Go to our "CLOSINGS" tab on our website to see our updated Coronavirus Policy

Month: February 2022

Allergies in February?

If you are suffering from allergy symptoms and you live in the Washington, DC, Northern Virginia, and Maryland metropolitan area, you are not alone. There may be many reasons why this is so. You should understand that there are a variety of allergens that could be affecting you, even in February. We will discuss some of them below.

It should be noted that dust allergy is an allergy that occurs throughout the year. Dust is always present no matter how clean you are. In fact, it is not typically the dust particles that you often see in the air near a well-lit window that is the culprit in someone with dust allergies. It is the dust mites that are primarily responsible for causing the annoying symptoms in a dust-allergic individual. Dust mites are arachnids like spiders and ticks. They are microscopic and live off of the dead skin that sloughs off all individuals. A dust-allergic individual is actually allergic to the dust mite’s feces as well as its exoskeleton. The 2 common species of dust mites in the U.S. are Dermatophagoides farinae (i.e., American house dust mite) and Dermatophagoides pteronyssinus (i.e., European house dust mite). Both species are responsible for causing or contributing to both allergic rhinitis (i.e., hay fever) and asthma. The classic symptoms of allergic rhinitis may include sneezing, nasal congestion, runny nose, post-nasal drip, itchy nose, itchy throat, sinus congestion, sinus pressure, sinus pain, headaches, snoring, itchy eyes, watery eyes, puffy eyes, and/or redness of the eyes. Asthma symptoms, on the other hand, may include wheezing, chest tightness, coughing, and/or shortness of breath. Even though dust is a perennial allergen, it can worse for some individuals in the Winter, when a house is generally more closed up compared with the other seasons.

Mold is another perennial allergen that is bothersome to many individuals with allergic rhinitis and/or asthma. Although molds tend to be present in every season, they tend to be more abundant in the Fall, when leaves fall off of the trees and sit on the wet ground. This setting is perfect for molds as the moisture is a catalyst for mold growth. It should be noted that Washington, DC was built on a swamp and is thus is a great environment for molds to grow. Many individuals who live in the Washington, DC metro area are bothered by this abundance of mold and as a result suffer more than they would have if located in a different part of the country. Mold, just like dust, can cause or aggravate both allergic rhinitis and/or asthma. Mold-sensitive individuals may complain of runny nose, nasal congestion, post-nasal drip, itchy nose, itchy throat, sinus headaches, snoring, sinus pressure, sinus congestion, sinus pain, watery eyes, itchy eyes, redness of the eyes, swelling of the eyes, chest tightness, wheezing, coughing, and/or shortness of breath depending on whether they exhibit allergic rhinitis symptoms, asthma symptoms, or both. In addition, there are conditions like allergic bronchopulmonary aspergillosis (ABPA) and allergic fungal sinusitis that occur because of an allergy to molds where an inflammatory reaction ensues. These 2 disorders are more involved than that of the standard allergic rhinitis situation, thus requiring more specialized tests and more complex treatments in the diagnosis and management of these conditions.

Lastly, when one thinks about allergies in the month of February, one must think of tree pollen. In the metro Washington, DC area, trees begin to pollinate earlier than they have done even 10 years ago. In the past, trees would typically begin to pollinate in late February. In the last few years however, we have seen pollination begin in early February! This early tree pollination is what accounts for the earlier symptoms of hay fever felt by allergy sufferers in the Washington, DC area. Tree pollen also causes or aggravates both asthma and/or allergic rhinitis. Again, tree-sensitive individuals may experience nasal congestion, post-nasal drip, runny nose, sneezing, itchy nose, itchy throat, itchy eyes, watery eyes, puffy eyes, redness of the eyes, snoring, sinus pain, headaches, sinus congestion, sinus pressure, coughing, chest tightness, wheezing, and/or shortness of breath depending on whether they have asthma symptoms, allergic rhinitis symptoms, or both.

It must be stated that many allergy sufferers are allergic to more than one of these allergens (i.e., allergic to dust, molds, and tree pollen), and thus may exhibit far worse symptoms than if they were allergic to only one or two of them. In these individuals with multiple allergen sensitivity, they will most likely have allergy symptoms for much longer than the month of February or even one season. They usually have allergic rhinitis and/or asthma symptoms throughout the year.

