Allergies – Canyon View Medical

Why Am I Developing Allergies, and How Can I Prevent Them?

Posted on April 19, 2022January 13, 2023 by Avery Dustin

Two to Three hundred years ago, very few people suffered from allergies. Nowadays, it’s common for people to be allergic to multiple things. What has changed? Why are people becoming more and more allergic to chemicals, foods, animals, and our natural environment? There are numerous reasons:

1. We have fewer bacteria in our intestines. We are exposed to cleaner water and more soap and hand sanitizer. C-section delivers more of us, so we are not exposed to our mother’s natural vaginal bacteria (1). We are exposed to more antibiotics, especially as children. Fewer bacteria diversity in the intestines has been shown to increase the risk of developing allergies.

2. For decades, doctors recommended waiting to introduce certain foods till later in childhood. We now know this increases the chance of developing a food allergy (4).

3. We are exposed to more acid-reflux medicines, which reduce stomach acid. Lower stomach acid affects food digestion and how our immune system is exposed to food (3).

4. We spend less time outdoors, especially as children and fewer of us grow up on farms, having less exposure to farm animals (5).

5. We have been exposed to more pollution and 1st or 2nd hand smoking. These have altered how our immune system interacts with our environment (5).

6. Our children wear shoes more when they play outside. When children’s feet have less exposure to bacteria and worms, the risk for allergies goes up (5).

We can control some of these risk factors now, some of them we can modify, and some we cannot. To decrease your and your children’s risk of developing allergies, you can do the following:

1. Eat various foods in your home, including milk, nuts, eggs, and soy. Expose your children to them starting at six months (see your allergist first if there is a family history of life-threatening food allergy). Eat these foods when you are pregnant. If your infant was born via C-section, give them a few different probiotic supplements in their first five years (2).

2. Keep your infant off acid reflux medicine unless necessary. Eat healthily and lose weight to avoid having to take acid-reflux medicine.

3. Avoid taking and giving your children antibiotics unless necessary.

4. Let your kids go outside in the backyard barefoot (within reason).

5. Limit kids’ screen time, and get them outside as much as possible, as young as possible.

6. If you have an opportunity to live on a farm in a less polluted area, take it.

7. Limit hand sanitizer and soap use (within reason) in your home.

8. Stop smoking/vaping.

9. Consider taking a daily probiotic with various strains in it.

By David Beckstead, MD

Sources:
1. Koplin J, et al. Is cesarean delivery associated with sensitization to food allergens and IgE-mediated food allergy: a systematic review. Pediatr Allergy Immunol. 2008;19(8):682.
2. Kuitunen M, et al. Probiotics prevent IgE-associated allergy until age five years in cesarean-delivered children but not in the total cohort. J Allergy Clin Immunol. 2009;123(2):335.
3. Mitre E, et al. Association Between Use of Acid-Suppressive Medications and Antibiotics During Infancy and Allergic Diseases in Early Childhood. JAMA Pediatr. 2018;172(6):e180315. Epub 2018 Jun 4.
4. Commins S. Food intolerance and food allergy in adults: An overview. UpToDate. Accessed 3/9/22.
5. Platt-Mills T, Commins S. Increasing prevalence of asthma and allergic rhinitis and the role of environmental factors. UpToDate. Accessed 3/9/22.

Allergy Relief And Immunotherapy (Shots and Drops)

Posted on March 30, 2021January 13, 2023 by Avery Dustin

What Is Immunotherapy?
Immunotherapy means giving your body what you are allergic to in small amounts, gradually increasing the amount over time, to train your body to become immune/tolerant to the thing for which you are allergic. In other words, it cures you of your allergies.

What Does Immunotherapy Treat?
Immunotherapy works well for Hayfever (itchy eyes, congested/runny/sneezy nose). It also works well for Allergy-induced Asthma. Children with asthma who do Immunotherapy treatments are 50% more likely to outgrow their asthma. Immunotherapy is for individuals as young as age 5, up to any age.

What Are the Options?
One to two injections (depending on the severity of your allergy) in the arm(s), given in the clinic, once a week for the first 12 months, then every two weeks for two more years for a total of three years. You can also use liquid drops placed under the tongue daily for three years, which you give yourself at home.

How Effective Is Immunotherapy?
Immunotherapy is about 85-90% effective in treating the specific allergen for which you may suffer. In other words, about 9 out of 10 people will have life-long relief from their allergies if they complete the three years of treatment. It takes about three to six months of treatment before allergy symptoms begin to subside.

