WHAT IS ALLERGY?
Allergy refers to an abnormal sensitivity to a substance that normally does not cause problems to most of us. This hypersensitivity may manifest in various organ system resulting in illnesses, like allergic asthma (lungs), allergic rhinitis or hay fever(nose) and atopic eczema (skin).
About 15% of the population suffers from allergic rhinitis. In Singapore, about one in six children suffer from Allergic Rhinitis. It is more common all year round as compared to seasonal rhinitis.
WHAT ARE ALLERGENS?
Allergens are the substance that cause allergic reactions. There are many known allergens, and different people can be sensitive to different sets of allergens. These allergens can enter the body by inhalation, eating, or through direct contact to the skin.
Common examples of allergens include house dust mites, cockroaches, mold and animal dander or hair.
WHAT IS ALLERGIC RHINITIS?
Allergic Rhinitis occurs when an allergen is inhaled.
- Blocked nose
- Running nose
- Sneezing episodes
- Nose/ throat itch
- Mouth breathing
- Throat clearing cough
- Disturbed sleep
- Itchy, watery or puffy eyes
- Undereye discolouration / Dark eye circles known as allergic shiners
SKIN PRICK TEST
The test is the most common and cost-effective method of determining a person’s sensitivity to the various allergens. It can also help to determine a person’s degree of sensitivity to the allergens.
WHY DOES MY CHILD HAVE ALLERGIC RHINITIS?
Most allergic diseases are due to a combination of genetic and environmental factors. This means that there is usually a family member with asthma, allergic rhinitis or eczema. However, this alone does not account for the increase in allergic diseases that is happening all over the world. Factors in the environment may account for this.
WHAT ARE HOUSE DUST MITES?
House dust mites are microscopic creatures that are found everywhere in mattresses, pillows, bedsheets, clothes, soft toys, sofas and carpets. Allergic individuals who may suffer from asthma, allergic rhinitis or eczema are commonly sensitized (allergic) to these house dust mites. The commonest dust mite in Singapore is called Blomia tropicalis. The droppings of these dust mites is the most common trigger of allergy and asthma.
HOW DO I AVOID THEM?
As people spend most of their time in the bedroom, it is most important to reduce the levels of dust mites there.
Some simple but very effective measures
- Wash bedsheets and pillowcases in hot water (>60°C) once a week
- Avoid pillows, comforters etc that are made of natural materials (e.g. feathers) and replace them with items made from synthetic fibres
- No stuffed toys and thick heavy curtains in the bedroom
- Clothes and books should be stored in a closed cupboard
- Damp dusting should be used to clean surfaces-avoid feather dusters!
- Air-conditioners, if used, should be cleaned regularly
- No carpets in the room
- No pets in the room
- Cover your mattresses and pillows with special non- allergic covers
- Vacuum with HEPA (high-efficiency particulate) filter vacuums
WHAT MEDICINES ARE USED IN ALLERGIC RHINITIS?
- Topical (nasal spray) steroids are often prescribed. These are generally safe and should be used as prescribed over a period of time and not on an as needed basis.
- Antihistamines are safe and effective, even in very young children. They sometimes need to be taken over a sustained period of time to be effective. Some may cause your child to be sleepy. Consult your doctor about this.
- Other medicines such as nasal decongestants, mucolytics (medicines that thin the mucus) and antibiotics are sometimes used
- If medical therapy fails, specific Sublingual Immunotherapy (SLIT) may be recommended for your child. This therapy involves allergen drops deposited under the tongue with a special “pump” delivery system. The minimum duration of treatment is 3 – 5 years. The main advantage is that the positive effect may be long lasting after the end of treatment.
WILL ALLERGIC RHINITIS DEVELOP INTO ASTHMA?
Many parents are worried that prolonged cough will develop into asthma. This is a myth. Coughing does not cause asthma. Your child may be coughing because he already has mild asthma. Allergic rhinitis and asthma can co-exist, so it is not surprising that someone with allergic rhinitis later develops asthma.
Senior Ear, Nose & Throat Consultant
Dr Annette Ang is a Senior Ear, Nose and Throat Consultant who has spent the last decade practising as a senior consultant pediatric otolaryngologist at Singapore’s top pediatric hospital. She has a special interest in complex airway management.
She brings with her a wealth of surgical experience in managing children with ear, nose, throat and airway problems.
To book an appointment,