Allergies in childhood (and adults) are becoming more common worldwide. Currently, in South Africa, more patients are diagnosed with allergies and asthma than ever before! Allergy is a medical condition and occurs when your body’s immune system is hypersensitive and reacts easily to triggers from the environment. These triggers are called allergens. Allergens are often proteins, which your body’s immune system “sees” as strange or foreign, causing your body to launch an immunological attack. In normal individuals (not suffering from allergy), these allergens will simply be ignored by their immune system. Allergens can be inhaled (respiratory allergies), ingested (food- or drug allergies), or injected into the body (drug- and bee sting allergies). Allergies often manifest in early years (childhood) and fortunately are outgrown in most cases. There are some allergies (e.g. allergies of the nose, peanut allergy, and shellfish allergy) which unfortunately persist into adulthood and will not be outgrown. An early manifestation of allergies maybe an allergic condition of the skin, called Atopic Dermatitis (‘eczema’).
Why certain people are allergic and prone to develop allergies, are largely unknown. A first-degree family member (mom, dad, brother, or sister) affected by allergy makes your chance to suffer from the same, or other allergies, more likely. Parents with the same allergy (e.g. asthma or skin allergies), furthermore makes it even more likely to pass it down to their offspring. Early environmental exposure also plays a part in “switching on” certain allergic genes of your immune system. Certain triggers, like cigarette smoking exposure, are not true allergens, but are considered irritants. Exposure to these can make your already existing allergies, like asthma, worse and can cause an acute asthma attack.
Some exposures (e.g. being the younger sibling of a large family and attending a crèche) may protect a young child from developing allergy later in life. Exclusively breastfeeding (for at least the first four months of life), being born via normal vaginal delivery, keeping your child’s immunizations up to date and growing up on a farm (rural environment), have also been shown to protect against allergy. If there is not a family member affected by pet allergy, early exposure to cats and dogs, have recently been shown to protect, rather than cause pet allergy. Ask your doctor to test specifically for cat and dog allergy, before pets are being blindly avoided – avoiding exposure to pets may indeed do your child more harm than good!
Allergies often affect more than one system in your body, and it is important that your doctor takes a good history from you and examines you thoroughly, to determine if you suffer from multiple manifestations of allergy. Common allergies include food (e.g. cow’s milk protein allergy, egg and peanut allergy), asthma, allergies of the nose (called allergic rhinitis), allergies of the skin (called atopic dermatitis), drug allergy (e.g. penicillin allergy) and allergies of the eyes (called allergic conjunctivitis). A serious reaction, called anaphylaxis, may occur when your body has a potential life-threatening reaction towards a specific allergen, causing multiple body systems (respiratory, skin, gastrointestinal and cardiovascular) to be affected at the same time. Early recognition and prompt emergency treatment are important, as anaphylaxis can be fatal.
After identifying a specific allergen (through an allergy skin prick test or blood testing), your doctor will start treating your allergy. Treatment will generally involve: advice on how to avoid or minimize exposure to your allergen(s), medicines (antihistamines and asthma inhalers) or creams/emollients for your skin. Please ask your doctor to thoroughly educate you on how to use your medication, as administration of some of these (e.g. your asthma inhalers and nasal sprays) need specific techniques for it to be effective. Most allergies are chronic, and daily treatment is necessary to keep your symptoms under control. Do not stop your medicine, unless advised by your doctor. Regular follow up appointments are often necessary to determine whether allergy treatment can be de-escalated if you are better. DO NOT stop your medication yourself, as this may cause your allergies to flare up and in the case of asthma, may case a serious, possible life-threatening asthma exacerbation.
If you are using a medical scheme, also ask your doctor if your own or your child’s medical condition is a Prescribed Minimal Benefit (PMB), as common chronic allergic conditions (e.g. asthma) and the follow up of doctor’s visits are covered under the chronic benefits of your medical scheme.