Understanding the Allergic March
It was a pleasure for me to give a talk on the Allergic March. Essentially the allergic march describes how children first starts off with eczema. This is closely followed by food allergy. These children then go on to develop allergic rhinitis which can end up with asthma.
Everyone always asks me, why do I focus so much on eczema (atopic dermatitis)? The reason is that eczema is the spark that ignites the progression of allergic diseases. If allergic rhinitis or food allergy is the first step, you can bet that I will be focusing on that specific topic instead.
I spoke about:
- How the eczematous skin can cause the development of food allergy.
- To prevent food allergy you have to introduce foods early.
- Why you should not use skin care products that contain food proteins, as doing so will cause food sensitization and food allergy.
United Airway Disease: The Link Between Allergic Rhinitis and Asthma
I introduced the concept of “United Airway Disease” in which Allergic Rhinitis and Asthma are closely linked. A child with uncontrolled allergic rhinitis will lead to nasal congestion. An obstructed nose will lead them to breathe through the mouth. This constant mouth breathing can cause facial and dental maldevelopment with crooked teeth, receding jaw and narrow cheeks.
It turns out that mouth breathing also will cause increased risk for the development of Asthma as found out through the Nagahama Study. Thus it is important to evaluate a person with Allergic Rhinitis for Asthma and vice versa.
Steroid Phobia and the Importance of Proper Steroid Use
My co-speaker Prof David Price and I discussed about how patients are getting misinformation from the internet and “steroid phobia”.
This “steroid phobia” can affect the proper management of patients with eczema, allergic rhinitis and asthma.
I want to explain that steroids, is neither good nor bad. It is simply a tool and it is a very helpful tool to help treat and manage allergic diseases. The key is maintaining proper follow-up and following the doctor’s instructions on use.
I mentioned how some patients may just be seeking a simple reassurance from their doctor.
And some patients may need time to digest the information that was given.
I have previously written on asthma and inhaled steroids growth concerns. The point I want to make is, the proper use of steroids by a trained doctor is safe.
In asthma, the inhaled steroids will keep your disease under control.
If you do not use your inhaled medications out of fear, the severe asthma attack will necessitate oral or IV steroids use for rescue. The steroid rescue dose that you receive is much much higher than what is in your asthma controller medication.
Allergen-Specific Immunotherapy: A Long-Term Solution
There is a treatment of allergic rhinitis and asthma called allergen specific immunotherapy. This treatment is a disease modifying therapy which alters your immune system’s allergic response.
This treatment has shown to be effective, safe, reduces medication use and also has long term benefits.
Information You Can Use
- Allergic March: Eczema often triggers the progression of allergic diseases—followed by food allergies, allergic rhinitis, and asthma.
- United Airway Disease: Allergic rhinitis and asthma are linked. Uncontrolled rhinitis can cause mouth breathing, leading to facial/dental issues and increased asthma risk.
- Steroid Phobia: Steroids are a safe, effective tool when used properly under medical supervision. Avoiding steroids out of fear can lead to more severe health issues.
- Allergen-Specific Immunotherapy: A disease-modifying treatment for allergic rhinitis and asthma that reduces medication use and offers long-term benefits.