ALL ABOUT ALLERGIES

What are allergies?

An allergy, or ‘hypersensitivity’, occurs when there is an abnormally vigorous overreaction by the immune system in response to a usually harmless, foreign substance (like pollen or certain foods) that your body incorrectly identifies as a “threat”. The foreign substances that bring about allergic reactions are known as allergens.

Allergies are very common, and while they are just irritating to most people who suffer from them, they can also make you feel pretty miserable. Some people, however, may experience severe symptoms or anaphylaxis – an allergic reaction that is a life-threatening emergency.

Generally, allergies cannot be cured, but treatments can help relieve your symptoms.

Disappointed young Afro American woman uses nasal aerosol suffers from allergic rhinitis has red swollen eyes looks unhappily at camera dressed in casual t shirt, with Texa Allergy Logo in the bottom right corner.

Symptoms

Allergy symptoms, which can range from mild to severe, depending on the type of allergen and may affect different parts of your body, most commonly the upper airways, sinuses and nasal passages, skin and digestive system. The common types of allergy and their symptoms are listed below:

Hay fever (allergic rhinitis)

Symptoms

  • Sneezing
  • A runny and stuffy (congested) nose
  • Itching, pain, redness or swelling in the mucous membranes of the nose, eyes or roof of the mouth
  • A scratchy or sore throat that can cause you to try and “clear your throat” by coughing
  • Watery, red or swollen eyes (allergic conjunctivitis)
  • Black colouration (dark circles) underneath the eyes (called allergy “shiners”)
  • A loss of smell or taste
  • Headache, especially around the sinuses, nose and eyes
  • Feeling tired or rundown

Food allergies

Symptoms

  • Swelling, tingling or itching of the tongue, lips, throat, mouth or face
  • Hives (medically known as urticaria) commonly manifest as a sudden outbreak of swollen, pale red bumps or plaques (wheals) on the skin
  • An itchy skin rash (eczema)
  • Vomiting, diarrhoea or stomach pain
  • Sudden hypotension (a drop in blood pressure), difficulty breathing and wheezing (severe cases)

Insect bites and stings

Symptoms

  • Swelling (medically known as oedema), redness and pain at the bite/sting site, and after time, a lump may form there
  • Itching or hives
  • Difficulty breathing and wheezing (severe cases)

Medication allergies

Symptoms

  • Itchiness
  • Rash or hives
  • Swelling (commonly of the face)
  • Wheezing and breathing problems

Skin Allergies

Symptoms

Eczema
Contact dermatitis
Atopic dermatitis

  • Itchiness
  • Rashes or blisters
  • Redness
  • Dryness, cracking, flaking or peeling
  • Swelling
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Causes

According to the Allergy Foundation of South Africa (AFSA), about one-third of South Africans will probably experience an allergic reaction at least once in their lives.

What happens in the body when you have an allergic reaction:

  • When a specific allergen (such as pollen) that you are allergic to enters your body, it triggers your immune system to make allergy-causing antibodies called immunoglobulin E (IgE).
  • The antibodies attach themselves to specialised cells called mast cells that respond by releasing the chemical histamine.
  • The release of histamine causes inflammation (redness, swelling and itching).

Common allergens

Common allergens or “triggers” include:

  • Airborne allergens: Commonly pollen, animal dander, dust mites and mould spores.
  • Foods: Commonly including peanuts, tree nuts, gluten in wheat germ products (for example, in people with coeliac disease), soya, shellfish, eggs and milk.
  • Pet allergies: These include allergies to the hair, skin cells, saliva or urine of pets (typically dogs and cats) and other animals.
  • Insect stings and bites: These include stings from a bee, wasp or hornet and bites from mosquitoes, ticks or spiders (snake venoms or other “poisonous” animal bites or stings are also caused by an allergic reaction).
  • Medications: Particularly penicillin and penicillin-based antibiotics, sulpha-containing antibiotics (sulphonamides), aspirin or non-steroidal anti-inflammatories.
  • Metals: This is generally in the form of contact dermatitis in reaction to nickel found in jewellery.
  • Environmental allergens: These can include cigarette smoke and pollution.
  • Other: Latex as well as detergents and cosmetics can also cause skin allergies in some people, while resins from certain plants, like poison ivy, are also well-known skin allergens. Cockroaches can also cause asthma or allergic rhinitis.

You may be more sensitive to certain allergies based on whether you have the following:

  • Atopy, if you are still a child: Atopy is a genetic predisposition to asthma or allergy, typically seen in children with a family history of these conditions. While you can develop allergies as an adult for the first time, it is far more likely to develop an allergy as a child. According to the AFSA, a child without a family history of allergies has about a 15 % risk of developing an allergic condition within the first few years of life. However, if one parent has an allergic condition, this risk increases to 40-50 %, and if both parents have allergies, up to 60-80 %. More than 40 % of allergy sufferers in South Africa are children.
  • Asthma or other allergic conditions: It is more likely that you are allergic to other allergens as well.
  • Female sex: While as children, more boys develop allergies than girls, this reverses after puberty. This is because the female hormone estrogen is known to exacerbate sensitivity to allergens, while the male hormone testosterone is probably protective.
  • Overweight or obesity.

