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Other Treatments for Allergic Rhinitis

A common treatment for allergic rhinitis is allergy shots (immunotherapy).

Immunotherapy

Immunotherapy is often recommended for people who have developed severe side effects from medication, or whose allergy symptoms do not respond well to medication. It may also be helpful for people who have frequent, unavoidable exposure to allergens. Studies have shown that immunotherapy is effective in over 85% of people who receive the treatment consistently.
The purpose of immunotherapy is to decrease or eliminate your response to a particular allergen or group of allergens. This is done by injecting a very tiny extract of the allergen into the skin, and increasing the dose very gradually at regular intervals until the immune response to that allergen is decreased or eliminated. When you are exposed to an allergen in this way, your body begins to make some protective antibodies. Since the allergen dose starts out very small, you do not experience the usual symptoms despite exposure to the allergen.
Sublingual immunotherapy may also be used. This type of treatment involves putting the allergic substances under the tongue, rather than using allergy shots.
How the Process Works
Once your injections are at maintenance level, the frequency of injections will be reduced to every 2-4 weeks. Your doctor may monitor your immune response periodically with skin testing. Treatment will continue for 3-5 years until your symptoms have been significantly reduced or eliminated.
Once your injections are at maintenance level, the frequency of injections will be reduced to every 2-4 weeks. Your doctor will monitor your symptoms and may do skin testing. Treatment will continue for 3-5 years until your allergic response has been significantly reduced or eliminated.
The Long-term
Immunotherapy is a treatment program that will take 3-5 years to complete. If you are considering this form of treatment, you will need to make a commitment to receive these injections on a regular schedule. If you miss one or more treatments, there is a risk that your allergen immunity will be compromised, and you may need to begin the process again.
Side Effects
On occasion, some people experience a localized reaction to the shot, which may consist of itching, redness, or a small hive at the injection site. These symptoms usually disappear within 1-2 hours.
In very rare instances, a systemic reaction may occur. This might produce symptoms—such as sneezing; itching of the eyes, throat, hands, or feet; or asthma. This type of reaction usually occurs within twenty minutes of the shot, so your doctor will have you wait at least 20 minutes after receiving an injection to monitor for a reaction.
Who Should Not Have Immunotherapy
Immunotherapy is not recommended for people who are taking beta-blocker medications. These drugs are usually prescribed for people who have high blood pressure or heart rhythm problems. You may also be advised not to undergo immunotherapy if you have a weakened immune system, uncontrolled asthma , severe lung disease, severe reactions to allergy skin testing, or if you are currently wheezing.
Researchers are still studying if it is safe for pregnant women to start allergy shots. However, it is safe for pregnant women who are already on maintenance dosage to continue their allergy shots.
When to Contact Your Doctor
Notify your doctor right away if you have:
  • Changes in your allergy reaction
  • Adverse reactions to the injection
  • Changes in medications prescribed by another doctor

Sublingual Immunotherapy

Sublingual immunotherapy is another treatment that is similar to allergy shots. With sublingual therapy, small amounts of allergens are placed under the tongue. This treatment is more popular in Europe. While it has shown to reduce symptoms in some studies, more research is needed.

References

Advice from your allergist: rhinitis. American College of Allergy, Asthma, & Immunology website. Available at: http://www.acaai.org/public/advice/rhin.htm. Accessed September 15, 2008.

Allergic rhinitis. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what.php. Updated September 2009. Accessed February 12, 2010.

Middleton E. Allergy: Principles and Practice. 7th ed. St. Louis, MO: Mosby-Year Book, Inc; 2009.

8/27/2013 DynaMed's Systematic Literature Surveillance. https://dynamed.ebscohost.com/about/about-us: Kim JM, Lin SY, et al. Allergen-specific immunotherapy for pediatric asthma and rhinoconjunctivitis: a systematic review. Pediatrics. 2013 Jun;131(6):1155-67.

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