We are soon entering winter, a season conducive to the development of allergies. Allergist Habib Chabane explains how to recognize and treat them.
– Why doctor: What are the most common allergies in winter?
Dr. Habib Chabane – The most common allergies in winter are those triggered by house dust mites. Indeed, the drop in temperature leads to less ventilation of the rooms, to putting on heating and drying the laundry inside, which creates a microclimate favorable to these allergens.
Pollen allergies can also develop in winter, because in some areas, trees start emitting pollen very early in the year.
– How do they manifest?
They can manifest themselves in adults as well as in children, in the form of rhinitis, conjunctiva, bronchitis, asthma, eczema, infection, etc… The eyes can also sting and the nose run or clutter, with repeated sneezing.
– What questions should the general practitioner ask when faced with an allergic patient?
No symptom is specific to the allergy: you can have a stuffy nose and itchy eyes for different reasons. The general practitioner must therefore first question the patient about his symptoms and their temporality: when do they occur, how often and following what activities? He must then ask the patient about his possible allergic history, personal or family. Finally, you have to ask the person if their symptoms are lateral or bilateral (the allergy is often bilateral, editor’s note).
I recall on this occasion, because many doctors are mistaken on this subject, that it is not because the prescription of antihistamines works that the patient is necessarily allergic.
– What test should the general practitioner prescribe to be sure that his patient is allergic?
To find out if it is a respiratory allergy, the general practitioner must prescribe a test for the specific IgE of pneumallergens, not to be confused with an identification test.
– When should you consult an allergist?
First, you should only go to see a specialist when the allergy is confirmed by the kind of test I just mentioned.
You should also consult an allergist if, despite the treatments put in place by the general practitioner, the symptoms return regularly and remain disabling on a daily basis, hindering, for example, social life, work or sleep. An allergic person who, despite taking several medications (eye and nose drops, tablets, etc.), still suffers from residual symptoms can also make an appointment with a specialist.
– Concretely, what more does an allergist offer patients?
The allergist can do a complete assessment, which is used to precisely identify the allergen(s) responsible for the symptoms. Once the problematic allergen has been identified, the allergist will either propose eviction measures (house dust mites, molds, cats, dogs, etc.), or a desensitization process. In the long term, this can allow the patient to considerably reduce his treatments, or even to do without them.
– What progress has been made recently in terms of testing?
The arrival of new biological tests now makes it possible to know much more precisely what the person is allergic to, because they detail the composition of the problematic elements. For example, in grass pollen, there is not one allergen, but at least 12, which the old tests could not detail.
– What does it change for people with allergies?
This makes it possible to set up much more targeted treatments, which are therefore shorter and more effective.
– Can we speak of a real revolution for your profession?
Most likely. Molecular allergology has changed the way we apprehend and take care of patients. The treatments we use are also better standardized than before. Finally, new recommendations from national and international allergology authorities have made it possible to identify new rules of good practice concerning desensitization. For example, since 2018, we no longer do subcutaneous injections, as this could have serious or even fatal side effects.
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