Treatment

There are several different types of medications available in different forms (tablets, liquids, nasal sprays, eyedrops and ointments or skin creams) to help relieve and manage allergy symptoms, including:

  • Antihistamines: These are the most common medication for the relief of allergy symptoms. They work by blocking the chemical, histamine, that causes the symptoms of allergy.
  • There are several different types of antihistamines available over-the-counter in different forms to ease the different types of allergy symptoms.
  • Take these medications with precaution as they tend to cause drowsiness and may make you feel tired. As such, antihistamines may not be suitable for use if you are going to be driving or doing any activity that requires full alertness.
  • Decongestants: These are usually available as nasal sprays that can relieve congestion (stuffiness) in the nose or sinuses.
  • Corticosteroids: These medications help relieve symptoms by reducing inflammation. Steroids can be found in some nasal sprays and skin creams but are also available in tablet or inhaler form. Your doctor may need to prescribe you a steroidal medication that can help manage your symptoms.
  • Long-term corticosteroid use can cause cataracts, osteoporosis, muscle weakness, thinning of the skin, stomach ulcers, increased blood sugar (glucose) levels, delayed growth in children and can also worsen high blood pressure. Talk to your doctor or healthcare provider if you are going to be using corticosteroids for a long period of time.
  • Mast cell-stabilisers: These medications block mast cells from releasing histamine. Your doctor may prescribe these when you cannot use histamines or when antihistamines are
    not working effectively to relieve your symptoms. Mast cell stabilisers do not provide immediate relief of symptoms but require at least a few day’s uses to be effective.
  • Leukotriene inhibitors: These tablets block the other chemicals that help to cause allergy symptoms. Your doctor will have to prescribe these medications as they are sometimes known to cause, or aggravate, psychological conditions like anxiety and depression.
  • If you cannot use these medications or if they have not worked to relieve your allergy symptoms, your doctor may suggest allergen immunotherapy. The goal of immunotherapy is to try to train your body’s immune system not to react to specific allergens by carefully timed and gradually increasing exposure to allergens, such as pollens, dust mites and mould. Immunotherapy is usually given as a series of injections at a healthcare facility or immunology clinic. Immunotherapy needs to be carefully monitored by a healthcare professional, as it can cause side effects, such as swelling and pain at the site of injection, or even anaphylaxis.

Recently, cellulose powders as barrier protections, such as hydroxypropyl methylcellulose (HPMC), which literally ‘shields’ the nasal membrane from airborne allergens, or other similar products used as nasal sprays, have been found to provide some benefit in preventing or relieving hay fever symptoms. Some of these products may be available over-the-counter to purchase.

Complications

Having an allergy increases your risk of certain other medical problems, including:

  • Anaphylaxis
  • Asthma: If you have an allergy, particularly hay fever, you are more likely to have asthma. Asthma attacks are also very often triggered by exposure to airborne and environmental allergens
  • Upper respiratory tract, ear and lung infections: Your risk of getting rhinitis, sinusitis, otitis media and bronchitis is higher if you have hay fever or asthma.

What is Anaphylaxis?

Anaphylaxis is an allergic reaction that is serious and life-threatening.
Anaphylaxis most commonly occurs because of reactions to food (for example, peanuts and shellfish), insect bites and stings, or certain medications. Anaphylaxis requires immediate medical treatment, including a prompt injection of adrenalin.

Common symptoms of anaphylaxis include:

  • Sudden hypotension (a drop in blood pressure)
  • Breathing difficulties, including shortness of breath, feeling like your chest is tight and wheezing
  • Skin rash
  • Feeling weak/light-headed
  • Tachycardia (a fast heartbeat) and/or a weak pulse
  • Nausea and vomiting
  • Loss of consciousness

To treat anaphylaxis, an injection of adrenalin (also known as epinephrine) is given. People with severe allergies may need to carry a self-injecting needle and syringe device (known as an auto-injector) to use in cases of anaphylaxis. These self-administering injections are commonly known as “epi-pens”.

Even if your symptoms improve after self-administration of an adrenalin injection, you should still seek medical attention to make sure you are in no more danger and because you may require a second shot to stop symptoms from worsening again.

Additionally, if you have ever experienced any signs or symptoms of anaphylaxis in the past, make an appointment to see your doctor for proper management of your allergy.

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  1. Based on internal analysis by Pharma Dynamics (Pty) Ltd using data from the following source: IQVIA TPM Dec 2024, ATC3 – R6A – Antihistamines systemic, 2nd generation, Brands measured in Units, reflecting estimates of real-world activity. Copyright IQVIA. All rights reserved.
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Disclaimer

These articles are for information purposes only. It cannot replace the diagnosis of a healthcare provider. Pharma Dynamics gives no warranty as to the accuracy of the information contained in such articles and shall not, under any circumstances, be liable for any consequences which may be suffered as a result of a user’s reliance thereon.

The information the reader is about to be referred to may not comply with the South Africa regulatory requirements. Information relevant to the South African environment is available from the Company and in the Professional Information/Patient Information Leaflet/Instructions for Use approved by the Regulatory Authority

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