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Who is an allergist, and what do they do?

Allergy is a reaction to a substance. This substance can be anything from pollen to dust or some edible substance. This foreign substance that causes the allergy is known as an allergen. Allergists, also known as immunologists, are medical specialists who diagnose and treat all kinds of allergies, including hay fever, asthma, food allergies, eczema, and psoriasis. Since allergies are hypersensitivity or overreaction of the immune system, allergists must comprehensively understand the immune system's functioning or the body's mechanism to fight infections.

An allergist works with their patient to identify the trigger of the allergic reaction. They may also perform a couple of tests to diagnose the specificity and severity of the allergy to treat them effectively. Based on the trials and diagnosis, allergists can prescribe different treatments depending on the severity and sometimes the patient's choice. The prescriptions could be as easy as avoiding the allergen or carrying an epinephrine pen (EpiPen), or it could be as complicated as going through immunotherapy (boosting or changing the immune system through different therapies).

Education and training

To become a board-certified allergist, one must attend four years of medical school and finish three-year residency training in pediatrics or internal medicine. Then, one must pass an examination conducted by the American Board of Pediatrics or the American Board of Internal Medicine to get board certification.

Certified doctors then undergo two years of fellowship in allergy and immunology. After fellowship, doctors need to pass the certification exam conducted by the American Board of Allergy and Immunology to become board-certified allergists.

When should you see an allergist?

Allergies are either easily noticeable or are underlying and may require an allergist's intervention for proper treatment. The various signs that indicate you must see an allergist near you include the following:

1. Ear infections or sinus infections- Specific allergies cause inflammation, which can block the eustachian tubes or sinuses, causing sinus infections or ear infections. If such issues persist, you must see an allergist for proper diagnosis and treatment. Allergists can even prevent the recurrence of these infections.
2. Over-the-counter allergy medications are ineffective- If you have hay fever or seasonal allergies, you must see an allergist, especially when common over-the-counter medications are ineffective in controlling the symptoms. Allergists examine your condition and prescribe proper medications to manage the symptoms and treat the disorder.
3. Frequent throat and mouth irritation- Food allergies can cause significant symptoms like soreness or itching in the throat, mouth, or face. Allergists can detect such food intolerances and allergies. They can offer proper treatment to manage the symptoms. Allergists guide you on safe food habits to prevent such allergies.
4. Chronic insomnia or snoring- Allergies can cause inflammation or irritation in the sinus cavity. You may experience difficulty breathing when asleep, resulting in insomnia or snoring. If you snore continuously during sleep or have trouble getting good sleep at night, you must visit an allergist near you. They can identify the cause and provide proper treatment to cure the condition. 

Tests and procedures done by allergists

Allergists perform different types of allergy tests to identify which substances (allergens) are causing you to have allergic reactions. People can get allergic to various environmental things, such as pet dander, pollen, and mold. Accordingly, some may be allergic to latex or bee stings. Some people get allergies to food like milk, soy, or peanuts.

Allergy tests help allergists pinpoint the cause of allergic reactions and devise a treatment plan to help manage your symptoms. Some of the standard allergy tests include the following:

• Skin prick (scratch) test: During the test, the healthcare professional will use a thin needle coated with potential allergens to prick the skin on the back of the forearm. They may also pour droplets of these allergens or use a device to scratch and puncture the area lightly. After that, they will wait for some time to check for allergic reactions like redness of the skin, round spots called wheals, and rashes. Allergists use the test to check for food, airborne, and penicillin allergies.
• Intradermal skin test: Allergists perform intradermal skin tests when skin prick tests are inconclusive or negative. They will inject small amounts of the allergens into the outer layer of the skin and check for allergic reactions. Intradermal skin tests can also help to check for allergies to medications, irritants in the air, and insect stings.
• Patch test: Allergists use patch tests to identify the cause of contact dermatitis. In this test, they apply a patch (bandage) with allergens on it to your skin. They may also put drops of allergens on the skin and cover them with a bandage. After that, they instruct you to go home and come back after 48 or 96 hours. Then, they remove the patch or bandage and check your skin for signs of allergic reactions.
• Bloog (lgE) test: Allergists can also identify allergies with the help of blood tests. They will extract and send a sample of your blood to a lab and add allergens to the sample to measure the immunoglobulin E (IgE) levels. IgE is an antibody involved in allergies. A total IgE test can help determine how much of it your body makes when exposed to potential allergens.
• Oral challenge test: In this test, allergists will supervise patients as they eat or swallow a small amount of suspected food allergen. They will also provide medical supervision to treat any symptoms that may develop during the test.

