Well-Being, Wealth, N More

The reaction will depend on the body part involved and the severity of the reaction. Here’s what to look for.

Understanding Hay Fever – the Basics

What Is Hay Fever?

Hay fever is an immune disorder characterized by an allergic response to pollen grains and other substances. Also known as allergic rhinitis, there are two types: seasonal, which occurs only during the time of year in which certain plants pollinate, and perennial, which occurs all year round. (A related problem, nonallergic rhinitis, shares symptoms with hay fever but isn’t caused by allergies.)

Typically, if you suffer from hay fever in the spring, you’re probably allergic to tree pollens. Grass and weed pollens may be causing your allergic reaction during the summer. In autumn, ragweed may plague you, and fungus spores cause problems from late March through November.

People with year-round (perennial) hay fever are usually allergic to one or more allergens found indoors. These include house dust mites, feathers, and animal dander (the tiny skin flakes animals such as cats and dogs shed along with fur), all of which may be found in pillows, and bedding, heavy draperies, upholstery, and carpeting. Another common allergen, mold, is usually found in damp areas such as bathrooms and basements.

What Causes It?

If you suffer from hay fever (allergic rhinitis), it’s because your immune system views harmless inhaled pollen or other allergens as dangerous substances invading your body. Your system overreacts, flooding your bloodstream with chemicals like histamine and leukotrienes, which inflame the lining of your nasal passages, your sinuses and eyelids, and also set in motion other symptoms associated with hay fever, such as sneezing.

All of these symptoms are meant to protect your body either by expelling the allergen or by swelling body areas, such as the nasal passages, so the allergen can’t enter. As a result of congestion in the veins in the lining of your sinuses, dark circles, commonly known as allergic shiners, may appear under your eyes. If you have perennial allergic rhinitis, they may be present all year round. The swelling of your nasal membranes may also close the sinus drainage openings, causing sinusitis. Rhinitis may also be associated with nasal polyps — small, non-cancerous growths; nosebleeds are also common during hay fever attacks.

Hay fever is almost always an inherited trait (genetically determined). The majority of patients with hay fever have a parent or sibling who also has allergies. People with asthma or eczema (allergic dermatitis) are more likely than others to develop hay fever; and about one-third of those with allergic rhinitis also have at least mild, intermittent, allergic asthma.

Allergies and Anaphylaxis

Anaphylaxis is a serious, potentially life-threatening allergic response that is marked by swelling, hives, lowered blood pressure, and dilated blood vessels. In severe cases, a person will go into shock. If anaphylactic shock isn’t treated immediately, it can be fatal.

This condition occurs when the immune system creates specific disease-fighting antibodies (called immunoglobulin E or IgE) toward a substance that is normally harmless, such as food. When you are first exposed to the substance, your body does not react, but it does produce the antibodies. When you are exposed to the substance again, the antibodies spring into action, releasing large amounts of a protein called histamine. Histamine causes the symptoms described above.

What Are the Symptoms of Anaphylaxis?

Anaphylaxis may begin with severe itching of the eyes or face and, within minutes, progress to more serious symptoms. These symptoms include swallowing and breathing difficulties, abdominal pain, cramps, vomiting, diarrhea, hives, and angioedema (swelling similar to hives, but the swelling is beneath the skin instead of on the surface).

If you have symptoms of anaphylaxis, seek emergency medical attention immediately. The condition can quickly result in an increased heart rate, sudden weakness, a drop in blood pressure, shock, and ultimately unconsciousness and death.

What Are the Common Triggers of Anaphylaxis?

Food is generally the most common cause of anaphylaxis. Common food triggers include nuts, shellfish (shrimp, lobster), dairy products, egg whites, and sesame seeds. Wasp or bee stings are also common causes of anaphylaxis.

Additionally, exercise can trigger anaphylaxis if the activity occurs after eating allergy-provoking food.

Pollens and other inhaled allergens (allergy-causing substances) rarely cause anaphylaxis.

Some substances can cause reactions — called anaphylactoid reactions — that are similar to and just as serious as anaphylaxis, but do not involve immunoglobulin E antibodies. Common causes are fish, latex, and some medications, such as penicillin.

How Is Anaphylaxis Diagnosed?

Anaphylaxis is diagnosed based on its symptoms. People with a history of allergic reactions may be at greater risk for developing a severe reaction in the future.

Skin testing may help confirm the substances that cause severe allergic reactions. However, this type of test may not be recommended if you have reason to suspect that you will have an anaphylactic reaction to the substance.

What Is the Treatment for Anaphylaxis?

There is only one rapidly effective treatment for anaphylaxis — epinephrine by injection. Epinephrine is adrenaline and it rapidly reverses anaphylactic symptoms. It is typically given through an automatic injection device. The most common injection site is the thigh.

If you are near someone who is going into anaphylactic shock, call for professional medical help immediately. CPR and other lifesaving measures may be required.

In addition to epinephrine, treatment for shock includes intravenous fluids and medicines that support the actions of the heart and circulatory system. After a person in shock is stabilized, antihistamines and steriods may be given to further reduce symptoms.

How Can I Be Prepared for Anaphylaxis?

