Allergist: what the doctor does and when to see one

An allergy is a reaction of the immune system to a substance that does not bother most people. Symptoms can be mild, but in some people the reaction is very serious. An allergist helps determine what exactly triggers the reaction and how to reduce the risk.

Who is an allergist-immunologist

Allergology is a branch of medicine that studies allergic reactions and diseases, their causes, mechanisms of development and manifestations, and methods of diagnosis, prevention, and treatment. In practice, an allergist, also called an allergist-immunologist, works with complaints in which the body's defense system responds to a false alarm: the immune system fights not microbes but pollen, food, or animal fur. The role of heredity and environment is still debated: both genes and living conditions probably matter. It is useful to remember that an allergy is not a "weak immune system" or a sign that the defenses have "failed": they are working, but choosing the wrong target.

What an allergy doctor does

The task of an allergy doctor is to find the culprit of the reaction and distinguish allergy from conditions with similar symptoms. Allergology covers a wide range of diagnoses: allergic rhinitis and conjunctivitis, hay fever, urticaria, atopic dermatitis, bronchial asthma, Quincke's edema, reactions to foods, animals, insect stings, and medications. Common allergens:

• tree and grass pollen, which causes seasonal runny nose;
• house dust mites;
• foods such as peanuts, milk, and eggs;
• animals, most often cats and dogs;
• bee and wasp stings, as well as some medications.

People with allergies are often sensitive to several substances at once, so finding the cause requires patience.

What symptoms lead people to see an allergist

Reasons for consultation include runny nose and sneezing, red or watery eyes, pain and tenderness around the cheeks, eyes, or forehead. Respiratory reactions cause cough, wheezing, and shortness of breath. On the skin, there may be raised rash — urticaria, itching, and redness; on brown and black skin, redness is harder to notice. Abdominal symptoms include diarrhea, cramps, bloating, nausea, and vomiting. Swelling of the eyes, lips, mouth, or throat is a separate symptom that requires vigilance. A reaction may appear within minutes or several hours after contact.

What tests an allergist performs

The doctor may order skin and laboratory tests. A skin prick test is when a small amount of allergen is applied to the skin and checked for a reaction. Blood tests are also available. In some cases, a food challenge is used: the product is given gradually in increasing amounts under specialist supervision. Some tests are performed in a specialized clinic, to which the doctor writes a referral. If a person sees a specialist, the specialist can provide a plan describing how to manage the allergy. Such a plan is not a substitute for in-person monitoring but a working document for the patient and their family.

When allergy requires urgent medical attention

A routine reason to see a doctor is suspected allergy in oneself or a child: recurring symptoms without an obvious cold, seasonal runny nose, rash after food or a sting. Urgency is needed when the reaction goes beyond runny nose and rash. A severe reaction — anaphylaxis — requires immediate hospital care.

Allergy itself is not a reason to call an ambulance; 103 or 112 — if lips, mouth, throat, or tongue suddenly swell, breathing becomes very fast or difficult, a feeling of suffocation appears, the throat tightens or swallowing is difficult, the skin, tongue, or lips turn blue, gray, or pale, the person suddenly becomes confused, drowsy, or dizzy, someone has lost consciousness and does not wake up, a child has gone limp and does not respond as usual.

This material is for reference and does not replace a doctor's consultation: only a specialist at an in-person appointment can make a diagnosis and choose a management approach.

This content is for reference and does not replace a doctor's consultation. Medical disclaimer