The most common chronic health issue treated by allergists in the U.S. 

Asthma is a majorly prevalent chronic lung disease in the U.S. In this condition, the airways narrow, swell, and produce excess mucus—making breathing difficult. If not managed well, asthma can be a life-threatening condition. Although there is no cure for asthma, one can control the symptoms with the help of medications for everyday healthy living. 

The exact cause of asthma is unknown. However, researchers believe that the following factors increase the risk of asthma:

• Family history of respiratory diseases or asthma
• Allergies 
• Respiratory infections, like a respiratory syncytial virus, can damage children's lungs.
• Exposure to environmental factors that irritate the airways, such as fumes, smoke, second and third-hand smoke, dust, and all other allergens

Asthma attack triggers are the factors that can cause an instant asthma attack or something that worsens your asthmatic symptoms. Just like symptoms, triggers for different people are also different. Some factors that act as triggers are:

• Workout or exercise
• Mold develops in damp places
• Pests, such as cockroaches and mice
• Pets, their fur, or pet dander can cause irritation
• Dust mites
• Different atmospheric pollutants
• Strong chemicals or smells
• Occupational exposures
• Tobacco smoke

Signs and symptoms of asthma

Asthmatic symptoms vary from person to person. Before knowing about the symptoms, let us first discuss an asthma attack. An asthma attack is a sudden discomfort in breathing. During normal breathing, muscles around the airways are relaxed, allowing air to move quickly and easily. However, the following three things happen during an asthma attack:

• Bronchospasm is when the muscles around the airways constrict, narrowing the airways and restricting airflow.
• Inflammation of the airways makes them swollen and thus limits airflow.
• Excess mucus during an asthma attack clogs the airways, making breathing difficult.

The most common symptoms of asthma are:

• Shortness of breath
• Chest pain
• Coughing and wheezing
• Sleeping issues due to difficulty in breathing or coughing and wheezing
• Cough lasting for more than a week
• Cold lasting for more than ten days
• Pale or sweaty face
• Blue lips or fingernails

Treatments for asthma

As mentioned above, asthma has no permanent cure as it is a chronic condition. Prevention and management of the symptoms are the keys to controlling the disease and living an everyday life. The allergist may prescribe an instant relief inhaler in case of a sudden asthma flare-up. The appropriate medications for an asthmatic patient depend on age, symptoms, and triggers. 

There are two types of medications to control asthmatic symptoms, i.e., long-term medications to reduce inflammation in airways and bronchodilators or quick-relief inhalers for instant, short-term relief during an attack. Moreover, some patients may also need allergy medications to relieve the symptoms. Long-term medications are generally taken daily, including corticosteroids, leukotriene modifiers, combination inhalers, and thiophene. However, if the doctor recommends, quick-relief medications are accepted only during an attack or before exercise.

Are allergies life-threatening? 

While most people have mild to moderate allergy symptoms such as skin rashes, itching, watery eyes, and a runny nose, some may experience a more severe allergic reaction. Severe reactions may be confined to one part of the body or may occur in the whole body at the same time. The most severe form of an allergic reaction is called anaphylaxis and can be life-threatening if not treated immediately. An anaphylactic reaction can be triggered by many different types of allergens (substances that are not particularly harmful that cause allergic reactions). Some examples of common triggers include an insect sting, a specific food (such as peanuts and shellfish), certain plants or pollen, latex in rubber products, or a medicine. In some instances, a first-time exposure to a specific allergen may result in a mild reaction, while repeated exposures may cause more serious reactions.

Further, those with allergies who have never experienced an anaphylactic reaction have a chance of it occurring in the future. Those who have had one in the past are at risk of having one in the future as well. Most severe reactions occur within seconds or minutes after exposure to the allergen. Some occur after several hours, mainly if the allergen is a food and leads to an allergic reaction after it has been consumed. In very rare cases, reactions develop after 24 hours. It is also important to note that a second anaphylactic reaction, also known as a "biphasic reaction," can occur 12 hours after the initial reaction has happened. 

The most dangerous symptoms of anaphylaxis affect a patient's breathing and/or cardiovascular system, i.e., the heart and blood pressure. Other symptoms include- 

• Loss of consciousness
• Severe shortness of breath
• Lightheadedness
• A rapid or weak pulse
• Nausea 
• Vomiting
• Wheezing or difficulty breathing

In case you or a loved one experiences an anaphylactic reaction, seek emergency medical care immediately. You must call 911 or a local emergency number right away. If you are aware of your allergies and carry an epinephrine auto-injector (Ex, Auvi-Q, EpiPen, etc), administer it immediately. Even if your symptoms subside after the severe reaction, you still need to visit a doctor as soon as possible who can ensure your symptoms do not return after the effect of your injection wears off. 