The board certified allergists at Black and Kletz Allergy have over 50 years of experience in diagnosing and treating allergic rhinitis, asthma, immunologic disorders, and all other types of allergies. We treat both adult and pediatric patients. Black & Kletz Allergy has 3 convenient locations with on-site parking located in Washington, DC, McLean, VA (Tysons Corner, VA), and Manassas, VA. The Washington, DC and McLean, VA offices are Metro accessible and we offer a free shuttle that runs between the McLean, VA office and the Spring Hill metro station on the silver line. To schedule an appointment, please call any of our offices or you may click Request an Appointment and we will respond within 24 hours by the next business day. We have been servicing the greater Washington, DC metropolitan area for many decades and we look forward to providing you with state-of-the-art allergy and asthma care in a friendly and pleasant environment.

Allergy Skin Testing in Children

Many parents wonder at what age can children be skin tested for allergies?

Skin testing is a simple and common procedure used to detect what an individual is sensitized (i.e., allergic) to. It entails the application of a small amount of a chemical antigen, which is extracted from the natural allergy causing substance, on the skin and then interpreting the result after approximately 15 to 20 minutes. Allergic individuals carry proteins called specific antibodies. These antibodies, which are found in the bloodstream, react to various external allergenic triggers depending on the sensitivity of the child.

When the antigen or allergen is introduced into the top layers of the skin with a small plastic toothpick-like applicator, the corresponding antibodies react with the antigen and release chemicals, such as histamine, at the site of reaction. These chemicals cause stretching of the blood vessel walls as well as fluid leakiness into the surrounding tissues. A positive skin test reaction will appear as a small raised bleb or wheal with redness surrounding the raised bleb at the site of the skin test area. This reaction confirms the presence of specific antibodies against the antigen and thus proves that the child is allergic to the substance being tested since it triggered the production of these antibodies.

The ability of the skin to react to outside allergy-causing substances is present at birth. It is true that most children do not develop sensitivities to outdoor allergens such as tree, grass, and/or weed pollens until about the age of 2 or 3. However, they can be sensitized to indoor allergens (i.e., dust mites, pet dander, cockroach) much earlier than that. Many infants can be allergic to foods even during the first few weeks of life. Since this is true, it is appropriate to skin test young children as soon as they develop allergy-related symptoms.

The consideration of allergy immunotherapy (i.e., allergy shots, allergy injections, allergy desensitization, allergy hyposensitization) is not the only reason to skin test children. If we can detect which food a child is sensitized to, we can prevent food-induced reactions by eliminating the offending food and substituting it with suitable alternatives. The identification of specific indoor environmental allergy triggers in young children will also enable us to implement proper control measures in order to reduce their exposure to those allergens which will in turn reduce their symptoms and decrease the need for medications.

Allergy skin testing is mainly done in children when one is trying to assess if a child may have food allergies, allergic rhinitis (i.e., hay fever), insect sting (i.e., bees, wasps, hornets, yellow jackets) allergies, medication allergies, and/or asthma. Although skin testing is the preferred method, the allergist will determine which type of allergy testing is appropriate for each child depending on whether the child is taking a medicine that may prevent or reduce a reaction to a skin testing substance, has a skin disorder that makes it difficult to see the results of skin testing, or has had a previous allergic reaction to skin testing with severe symptoms, which is extremely uncommon. Skin prick testing in children causes very little discomfort and is well tolerated. It is also safe and as stated above, adverse effects from skin testing are extremely rare.

The board certified allergy specialists at Black & Kletz Allergy in the Washington, DC, Northern Virginia, and Maryland metropolitan area will gladly answer any questions and concerns about allergy skin testing for both children and adults. Dr. Michael Kletz and Dr. Appaji Gondi at Black and Kletz Allergy, have been diagnosing and treating individuals with hay fever (i.e., allergic rhinitis), asthma, sinus problems, insect sting allergies, hives (i.e., urticaria), eczema (i.e., atopic dermatitis), swelling episodes (i.e., angioedema), food and medication allergies, and immunological problems for more than 60 years combined. We have an office in Washington, DC and 2 other offices in Northern Virginia with locations in McLean, VA (Tysons Corner, VA) and Manassas, VA. All 3 office locations offer on-site parking and the Washington, DC and McLean, VA locations are also Metro accessible. There is a free shuttle that runs between our McLean office and the Spring Hill metro station on the silver line. For an immediate appointment, please call us or you may click Request an Appointment and we will respond within 24 hours by the next business day. The allergy doctors at Black & Kletz Allergy pride themselves in providing excellent state-of-the-art allergy and asthma care in a professional and compassionate environment.