What Is the Cost?
Immunotherapy (or allergy shots) is covered by Medicaid, Medicare, and most commercial insurance plans, although you may have to meet your deductible. Most insurances don’t require a co-pay when you come in for an allergy shot. Most insurance companies don’t cover allergy drops. A three-month supply of drops is about $110 for one vile or $160 for two vials (two vials may be necessary if we can’t fit all your allergens into a single vial).

How Do I Get Started?
Start by getting tested for common allergens, including local pollens, molds, dust mites, trees, grass, weeds, pets, etc. Based on these results, allergy drops/shots will be made specifically for you.

Dr. David Beckstead MD and his specially trained medical assistants perform allergy skin tests and administer allergy shots at our Spanish Fork location. Call 801-798-7301 and ask to schedule an allergy skin testing appointment with one of Dr. Beckstead’s skilled assistants.

Allergy Myths

Posted on April 4, 2018January 13, 2023 by Avery Dustin

Myth #1: You can only develop food allergies when you are younger.

False. About 15% of people who develop food allergies develop them when they are adults. You can develop an allergy to any food at any time in life, although the most common food allergies to develop as adults are nuts/peanuts and seafood/shellfish. The peak decade you can develop allergies as an adult is in your 30’s (2).

Myth #2: Food allergies can cause chronic stomach pains.

False. Food allergies can cause stomach pains, but when they do, stomach pains are rarely the only symptom. Stomach pains from a food allergy are usually severe with accompanying vomiting and diarrhea. Usually, there are other symptoms like hives, throat swelling, trouble breathing, heart racing, and dizziness. An allergic reaction usually occurs within minutes to a few hours of eating the food. In other words, usually, a food allergy reaction that gives you stomach symptoms is acute and severe, not chronic and mild/moderate. You can usually figure out what food caused the reaction, avoid that food, and thus prevent chronic stomach issues (1). If you are wondering if you are allergic to some food that is causing your stomach pains, but you don’t have a good idea of what food is causing the symptoms, then it is unlikely a food allergy.

Myth #3: There are hypoallergenic breeds of dogs and cats for people who are allergic to these animals.

False. There is no evidence that certain breeds are more hypoallergenic than others (6).

Myth #4: If you are allergic to eggs (even deathly allergic) you cannot get the regular flu vaccine.

False. The CDC now recommends that all people >6 months old, even those with a severe life-threatening egg allergy, be given the regular flu vaccine every year. A study was done where 4000 individuals with egg allergy were given the regular flu vaccine. Over 500 of them had a history of a severe life-threatening egg allergy. None of them had a reaction to the flu vaccine (5).

Myth #5: Medication allergies always run in families.

False. There are a few exceptions to this. But the exceptions are few and far between (7). Most antibiotic allergies are not genetic. Check with your doctor, but chances are if you have an allergy to a medication, your child does not have an increased risk of having a reaction to the same or related medication. If your child has a reason to take a medication you are allergic too, and it is the 1^st choice medication to be on, be open to the option of giving it to your child if a doctor recommends it.

Myth #6: The first thing you should try for your allergic runny nose is an over-the-counter allergy pill.

False. The first thing you should try, if you have not already, is an over-the-counter nasal steroid like Nasacort, Rhinocort, Flonase, or their generics. There is research showing they are much more effective than over-the-counter allergy pills.

Myth #7: Chronic hives are from a food allergy.

False. It is rare that chronic hives are from a food allergy. Usually, chronic hives are idiopathic, meaning, there is no known cause. Or, there are other triggers like cold, heat, or stress. Certain foods that are rich or spicy may make chronic hives worse, but avoiding these foods won’t necessarily make the hives go away (8).

Myth #8: If food allergies run in you or your family you should avoid giving those foods to your kids.

False. A growing substantial amount of research shows that, even in families where food allergies run rampant, the earlier an infant is introduced to allergy-risk foods (after age 4-6 months) the less likely they are of developing an allergy to it (3). With the exception of introducing cow’s milk at 12 months of age, all children should be introduced to all foods at home after 4-6 months of age, unless:

-Your child had a reaction to a certain food already before age 4-6 months

-Your child has a sibling that had a serious reaction to peanut

-Your child has moderate to severe eczema

Children who meet one of these criteria should have skin tests for, and possibly be introduced to, the allergy-risk food in an allergist’s office (3).

