Grass pollen
• Tree pollen
• Dust mites
• Pet dander
• Bee and wasp stings
• Peanut

You may not be sure what's causing your symptoms. In which case, speak to your GP about a skin prick test or allergy blood test to help them make a diagnosis.²⁰ They’ll be able to tell you if allergy immunotherapy could be an option. Eligibility depends on age and medical history, as well as trigger.²¹

Allergy relief: what are the side effects?

Any form of medicated allergy relief can cause side effects so read the information leaflet carefully first. If you give allergy medicine to children it must be specifically tailored for them.

Immunotherapy can cause allergic symptoms at the start, which is logical. This usually calms down over time. Where there is any risk, treatment takes place under medical supervision.^2,21 

The short version

Allergies can significantly impact your daily life and overall health.¹ This article outlines a typical 3-step approach to managing symptoms, including prevention strategies, short-term allergy relief and treatment to help the immune system become more tolerant.² Talk to a doctor to find out what your options are so you can make an informed decision about your health.