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Allergies affect up to 50 million people in the United States. Allergic rhinitis (also known as hay fever) is the most common form of allergy. Symptoms can include runny nose, stuffy nose, sneezing, itching, post-nasal drip, cough, headache, and itchy/watery eyes. Allergic rhinitis can lead to other problems such as asthma, sinusitis (sinus infections), ear infections, recurrent sore throats, altered sleep, fatigue, irritability, and poor school or work performance. Allergic rhinitis may be seasonal in some people while it occurs year round for others. The most common triggers of allergic rhinitis are trees, grasses, weeds, pet dander, dust mites, cockroaches and molds. Treatment options include avoidance measures, medications, and allergy immunotherapy (allergy shots). The first step in achieving effective allergy relief is allergy testing to determine which substances are causing your allergies. Your doctor can then help you learn how to reduce your exposure to those allergy causing substances. Additionally, there are a wide variety of over-the-counter and prescription medications available to help reduce your allergic symptoms. The most effective therapy, allergy immunotherapy, is the one treatment option which can permanently decrease a person's allergies. A board certified allergist has specialized training and expertise in diagnosing and treating allergies and asthma. Our allergists will work with you to develop an individualized allergy treatment plan that works best for you. Fortunately, the vast majority of allergy sufferers can find excellent relief with the right treatment plan.

Finding out what you are allergic to is an important first step in obtaining relief from your allergies. A board certified allergist has extensive training in interpreting allergy tests combined with a detailed medical history in order to determine the specific things that trigger a patient's allergies. Allergy tests can be performed in adults and children of any age. In most cases an allergy skin test is the best test because it is accurate, quick, and causes minimal to no pain. A small drop of the suspected allergen is pricked or scratched on the surface of the skin. Many suspected allergens can be tested at the same time. If you are allergic, you will develop a small area of redness and swelling at the test site. In some cases the doctor will recommend an additional step in testing where a small amount of the allergen is injected into the skin. The results of skin tests are available within 20 minutes and the doctor will then meet with you to discuss the results, teach you how to avoid those allergens, and will discuss treatment options with you.

Asthma affects over 20 million people in the United States. It can lead to life threatening attacks and is one of the leading causes of absences from school and work. Asthma results from inflammation and obstruction of airflow in the bronchial tubes. The most common symptoms of asthma are coughing (especially at night or with exercise), trouble breathing, shortness of breath, chest tightness or wheezing. Many people do not know that they have asthma and sometimes a cough that won't go away is the only symptom of asthma. Asthma can be triggered by things that don't bother most people, but can make inflamed lungs worse if you have asthma. Asthma triggers can include pollen, dust mites, animal dander, mold, smoke, strong odors, colds, respiratory infections, weather changes, stress, and exercise. If you have asthma, your allergist will help you find out which triggers make your symptoms worse. A majority of patients with asthma have allergies that can trigger their asthma, and keeping their allergies under good control is an important step in obtaining optimal asthma control. Additionally, patients need to make sure they take their controller medications as prescribed, learn how to recognize and treat worsening asthma, have regular follow-up appointments with their doctor, and have periodic lung function tests done. Fortunately, there are excellent asthma treatment options available today which are safe and effective. Asthma is a chronic condition which requires a team effort between the patient and doctor in order to achieve good control while minimizing both the amount of therapy needed and the impact on the patient's life.

Food allergies are on the rise and occur in up to 8% of children and 3% of adults. Food allergy reactions can be life threatening, so people with food allergies need to be very careful to avoid their food triggers. Many food allergies begin in young children, although they can develop at any age. People can become allergic to almost any food, but some foods are more likely to cause food allergies such as milk, eggs, peanuts, tree nuts, fish, shellfish, soy and wheat. Food allergy reactions usually occur within minutes of eating a food, but reactions can be delayed up to a couple of hours. Reactions can be variable and can include symptoms such as hives, swelling, itchy skin, runny nose, congestion, itchy eyes, vomiting, diarrhea, cramping, lightheadedness, throat swelling or trouble breathing. If you think you may have a food allergy, your allergist will combine your detailed history with allergy skin tests, allergy blood tests, and/or oral food challenges to determine whether or not you are allergic. Being diagnosed with a food allergy can be scary for some patients, but we will help you learn how to manage your condition and minimize its impact on your life. Patients who are found to be allergic will receive education on how to avoid coming in contact with your food allergens as well as how to treat a food allergy reaction if one occurs. Fortunately, many children will outgrow their food allergies over time and we will be able to help you know when it will be safe to return to eating that food again.