Myth #9: You should delay giving certain foods to all kids until a certain age to avoid developing food allergies.

False. The American Academy of Pediatrics suggested back in 2000 that delaying certain allergy-risk foods until certain ages would help prevent food allergies, but this recommendation was based on weak evidence. Since then, a lot of research has shown the opposite. The earlier you introduce allergy-risk foods like egg, peanut, soy, fish, shellfish, nuts, milk, the less likely your child will be allergic to those foods (3).

Myth #10: If you have a bad reaction to a bee, wasp, or hornet sting, chances are the next time you get stung your reaction will be worse, maybe fatal.

False. No matter what kind of reaction you have to a bee, wasp, or hornet sting, your chance of the reaction being worse the next time you get stung is <10% (4). This is not downplaying the fact that if you have a life-threatening reaction to a bee sting once, it is true that the next time you get stung, it will also likely be life-threatening.

Resources:

Burks, W. Clinical manifestations of food allergy: An overview. www.uptodate.com. Accessed 3/26/18.
Commins, S. Food intolerance and food allergy in adults: An overview. www.uptodate.com. Accessed 3/26/18.
Fleischer, DM. Introducing highly allergenic foods to infants and children. www.uptodate.com. Accessed 3/26/18.
Freeman, T. Bee, yellow jacket, wasp, and other Hymenoptera stings Reaction types and acute management. UpToDate. uptodate.com. Accessed 3/26/18
Kelso, JM, Wang, J. Influenza vaccination in individuals with egg allergy. www.uptodate.com. Accessed 3/26/18.
Lockey, RF. The myth of hypoallergenic dogs (and cats). PubMed. J Allergy Clin Immunol. 2012 Oct;130(4):910-1.
Pichler, WJ. An approach to the patient with a drug allergy. www.uptodate.com Accessed 3/30/18.
Saini, S. Chronic urticaria: Clinical manifestations, diagnosis, pathogenesis, and natural history. www.uptodate.com Accessed 3/26/18.

Is It Just Dry Skin?

Posted on November 22, 2017January 17, 2023 by Avery Dustin

Have you ever looked at your child’s skin and wondered if the dry redness you were looking at was eczema or just dry skin? While dry skin may be irritating to your child and yet simple to manage, eczema can present a different set of challenges when it comes to caring for your child’s skin. Eczema is a very common skin condition seen in about 10-15% of pediatric patients, usually starting before age 5. It is a chronic inflammatory condition of the skin that tends to run in families and occurs often with allergies and asthma. As we head into the winter months and drier air, our skin can become more vulnerable to general dryness, and children who suffer from eczema tend to have it worse.

A good routine can keep your child’s dry skin healthy. Skin becomes dry when it has a hard time retaining moisture. Moisturizers are the cornerstone of a good skincare routine. The drier your skin gets, the thicker your moisturizer should be. You should avoid lotions that are dispensed with a pump as these tend to contain alcohol, which can dry out your skin. Another important factor is water. Anyone who washes their hands multiple times per day will know that frequent washing in hot water is a fast way to dry out your skin. Opt for luke-warm water rather than hot, and always remember to moisturize after you wash.

When your child has eczema, the routine suggested above won’t be enough, especially during eczema flares. Eczema is also known as “the itch that rashes.” Dry skin begets itching, itching begets redness and thickened skin, and thus you have what is classically seen as an eczema flare: those thick, red patches of skin with a scaly appearance and vertical lines called excoriations that are a sure sign of your child scratching. The first line of defense against an eczema flare is to have a solid daily lubrication routine down. Since your child already has dry skin, try using a thicker moisturizer such as Aquaphor, Aveeno, or CeraVe once to twice daily, even during times between eczema flares. You may even opt for the greasiest – and messiest – of them all: vaseline. Moisturize the entire body once or twice daily, increasing as necessary with drier weather or worsening rashes.

