Dust Mite Allergy
Authored by Dr.Zareen Mohamed
Introduction
A hypersensitive reaction to immune system against any particular substance (allergen) is called as allergy. Dust mite allergy refers to hypersensitive reaction caused by exposure to tiny bugs (too small to see with naked eyes) in the dust in our house and premises. These dust mites survive in warm and humid conditions (as in bedding items and furniture in the home) and eat dead skin cells of humans and animals. Usually, individual mite has ability to produce more than 20 of waste droppings (specific protein) every day that spreads in the environments and settles down with the dust while their ability to cause allergic symptoms remain constant even after they die. The ideal environment for dust mites is when there is a temperature about ≼ 70 F and humidity ranging between 75 to 80 percent. Causes
Along with the live mites, dust also contains faeces, excretions and decayed bodies of dust mites. A specific protein in the mites is responsible for allergic reaction causing nasal inflammation, which triggers further symptoms. The immune system produces specific antibodies as a defense against foreign substances (allergens) to protect the body from harmful allergens. In case of allergic reactions, as usual, the body produces antibodies against allergens (even if they are not harmful) and leads to an inflammatory response. Symptoms Most allergies have some common signs and symptoms. Allergy to dust mites harms nasal passage making it inflamed, causing several clinical manifestations. Common symptoms of dust mite allergy may include: • Rhinorrhea (persistent discharge of mucus from nose) • Sneezing • Itching sensation in the eyes, nose and throat • Reddening of eyes • Swelling around the eyes • Accumulation of excess mucus in the throat (postnasal drip) • Cough and congestion • Facial pain and pressure • Rubbing nose (especially in children) In chronic cases, one may experience a severe asthma attack that causes: • Shortness of breath • Chest pain • Tightness in the chest • Abnormal sound while breathing • Severe coughing and wheezing • Lack of sleep When to see a doctor? Most of the times, it is confusing to identify and differentiate the common cold from allergy, as both share many common symptoms. However, following are some signs of allergy: • When you experience the above referred symptoms soon after exposure to dust while cleaning or dusting. • Symptoms continue even after a week Reach out to your doctor immediately, if: • You experience severe shortness of breath • Chest pain and some other severe symptoms are worrying you. Diagnosis Diagnosis of dust mite allergy may begin with discussing with your doctor about the typical symptoms, severity, onset of symptoms and its duration, pets at home, etc. This will help the doctor to further advice other tests, such as allergy tests (to identify the specific allergen) and some blood examinations, examining the body for allergy and assessment of family history.
Who are at Risk
While anyone can be allergic to a variety of allergens; the following factors may increase the risk of having a dust mite allergy: • A child (as exposure to dust is quite frequent) • Family history of allergies • Frequent exposure to dust mites, especially in childhood. Treatment The approach to minimize allergic reactions is to avoid exposure to dust mites as much as possible. For unavoidable exposures causing allergies, the following treatment approaches may help: Drugs and medications: Doctor may prescribe several anti-allergy drugs to relieve your symptoms. These may include: • Decongestants: Alone or in combination, these medicines help to relieve nasal congestion and ease breathing. These medicines should be taken with caution and only after expert’s advice if you have hypertension, glaucoma, enlarged prostate or any other chronic condition. • Antihistamines: These OTC (over-the-counter) medicines can address the symptoms, including mucus secretion, itching, sneezing etc. E.g. Loratadine, fexofenadine, cetirizine, etc. • Montelukast: It is a leukotriene modifier drug that helps to prevent the inflammatory response by the immune system thereby reducing the symptoms. • Corticosteroids: In the form of nasal spray, these help to reduce inflammation of the nasal mucus lining. E.g. ciclesonide, fluticasone propionate, mometasone furoate, etc. • Cromolyn sodium sprays: Helps to reduce the symptoms and are most effective when used before the onset of allergy symptoms and after being exposed to the dust. Immunotherapy (allergy shots or allergy drops under the tongue/ Sublingual immunotherapy (SLIT): When other treatment approaches fail to deliver the results, immunotherapy may be considered. It involves a series of allergen shots with gradually increasing doses (about two shots a week for about 3 months) and then a single shot for every four weeks, for about five years. This helps to build up immunity against specific allergens. Benefits of SLIT: • Effective in children in terms of treating the symptoms of rhinitis, asthma, and further worsening of symptoms. • Effective in preventing future asthma • Safe and easy to administer • Can be administered at home • No need of syringes and needle Nasal lavage or nasal douche: It is intended to expel the excess mucus and irritating allergens with the aid of saline water through specially designed irrigation device. Alternative treatments: Alternative benefits may add to the benefits of usual treatment approaches. These may include: Ayurvedic approaches: These may include various medicated oils (tail anu, neem oil, olive oil), coriander, clove, camphor, neem capsules, nimbarajanyadi tablet, and so on. Herbal drugs: Herbs with anti-allergic properties may include, turmeric, Guduchi, Picrorhizakurroa, those leaves, Guggulu, and so on.
(Note: Dr. Zareen does not prescribe any of these alternative medicines. Do not take any alternative treatments on your own. Talk to respective specialists before you make any choices.) Home remedies and lifestyle interventions: • Use allergen blocking covers to prevent exposure to dust mites in the bedding items. • Wash household cloths including beddings, pillow covers, curtains, etc., at least every week using hot water. • Use dryer (maintained at temperature >130 F) to dry beddings so that mites will be destroyed. • Use a protective mask while cleaning. • Extreme cold or freezing the beddings and other clothes can also kill dust mites. • Maintain lower humidity at home. • Use clothes that cannot absorb dust easily and are easy to clean. • Buy washable toys which can get cleaned of any dust by washing. • Use oiled mop to remove dust to avoid its resettling. • Use a good quality vacuum cleaner to clean the house. • Clean everything like a bookshelf, ornament boxes, magazines, etc in the house using cut clutter.