Is my allergic reaction serious?

Allergic reactions are very common, but occasionally they can be life-threatening. Knowing whether your symptoms are a minor annoyance or a medical emergency is important. This article will go over the signs and symptoms of mild, moderate, and severe allergic reactions so you can determine when to seek immediate medical care.

What Causes Allergic Reactions?

An allergic reaction occurs when your immune system overreacts to a normally harmless substance called an allergen. Common allergens include:

• Foods like peanuts, tree nuts, shellfish, eggs, milk, soy, and wheat
• Medications like penicillin or aspirin
• Insect stings from bees, wasps, hornets, or fire ants
• Latex
• Pet dander
• Pollen
• Mold

When you’re exposed to an allergen, your immune system produces antibodies called immunoglobulin E (IgE). These antibodies trigger the release of chemicals like histamine into your bloodstream, which cause allergy symptoms. The more times you’re exposed to an allergen, the more severe your reactions may become.

Common Allergic Reaction Symptoms

Allergic reaction symptoms typically occur within minutes to a few hours after exposure. They range from mild to life-threatening depending on the person and their sensitivity. Common symptoms include:

• Itchy, watery eyes
• Sneezing and runny nose
• Itchy throat
• Hives, itchy red bumps on the skin
• Coughing or wheezing
• Swollen lips or tongue
• Nausea, vomiting, diarrhea
• Dizziness, lightheadedness

Symptoms involving the skin, nose, eyes, mouth, and gastrointestinal tract tend to be milder. More severe reactions can cause breathing difficulties like wheezing, coughing, tightness in the throat, or shortness of breath. The most dangerous symptom is anaphylaxis, which causes the immune system to go into overdrive and can lead to dangerously low blood pressure, loss of consciousness, and even death.

Mild Allergic Reaction Symptoms

Mild allergic reactions involve symptoms confined to one part of the body, such as:

• Itchy, watery, red eyes (allergic conjunctivitis)
• Sneezing, runny or stuffy nose (allergic rhinitis)
• Itchy mouth or minor swelling of the lips, tongue, face, or around the eyes
• A few hives or mild itching
• Mild nausea, stomach pain, or discomfort

With mild reactions, you may not feel entirely well, but the symptoms are not too bothersome. These kinds of localized, mild symptoms do not indicate an emergency. However, it’s still a good idea to take an oral antihistamine containing diphenhydramine (Benadryl) or cetirizine (Zyrtec) to help calm the reaction. You can also use eye drops or nasal sprays to relieve eye or nose symptoms.

Moderate Allergic Reaction Symptoms

Moderate allergy symptoms are a step up from mild and involve more than one part of the body. Signs can include:

• Widespread hives or itchy rash
• Swollen lips, tongue, eyes, or face
• Runny nose, itchy eyes, and gastrointestinal symptoms like vomiting or diarrhea
• Abdominal pain and cramping
• Lightheadedness or dizziness
• More severe nausea and vomiting
• Noticeable wheezing or coughing with some shortness of breath or chest tightness

When multiple body systems are affected or reactions spread, it signals a more systemic reaction that requires medical attention. You should take an antihistamine, but also seek prompt medical care. Call 911 or have someone drive you to urgent care or the emergency room. Epinephrine may be needed to halt progression of the reaction. Doctors will provide oxygen, IV fluids, monitoring of blood pressure, steroids, and additional medication like epinephrine to open airways and reverse symptoms.

Severe Allergic Reaction Symptoms

A severe, life-threatening reaction is called anaphylaxis. Symptoms involve widespread hives or flushing of the skin, swollen throat, wheezing, low blood pressure, dizziness, fainting, nausea, vomiting, diarrhea, and abdominal pain. The most dangerous symptoms that require immediate medical treatment include:

• Difficulty breathing, shortness of breath, wheezing, or coughing due to throat swelling
• Weak, rapid pulse or palpitations
• Confusion, fainting, loss of consciousness, or slurred speech
• Chest tightness or pain
• Skin turning blue or pale
• Dizziness, loss of balance, or feeling faint

Anaphylaxis has the potential to restrict breathing and cause dangerously low blood pressure and inadequate oxygen delivery to the brain and other vital organs. Death can occur within minutes without treatment. Call 911 immediately if any severe symptoms develop after an allergen exposure. Emergency epinephrine is required to reverse anaphylaxis. Most people with known severe allergies carry auto-injectable epinephrine like an EpiPen in case this occurs. However, if you experience anaphylaxis with no auto-injector available, you still must go to the ER right away for epinephrine and monitoring.

Risk Factors for Severe Reactions

While anyone can experience anaphylaxis, certain risk factors increase the chances:

• Having a history of past severe allergic reactions
• Being a teenager or young adult
• Having asthma, especially if poorly controlled
• Having multiple allergies or allergy to peanuts, tree nuts, fish, or shellfish
• Not having easy access to epinephrine or medical care

People at highest risk should have epinephrine auto-injectors available and get evaluated by an allergist. They may recommend immunotherapy allergy shots to help desensitize you to the allergen. Avoiding the allergen completely is also imperative. Using medical identification jewelry stating your allergy can alert others in an emergency as well.

