Step 5: Should you see an allergist?

Many people begin by self-treating their allergies with over-the-counter (OTC) drugs. But if your allergy symptoms don't improve, or you have unpleasant side effects from OTC medicines, you may need to see a health care provider.

Your primary care doctor can prescribe an allergy drug for you. Some prescription medicines have fewer side effects than some OTC drugs. (Read more about OTC versus prescription drugs in step 10 .)

For many people, their allergies are bad enough that they wonder if they should see an allergist. You may even wonder what an allergist does. An allergist diagnoses, treats, and manages allergy-related conditions, like allergic rhinitis and asthma. Becoming an allergist or immunologist requires at least 9 years of medical training, followed by 2 - 3 more years of specialized study in asthma, allergy, and immunology. Those who are ABAI-certified passed the American Board of Allergy and Immunology's certification examination.

You should see an allergist if you have any of the following:

• Anaphylaxis: Those who have had a severe allergic reaction (anaphylaxis) to a food, a drug, or to exercise, and those who have had an anaphylactic reaction with no obvious trigger.
• Food Allergy: Those who have been diagnosed with a food allergy, those who have limited their diet because they believe they have had reactions to food, those who have experienced hives, swelling, itch, wheezing or GI symptoms after eating a food, and those with or expecting a newborn who want counsel on identifying or preventing food allergies.
• Insect Hypersensitivity: Those who have had reactions to insect stings or bites that extend beyond the part of the body with the wound.
• Asthma: (see Asthma Guide. )
• Allergic Conjunctivitis: Those whose eye allergies are prolonged or severe, who have found medications ineffective, or who also have other related conditions such as asthma or recurrent sinusitis.
• Allergic Rhinitis: Those who have prolonged or severe symptoms or who have found medications to be ineffective.
• Cough: Those with chronic cough of 3 - 8 weeks or more.
• Atopic Dermatitis: Those responding poorly to treatment and those who want to identify the role of dust mite allergies or food allergies in their eczema.
• Drug Allergies: Those with a suspected drug allergy who are likely to need that drug again.
• Sinusitis: Those with chronic or recurrent sinus infections.
• Hives : Those with severe hives caused by a food or drug, or with no known cause; those with chronic hives lasting 6 weeks or more.

Through testing, an allergist can identify the allergens that cause your symptoms. Your allergist can also help manage medication side effects, and offer advice on immunotherapy options.

If you suspect you are allergic to something and you've never been diagnosed, ask your primary care physician to refer you to an allergist, and find out if you have insurance coverage before making an appointment.

Reference

American Academy of Allergy, Asthma & Immunology. Consultation and referral guidelines citing the evidence: how the allergist-immunologist can help. J Allergy Clin Immunol . 2006;117(Suppl 2):S495-523.

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