If you are allergic to bee stings or any other substances that cause anaphylaxis, you should always be prepared. Ask your doctor to prescribe an epinephrine injection kit and carry it with you at all times.

Also, it’s important that you inform your health care provider of any drug allergies before undergoing any type of medical treatment, including dental care.

It is also a good idea to wear a MedicAlert bracelet or pendant, or carry a card that identifies your allergy. In cases of emergency, it could save your life.

Skin Conditions: Hives (Urticaria and Angioedema)

Urticaria, also known as hives, is an outbreak of swollen, pale red bumps or plaques (wheals) on the skin that appear suddenly — either as a result of the body’s adverse reaction to certain allergens, or for unknown reasons.

Hives usually cause itching, but may also burn or sting. They can appear anywhere on the body, including the face, lips, tongue, throat, or ears. Hives vary in size (from a pencil eraser to a dinner plate), and may join together to form larger areas known as plaques. They can last for hours, or up to one day before fading.

Pictures of Skin Problems

See pictures of skin problems such as ringworm and rashes in adults and children. Identify moles, skin cancers, and different types of bug bites.

• Adult Skin Problems
• Childhood Skin Problems
• Skin Cancer
• MRSA
• Ringworm
• Bug Bite Identification

© 2009 WebMD, LLC. All rights reserved.

Angioedema is similar to urticaria, but the swelling occurs beneath the skin instead of on the surface. Angioedema is characterized by deep swelling around the eyes and lips and sometimes of the genitals, hands, and feet. It generally lasts longer than urticaria, but the swelling usually goes away in less than 24 hours.

Rarely, angioedema of the throat, tongue, or lungs can block the airways, causing difficulty breathing. This may become life threatening.

What Causes Hives and Angioedema?

Hives and angioedema form when, in response to histamine, blood plasma leaks out of small blood vessels in the skin. Histamine is a chemical released from specialized cells along the skin’s blood vessels.

Allergic reactions, chemicals in foods, insect stings, sunlight exposure, or medicines can all cause histamine release. Sometimes it’s impossible to find out exactly why hives have formed.

There are several different types of hives, including:

Acute urticaria: Hives lasting less than six weeks. The most common causes are foods, medicines, or infections. Insect bites and internal disease may also be responsible.

The most common foods that cause hives are nuts, chocolate, fish, tomatoes, eggs, fresh berries, and milk. Fresh foods cause hives more often than cooked foods. Certain food additives and preservatives may also be to blame.

Medicines that can cause hives and angioedema include aspirin and other nonsteroidal anti-inflammatorymedications such as ibuprofen, high blood pressure medications (ACE inhibitors), or painkillers such as codeine.

Chronic urticaria and angioedema: Hives lasting more than six weeks. The cause of this type of hives is usually more difficult to identify than those causing acute urticaria. For more than 87% of people with chronic urticaria, the cause is unknown.

Chronic urticaria and angioedema can affect other internal organs such as the lungs, muscles and gastrointestinal tract. Symptoms include muscle soreness, shortness of breath, vomiting, and diarrhea.

Physical urticaria: Hives caused by direct physical stimulation of the skin — for example, cold, heat, sun exposure, vibration, pressure, sweating, and exercise. The hives usually occur right where the skin was stimulated and rarely appear elsewhere. Most of the hives appear within one hour after exposure.

How Are Hives and Angioedema Diagnosed?

Your doctor will need to ask many questions in an attempt to find the possible cause. Since there are no specific tests for hives — or the associated swelling of angioedema — testing will depend on your medical history and a thorough examination by your primary care doctor or dermatologist.

Skin tests may be performed to determine the substance that you are allergic to. Routine blood tests are done to determine if a system-wide illness is present.

How Are Hives and Angioedema Treated?

The best treatment for hives and associated swelling is to identify and remove the trigger, but this is not an easy task. Antihistamines are usually prescribed by your doctor or dermatologist to provide relief from symptoms. Antihistamines work best if taken on a regular schedule to prevent hives from forming in the first place.

Chronic hives may be treated with antihistamines or a combination of medications. When antihistamines don’t provide relief, oral corticosteroids may be prescribed.

For severe hive or angioedema outbreaks, an injection of epinephrine (adrenaline) or a cortisone medication may be needed.

How Can Hives Be Managed?

While you’re waiting for the hives and swelling to disappear, here are some tips:

• Apply cool compresses or wet cloths to the affected areas.
• Try to work and sleep in a cool room.
• Wear loose-fitting lightweight clothes.

When Should I Call the Doctor?

If hives or angioedema occur with any of the following symptoms, contact your doctor right away:

• Dizziness
• Wheezing
• Difficulty breathing
• Tightness in the chest
• Swelling of the tongue, lips, or face

Reviewed by the doctors at The Cleveland Clinic Department of Pulmonary, Allergy and Critical Care Medicine.

There is so much information relating to allergies on this website, the next article will continue with more Symptoms and Types of Allergies. Please come back tomorrow and read the next installment from WebMD relating to Poison Ivy and Plant Allergies, Bee Stings, Pet Allergies and more. If you have questions about your allergies, please don’t hesitate to write a comment with your personal contact information, I will be happy to write you a personal email and answer any questions  you might have.