Allergic Reaction First Aid

If you or someone else experiences an allergic reaction, quick action can halt progression and prevent a medical crisis:

• If symptoms are life-threatening, inject epinephrine or call 911 immediately.
• Move the person to fresh air if inhaled allergen triggered it.
• Loosen any tight or constrictive clothing and lay the person flat.
• Give antihistamine like diphenhydramine if able to swallow.
• Attempt to identify and remove the allergen if possible.
• Apply cool compresses to itchy areas.
• Monitor breathing and be prepared to perform CPR if needed.
• Keep them lying flat and legs elevated to prevent low blood pressure.
• Call emergency contacts like family if they lose consciousness.

Do not hesitate to call for help since early treatment of anaphylaxis can be lifesaving. If symptoms do not improve or the person loses consciousness, call 911.

When to Seek Emergency Treatment

Head to the ER, urgent care, or call 911 for any of the following scenarios:

• Difficulty breathing, tight throat, wheezing, or coughing
• Swelling of the lips, tongue, throat, or eyes
• Widespread hives all over the body or that keep spreading
• Signs of anaphylaxis like fainting, pale skin, weak pulse, confusion
• Nausea, vomiting, diarrhea, abdominal pain or cramping
• Dizziness, loss of balance, or fainting
• No improvement in symptoms after taking antihistamine medication

Do not drive yourself or let the person drive to the hospital, as anaphylaxis can progress rapidly and make driving unsafe.

Emergency epinephrine is the first-line treatment for anaphylaxis. Additional medications like steroids, antihistamines, oxygen, and IV fluids may be given to support breathing and blood pressure.

Allergy Testing

After a severe reaction, allergists can perform skin or blood tests to help identify your triggers. This allows you to strictly avoid allergens and have epinephrine on hand in case of accidental exposure. Common diagnostic allergy tests include:

• Skin prick testing: Drops containing allergen extracts are placed on your arm or back, then the skin is lightly pricked. If you’re allergic, a raised itchy bump will form within 15 minutes.
• Intradermal testing: Allergen extracts are injected just beneath the top layer of skin. A hive will form if you’re allergic.
• Blood tests: A blood sample is analyzed for IgE antibodies to known allergens.
• Oral food challenge: You ingest tiny doses of the suspected food allergen under medical supervision to confirm an allergy.

Identifying your allergies provides vital information to help avoid future severe reactions. Follow your allergist’s advice on management moving forward.

Anaphylaxis Treatment and Follow Up

After a severe reaction, you’ll need follow up treatment and management:

• Prescription for at least one epinephrine auto-injector to carry at all times.
• Recommendation to wear medical identification jewelry stating your allergy.
• Advice on strict allergen avoidance at home, work, school, restaurants.
• You may be prescribed antihistamines or inhalers for asthma.
• Your doctor may recommend immunotherapy allergy shots.
• Likely referral to an allergist for additional testing if the allergen is unknown.

Make sure to follow up with your primary care doctor and allergist as directed for ongoing management of this potentially life-threatening allergy.

How to Use an Epinephrine Auto-Injector

Epinephrine auto-injectors rapidly reverse anaphylaxis symptoms within minutes by raising blood pressure and opening the airways. Brand names include EpiPen, Auvi-Q, or Adrenaclick. Follow these steps to use an epinephrine auto-injector:

1. Remove the device from its carrying case.
2. Pull off the safety release cap.
3. Hold the injector with the tip pointing downward.
4. Aim and firmly push the tip straight into the middle of the outer thigh.
5. Hold in place for 3 full seconds to deliver the medication.
6. Remove the device and massage the injection site for 10 seconds.
7. Call 911 and seek emergency care immediately after injecting.
8. Note the time you gave the epinephrine.

Step-by-step instructions are also printed on the device label. Act quickly when using epinephrine on signs of anaphylaxis before symptoms progress.

Preventing Allergic Reactions

The best way to avoid an allergic reaction is to stay away from substances you’re allergic to:

• Read ingredient labels and avoid your food allergens.
• Watch for hidden ingredients in foods at restaurants.
• Ask about ingredients in unfamiliar foods or drugs.
• Wear a medical alert bracelet or necklace stating your allergy.
• Carry epinephrine auto-injectors and antihistamines when at risk.
• Avoid pet dander or have someone give medicine to your pets.
• Stay indoors when pollen and mold counts are high.
• Request allergen-free rooms when booking hotels.
• Clean often to remove dust and dander if allergic.
• Consider allergy shots to become desensitized.

Prevention is key to staying safe if you have known severe allergies. Carrying epinephrine, avoiding triggers, and getting prompt treatment can prevent progression to anaphylaxis.

Conclusion

Allergic reactions are very common but most are mild. However, severe life-threatening anaphylaxis can occur in some cases. Monitor your symptoms closely and watch for any signs of respiratory distress, low blood pressure, or widespread hives that keep spreading. Seek prompt emergency care for severe symptoms to halt progression and reverse the reaction immediately. With proper avoidance of triggers, carrying emergency epinephrine, and getting medical care when needed, severe allergic reactions can be effectively managed.