For children with eczema, a common bathing technique called the “soak and seal” is an excellent bathtime routine. This method helps your child’s skin retain the moisture from the bath, and adds moisture to the skin via a thicker moisturizing ointment such as one mentioned above. First, start with lukewarm water. Allow your child to soak for 10-15 minutes in the tub before washing them with soap at the end of the bath. For children with particularly sensitive skin, try using soap just a couple of times per week, and only on visibly dirty skin, the groin, and the armpits. and bathe your child as you regularly do. Avoid any soaps with dyes or fragrances. Anything with “Baby” on the label will surely have some additive to give it a scent or color that we associate with babies, so steer clear of these if your child tends towards dry skin or eczema. Once bathtime is over, rather than drying your child off completely, simply dab away water from their skin so that beads of water still remain. While still covered in these beads of water, use vaseline, Aquaphor, Aveeno, or CeraVe to seal in the moisture from the remaining water and provide additional moisture to the skin. Do this with each bath to encourage skin hydration. Additionally, you may choose to add colloidal oatmeal to the bathwater and allow your child to soak in this for 15-20 minutes before sealing in the moisture.

Of course, even the best laid out plans are not fool-proof and some children will still get those inflamed red patches of eczema. When this happens, there are different strengths of prescription steroid creams and ointments that may be necessary to help clear up your child’s skin. If these red patches start to ooze or your child develops a fever, they may have an infection of their eczema rash. If you are concerned about any of these things, bring your child in to see one of our pediatricians here at Canyon View Pediatrics and we can help determine the best treatment plan.

Some children who have eczema also have allergies. Avoidance of allergens will help control your child’s eczema. Occasionally, we encounter an eczema rash that doesn’t improve despite using prescription-strength steroid ointments. When this happens, we as pediatricians start to think about other factors that may be exacerbating your child’s inflammatory process. After careful evaluation, certain allergies may be discovered that once treated or avoided, make your child’s eczema more easily managed.

If you are concerned about your child’s skin or are having trouble controlling their eczema with over the counter creams and lotions, visit one of our pediatricians at Canyon View Pediatrics to discuss different options.

Getting Relief From Allergies – Allergy Testing and Treatment

Posted on April 8, 2016January 13, 2023 by Avery Dustin

Allergy testing and allergy injections/drops (Immunotherapy) are great options for people who have allergies difficult to treat with pills, nasal sprays, and/or eye drops.

One of the best ways to see what you are allergic to is through skin testing.

Skin testing involves placing on the skin tiny amounts of common substances that cause allergies. These substances are call Allergens. In about 20 minutes, if you are allergic to them, your skin will become red and swollen where the Allergen(s) were placed. In this way, we can tell what you are allergic to.

Skin testing is for children greater than age 6 months.

After having skin testing, we can tailor allergy injections or drops to match what you are allergic to.

The injections and sublingual drops/tablets are given for 3-5 years. After this period 85-90% of people are either cured of their allergies or they only need an over the counter allergy medicine to get the relief they need. Rarely though, some people do find that they need to be on the injections/drops lifelong in order to be free from allergy symptoms.

Allergy injections involve injecting tiny amounts of the Allergen(s) you are allergic too just under the skin of your upper arm. The injections are first given once a week for a year and then after that, they are given every 2 weeks for the next 2-4 years.

The Allergy drops involve placing liquid drops of the Allergen(s) under your tongue, once daily. This can be done at home, rather than at the clinic. There are also once-daily tablets that dissolve under the tongue for people allergic to grass and ragweed.

The amount of the Allergen injected in the arm or placed under the tongue is at first very tiny, and then it is progressively increased with subsequent doses. By starting with a small amount, and then increasing it, your body becomes immune to the Allergen and no longer reacts to it with allergic symptoms.

Some people start to notice an improvement in their allergies right away, but the majority of people start to see an improvement in 2-3 months. Therefore, it is wise to start the allergy injections 2-3 months before the worst season of the year for your allergies.

Allergy injections work best for the following allergy symptoms:

-Runny/Stuffy Nose

-Itchy Red Eyes

-Allergy Induced Asthma

-Allergic, Life-threatening reactions to bees and wasps

Allergy injections or drops can be given to children older than 5.

Allergy injections/drops cannot be given for food allergies.

Injections vs Sublingual Drops:

-Insurance should cover Allergy injections and sublingual tablets, but not Allergy liquid drops.

-There is more inconvenience with the allergy injections, which require regular visits to the doctor’s office.

-Sublingual drops can be done at home. However, drops must be taken daily, and they are less effective if doses are frequently missed.

-Severe adverse reactions to Allergy injections are very rare, but they are even rarer with Sublingual drops.

If you are suffering from allergies contact our office to schedule an appointment.