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Updated: Oct 17, 2022

Over 50 million Americans suffer from allergies each year. For some, allergies can worsen during certain seasons while others are affected by different allergens year-round. The effects of allergies can range from mild to severe and can also be debilitating or even fatal. Allergies are actually ranked 6th for chronic illnesses in the United States.

Dr. Khetarpal breaks down the causes, symptoms, and how to manage some of the most pervasive allergens that affect his patients.

What Causes Allergies?

An allergy is an unusual response of the body to an environmental agent. While most individuals may not be allergic to a particular item, some individuals are genetically predisposed to allergies to certain agents or become allergic as time goes by. The development of allergies depends on genetics, environmental interactions, degree of exposure to the particular allergen and duration of exposure, and yet unknown factors.

What is Allergic Rhinitis?

Allergic rhinitis is a condition in which an individual manifests nasal or sinus symptoms of being allergic to any agent to which they are exposed. These foreign agents could be inhalants or aerosolized particles such as pollens, dust mites, animal or pet dander, foods, certain chemicals, aspirin or non-steroidal medicines such as ibuprofen, or certain medicines. Typically a type I hypersensitivity reaction results in an early reaction to these allergens and a type III reaction to a delayed response that may take hours to develop.

Symptoms of Allergic Rhinitis

Symptoms of allergic rhinitis vary and can be seasonal - and for some of us unlucky ones - year-round. Typically sneezing, clear nasal discharge, postnasal drip, itchy eyes, itchy nose, nasal congestion, headaches, eye tearing, itchy palate, and even itchy ears may manifest with allergic rhinitis. Allergic eye symptoms may coexist with allergic rhinitis. For some patients, allergic rhinitis may also predispose them to persistent or chronic sinusitis and asthma.

Types of Allergens

Allergens are substances that can cause allergic reactions. While some of the most common allergens are pollen, dust mites, and dander, people can also be affected by things such as cologne and chlorine.

Most Common Airborne Allergens

Our data has shown that dust mites, pollens, molds, and cockroaches besides cat and dog dander are the most common allergens. Pollens may come from weeds such as ragweed or from trees such as mesquite, pine, cedar, or from local grasses such as Johnson or Bermuda grass. It is important to note that most individuals are allergic to more than one antigen. Some patients are aware of more severe allergic reactions and the antigens that

Most Common Food Allergens

Milk, wheat, corn, egg, tree nuts, soy are amongst the most common food allergies. Of course, there are individuals who are allergic to peanuts, shellfish, onions, lettuce, berries, fruits, bananas, etc. Food allergies can be identified by a process of elimination. Creating a food diary and correlating the symptoms with the type of food consumed is the best technique in identifying the culprit food allergen.

Testing for Allergies

Generally speaking, there are two types of tests. However, the personal history of an individual is important in guiding allergy testing. Skin testing either as prick test and percutaneous or intradermal testing is performed more commonly and is more sensitive than blood or RAST testing.

An allergy test identifies airborne and some food agents you might be allergic to. It also guides us in further treatment of allergies. Skin testing is generally less positive with food allergies than with inhalant allergies. Typically prick testing is performed on the back only after it is clear that the individual did not take antihistamines, nasal steroids, oral steroids, singular or beta-blockers for one week prior to the skin testing.

Skin Testing For Children

Generally, we have been successful in skin tests especially prick testing in children above the age of 3. If your child is very queasy or squeamish, then a RAST test may be offered. A RAST test or a radioallergosorbent test is a way of testing the blood for allergens. While the RAST test is quite reliable, it tends to underestimate the incidence of milder allergies.

Managing Your Allergies

Dr. Khetarpal recommends taking the following steps to help manage your allergies:

  • Wash all bedding, including mattress pads, in hot water or bleach every 10 days.

  • Clean your home. Dust mites are the by most studies the most common allergen to cause allergic reactions. Regular use of a vacuum cleaner with a HEPA filter, washing items in hot water, and mite-proof casings will reduce these allergens.

  • The use of HEPA filters in the bedroom, study, or TV room will help reduce the pollen and particle count.

  • Dust mite matter and pet dander hide in fabric, such as curtains, furniture upholstery, carpets, and bedding. Keeping these clean is important.

  • Remove carpeting in your home if possible

  • Avoid smoking

  • Basements, bathrooms, kitchens, and rooms with reduced ventilation must be well ventilated to prevent or reduce mold growth.

  • Bathe pets once a week to reduce pet dander, and, if possible, keep your pet out of the bedroom. Wash your hands after petting animals.

  • Because chalk can irritate children with allergies advise the children not to sit too close to the chalkboard

  • Limit the number of indoor plants; mold thrives in potting soil.

  • For individuals with food allergies, always read the ingredients before ingesting a new or packaged food. When dining out, ask restaurants for a list of ingredients or to prepare a meal without the offending food or additive.

Treatment for Allergies

The most well-known treatments are immunotherapy (Allergy Shots), allergy drops, and nasal sprays. Talk to your doctor about which treatment options are best for you. For more detailed information about treatment options available at Texas Sinus, Allergy, Snoring & Sleep Institute, click on the button below.


Do you suffer from allergies? Ask Dr. Khetarpal about allergy testing and treatment options. Same day and next day appointments available!

Dr. Khetarpal accepts most major insurance plans and is accepting new patients in The Woodlands and in The Heights. Make an appointment with Houston's #1 ENT


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