Can allergies be cured? 

As per the American College of Allergy, Asthma & Immunology (ACAAI), allergies cannot be completely cured. However, depending on the kind of allergy you have, there might be treatment options available that can help you manage your allergic symptoms. One example is immunotherapy. This preventative treatment is for people allergic to pollens, dust mites, and bee venom and involves gradually dosing the patient with the allergen, causing an allergic reaction in the patient's body. The immune system may then produce a 'blocking antibody,' which reduces allergy symptoms when the patient is exposed to that specific allergen again. These gradual, incremental increases will ultimately help the immune system become less sensitive to that allergen in the long run. Therefore, immunotherapy may help to decrease the risk of a severe allergic reaction and help patients live more comfortably. 

Only in rare instances might an individual outgrow their allergies. For example, a child allergic to foods like soy, eggs, milk, or wheat when they are young may outgrow those allergies when they become adults. However, it is essential to note that outgrowing your allergies is not guaranteed, and it is not possible to predict when or how a person will outgrow their allergies.

Find the best allergist near you in Austin, Texas

You must consult an allergist if you experience asthma signs or symptoms, such as persistent wheezing or frequent coughing. Early treatment for asthma may reduce the risk of permanent lung damage and prevent the condition from worsening over time. 

You can search for the best allergists in Austin using the Zocdoc website or the app. You can enter your locality to filter out the available providers in your area. You can further search according to your symptoms. Once you enter your symptoms or locality, Zocdoc will list the best healthcare specialists. You can see the comprehensive bios of each doctor, including their qualifications, accreditations, affiliations, awards, areas of expertise, experience, licensure, ratings, and spoken languages, on their Zocdoc profiles.

You may also filter your search for doctors who accept your insurance plan. Don't know about your insurance plan? Well, no need to worry. You can use Zocdoc's insurance checker option. Alternatively, you can get auto-filtered results for providers within your insurance network by updating your Zocdoc account's insurance information. You can also visit the Zocdoc app and upload a picture of your health plan card to get filtered results. Check out Zocdoc's patient help center for more insurance-related FAQs.

Moreover, you can also book an appointment per your schedule using our date filter. You can filter your search by doctor's gender, age, hospital affiliations, and whether or not they treat kids. You can also search for an allergist near you who offers online video visits before in-person appointments. Doctors who provide video visits will have a purple icon on their profiles. 

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Statistics of asthma in Austin, Texas

As per the asthma surveillance report published by the Centers for Disease Control and Prevention, in 2018, nearly 24.8 million Americans had asthma. There are approximately 1.6 million emergency room visits for asthma every year. As per the Texas Department of State Health Services, about 7% of children in Texas, i.e., more than 492,000, have asthma.

August is not a good month in Texas for people with weak lungs and hearts. Air pollutants like ground-level ozone, or "smog," increase in concentration as temperatures rise. Going outside on days with high ozone levels can trigger an attack in people with asthma. The most vulnerable groups are young individuals, older adults, and persons who work outside.

As per the Behavioral Risk Factor Surveillance System (BRFSS), in 2008, there were reportedly around 1,271,563 adults in Texas who had asthma. In Texas, adult lifetime asthma prevalence was about 12.2%, and adult current asthma prevalence was nearly 7.3% in 2018, compared with the U.S. rates of approximately 13.3% and around 8.5%, respectively. Moreover, in 2008, approximately 590,563 children in Texas had asthma. Child lifetime and current asthma prevalence were about 14.1% and almost 9.2%, compared with the 38 participating states' rates of around 13.3% and about 9.0%, respectively.

Sources

WebMD[1]

WebMD[2]

WebMD[3]

Mayo Clinic[1]

Center for Disease Control[1]

Center for Disease Control[2]

Texas Department of State Health Services

American College of Allergy, Asthma & Immunology[2]

American College of Allergy, Asthma & Immunology[3]

American College of Allergy, Asthma & Immunology[4]

American College of Allergy, Asthma & Immunology[5]

Cleveland Clinic[1]

Mayo Clinic[2]

WebMD[4]

MedlinePlus

Cleveland Clinic[2]

The content herein is provided for general informational purposes only and is not a substitute for professional medical advice, diagnosis or treatment. Medical information changes constantly, and therefore the content on this website should not be assumed to be current, complete or exhaustive. Always seek the advice of your doctor before starting or changing treatment. If you think you may have a medical emergency, please call your doctor or 9-1-1 immediately.