The first treatment for controlling dust mite allergy is avoiding dust mites as much as possible. When you minimize your exposure to dust mites, you should expect fewer allergic reactions or the reactions should be less severe. However, it's impossible to completely eliminate dust mites from your environment. You may also need medications to control symptoms.
Your doctor may direct you to take one of the following medications to improve nasal allergy symptoms:
- Antihistamines reduce the production of an immune system chemical that is active in an allergic reaction. These drugs relieve itching, sneezing and runny nose. Over-the-counter antihistamine tablets, such as fexofenadine (Allegra Allergy), loratadine (Alavert, Claritin), cetirizine (Zyrtec Allergy) and others, as well as antihistamine syrups for children, are available. Prescription antihistamines taken as a nasal spray include azelastine (Astelin, Astepro) and olopatadine (Patanase).
- Corticosteroids delivered as a nasal spray can reduce inflammation and control symptoms of hay fever. These drugs include fluticasone propionate (Flonase), mometasone furoate (Nasonex), triamcinolone (Nasacort AQ), ciclesonide (Omnaris) and others. Nasal corticosteroids provide a low dose of the drug and have a much lower risk of side effects compared with oral corticosteroids.
Decongestants can help shrink swollen tissues in your nasal passages and make it easier to breathe through your nose. Some over-the-counter allergy tablets combine an antihistamine with a decongestant. Oral decongestants can increase blood pressure and shouldn't be taken if you have severe high blood pressure, glaucoma or cardiovascular disease. In men with an enlarged prostate, the drug can worsen the condition. Talk to your doctor about whether you can safely take a decongestant.
Over-the-counter decongestants taken as a nasal spray may briefly reduce allergy symptoms. If you use a decongestant spray for more than three days in a row, it can actually make nasal congestion worse.
- Cromolyn sodium prevents the release of an immune system chemical and may reduce symptoms. You need to use this over-the-counter nasal spray several times a day, and it's most effective when used before signs and symptoms develop. Cromolyn sodium doesn't have serious side effects.
- Leukotriene modifiers block the action of certain immune system chemicals. Your doctor may prescribe this prescription tablet, montelukast (Singulair). Possible side effects of montelukast include upper respiratory infection, headache and fever. Less common side effects include behavior or mood changes, such as anxiousness or depression.
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- Immunotherapy. You can "train" your immune system not to be sensitive to an allergen. This is done through a series of allergy shots called immunotherapy. One to two weekly shots expose you to very small doses of the allergen, in this case, the animal protein that causes an allergic reaction. The dose is gradually increased, usually during a three- to six-month period. Maintenance shots are needed every four weeks for three to five years. Immunotherapy is usually used when other simple treatments are not satisfactory.
- Nasal irrigation. You can use a neti pot or a specially designed squeeze bottle to flush thickened mucus and irritants from your sinuses with a prepared saltwater (saline) rinse. If you're preparing the saline solution yourself, use water that's contaminant-free — distilled, sterile, previously boiled and cooled, or filtered with a filter that has an absolute pore size of 1 micron or smaller. Be sure to rinse the irrigation device after each use with contaminant-free water, and leave open to air-dry.
- Auerbach PS. Wilderness Medicine. 6th ed. Philadelphia, Pa. Mosby Elsevier;2012. http://www.mdconsult.com/books/page.do?eid=4-u1.0-B978-1-4377-1678-8..00062-3&isbn=978-1-4377-1678-8&sid=1411680414&uniqId=403732597-9#4-u1.0-B978-1-4377-1678-8..00062-3--s0040. Accessed Feb. 23, 2013.
- Reisacher WR. Allergy treatment: Environmental control strategies. Otolaryngology Clinics of North America. 2011;44:711.
- Bope ET, et al. Conn's Current Therapy. Philadelphia, Pa.: Saunders Elsevier; 2013. http://www.mdconsult.com/books/about.do?eid=4-u1.0-B978-1-4377-0986-5..C2009-0-38984-9--TOP&isbn=978-1-4377-0986-5&about=true&uniqId=236797353-5. Accessed Feb. 23, 2013.
- House dust allergy. American College of Allergy, Asthma, & Immunology. http://www.acaai.org/allergist/allergies/Types/dust-allergy-information/Pages/default.aspx. Accessed Feb. 23, 2013.
- Dust mites and dust. American Lung Association. http://www.lung.org/healthy-air/home/resources/dust-mites-and-dust.html. Accessed Feb. 23, 2013.
- Rhinitis. American Academy of Allergy, Asthma & Immunology. http://www.aaaai.org/conditions-and-treatments/allergies/rhinitis.aspx. Accessed Feb. 23, 2013.
- Is it a cold or an allergy? National Institute of Allergy and Infectious Diseases. http://www.niaid.nih.gov/topics/allergicDiseases/Documents/coldallergy.pdf. Accessed Feb. 23, 2013.
- Platts-Mills TA. Allergen avoidance in the treatment of asthma and allergic rhinitis. http://www.uptodate.com/home. Accessed Feb. 22, 2013.
- Caubet JC. Allergic triggers in atopic dermatitis. Immunology and Allergy Clinics of North America. 2010;30:289.
- Tips to remember: Allergy testing. American Academy of Allergy, Asthma & Immunology. http://www.aaaai.org/patients/publicedmat/tips/whatisallergytesting.stm. Accessed Feb. 23, 2013.
- AAAAI allergy and asthma drug guide. American Academy of Allergy, Asthma & Immunology. http://www.aaaai.org/conditions-and-treatments/treatments/drug-guide.aspx. Accessed Feb. 23, 2013.
- Is rinsing your sinuses safe? U.S. Food and Drug Administration. http://www.fda.gov/ForConsumers/ConsumerUpdates/ucm316375.htm. Accessed Feb. 23, 2013.
- Montelukast. Micromedex Healthcare Series. http://www.micromedex.com. Accessed Feb. 25, 2013.