Allergy immunotherapy also known as “allergy shots” works by gradually exposing the patient to increasing doses of the substances to which he or she is allergic. Allergy immunotherapy desensitizes the patient so that over time their allergy symptoms are reduced or even eliminated. While allergy medications can control symptoms, when you stop taking medications, your allergy symptoms will return. Allergy immunotherapy on the other hand is the only treatment that can lead to permanent remission of your allergies. After completing a course of immunotherapy, many patients can stop immunotherapy and still have excellent ongoing relief.  Research shows that allergy immunotherapy can also help prevent the development of new allergies and asthma.  Allergy immunotherapy has been proven to be effective in treating allergic rhinitis (hay fever), allergic asthma, insect sting allergy, and atopic dermatitis. Our practice prescribes high dose allergy immunotherapy in line with guidelines from the ACAAI and AAAAI national allergy societies. Use of high dose allergy immunotherapy maximizes both the immediate benefits and the duration of those benefits. Allergy immunotherapy should be considered for people who don’t respond completely to treatment with medications, who experience side effects from medications, who don’t want to take medications indefinitely, who have allergen exposure that is unavoidable, or who desire a more permanent solution to their allergic problem. For many patients, allergy immunotherapy can be a great option that allows them to come off of their allergy medications and to achieve long lasting relief.

It is estimated that over 2 million people in the United States are allergic to insect stings from bees, wasps, hornets, yellow jackets, or fire ants. Patients with insect sting allergy are at risk of having a life threatening reaction each time they are stung. Symptoms of an insect sting allergy can include generalized itching, hives, excessive swelling, difficulty breathing, throat swelling, dizziness, drop in blood pressure, or loss of consciousness. Patients who think they might be allergic to insect stings should see an allergist for insect allergy testing. Patients who are found to be allergic will be educated on methods to avoid future stings and will be prescribed self-injectable epinephrine to use in an emergency. Patients with insect sting allergy are also recommended to undergo a course of allergy immunotherapy in order to dramatically reduce their risk with future stings. Here in the Lowcountry, fire ants cause a majority of insect sting allergies. Additionally, because fire ants are so widespread and active year round in the Lowcountry, it can be very hard to avoid future stings even with appropriate precautions.

An oral food challenge may be performed when the medical history and results of allergy skin tests or blood tests are inconclusive. The in-office oral food challenge can be a safe and definitive method for determining whether or not a patient is allergic to a particular food. During a graded oral food challenge, the patient is fed small amounts of the suspected allergy causing food in increasing doses under strict supervision by an allergist. Oral food challenges are given in graded doses in the office so that if a reaction occurs it will usually be mild and the doctor will be immediately available to treat the reaction. Oral food challenges are also essential in order to determine when a patient may have outgrown their food allergy and be able to begin eating that particular food again. Accurate diagnosis of food allergies is very important because many people who think they may be allergic to a particular food in fact are not allergic and don't need to continue to worry about avoiding that food. Additionally, patients need to know which foods they are truly allergic to and which foods if eaten could potentially cause a life threatening allergic reaction.

Patch testing is performed when patients have an allergic skin condition called contact dermatitis. Contact dermatitis occurs when a patient becomes allergic to something which is coming in contact with their skin. Patients with contact dermatitis have recurrent or chronic episodes of itchy skin rashes. Patients can often become allergic to fragrances, dyes, preservatives or other chemicals in their personal care products. Patch testing is performed to help determine which contact allergens the patient is allergic to. Our patch testing is based off the North American Contact Dermatitis Group series of allergens consisting of the most common contact allergens. Hypo-allergenic tape is used to apply the contact allergens to the patient's back and the patches should be kept dry while in place. The patient then returns 2 days later to have the patches removed and read. There will be an additional appointment to have the patch testing results read 4 days after they were placed. The patient will be scheduled to meet with the doctor to review the results of the testing. We will teach you how to avoid your particular contact allergens, how to look for those allergens in your personal care products, and will give you lists of products which would be safe for you to use based off your specific test results.

We can perform a variety of lung function tests in our offices which along with your history and physical exam can allow the doctor to determine whether you have asthma and whether your asthma is under good control. We perform spirometry, methacholine challenge testing, and exercise challenge testing. We also are one of a few locations in the state which can perform impulse oscillometry which can provide objective measurements of lung function in young children down to age 3 who are unable to cooperate with other forms of lung function testing.