In keeping with the winter theme, I want to discuss things that cause allergy symptoms but are not really allergies. Many people are often shocked when their skin testing is negative, and I tell them they are not allergic. I run the risk of losing my credibility if I don’t hurry up and explain myself since they came in complaining of a profusely runny nose and nasal congestion. The explanation lies in the difference between allergies and irritants.
The word “allergy” implies the body saw a substance and made an immune response to that substance where the body is now primed with allergic antibodies waiting for the next exposure. That next exposure causes the release of histamine and other inflammatory chemicals that cause the sneezing, itching and the running of our nose.
Irritants, however, are all about air quality. Common irritants are cigarette smoke, pollution, dust (not to be confused with dust mites), perfumes/scents, cleaning fumes and changes in air pressure or temperature. A common trigger is the dramatic change in air pressure we experience during such activities such as flying in an airplane or driving up the Smoky Mountains. No one comes in after shoveling snow or scraping the ice off car windows and states, “I am so allergic to cold air,” but we often blow our noses once we are back inside.
So why is discriminating between the two important? The answer is in how they are treated. Allergies are treated with antihistamines, nasal sprays, decongestants, avoidance measures and allergy shots. Irritant symptoms don’t usually respond to newer antihistamines but can be treated with prescription nasal sprays, decongestants, nasal saline and air purifiers. Allergy testing can help separate the two or identify areas of overlap.
So if you recently walked through the mall (especially in front of Abercrombie & Fitch) and had to rummage through your pockets or purse looking for a tissue, rather than say “It’s allergies,” say “It’s NOT allergies,” instead.
Disclaimer: This blog is not intended to create a doctor-patient relationship with any reader. If you need personalized medical advice, contact your primary care physician or other physician in your community.