Effective Allergy Treatment
According to the ICD-10 classification, allergies are categorized as T78.4. Contrary to popular belief, allergies are not just a seasonal issue—they often persist throughout the year, as many allergy sufferers can attest. While springtime brings the most complaints of worsening symptoms, many people struggle with allergies on a daily basis. Various symptoms and discomforts indicate that the body is reacting abnormally to allergens, producing histamine. Histamine, in turn, is responsible for all the bothersome—and sometimes dangerous—effects of allergies. However, this doesn’t mean that medicine is powerless against them. Thanks to medical advances and growing knowledge about allergies, new antihistamines and effective treatments continue to emerge.
Types of Allergy Medications
There is a wide variety of allergy medications available on the market—ranging from tablets and syrups (which contain antihistamines) to different types of sprays that can help alleviate allergic rhinitis (hay fever). Allergy medications also include antihistamine ointments or creams for skin allergies.
First vs. Second-Generation Allergy Medications
The main difference between first- and second-generation allergy medications is clear: newer antihistamines do not cause drowsiness. First-generation drugs affect the nervous system and often have sedative side effects. As a result, many younger patients not only experienced allergy symptoms but also struggled with concentration due to their medication. When second-generation antihistamines became available, this problem was largely eliminated.
These newer medications contain safe, effective compounds that block histamine without the bothersome side effects (like drowsiness or brain fog), allowing allergy sufferers to function normally even during heightened allergen exposure.
Common Second-Generation Antihistamines:
Levocetirizine – Zyx, Xyzal, Alergimed, Cezera, Contrahist, Lirra, Zenaro
Bilastine – Clatra, Adablix, Bilaflex, Bilagra, Bilant, Bilargena, Clatexo
Desloratadine – Aerius, Jovesto, Hitaxa, Alerdes, AlergoTeva, Aleric Deslo Active, Dasergin, Dasselta, Deslodyna, Desloratadine, Dynid
Other slightly older second-generation antihistamines include:
Cetirizine – Zyrtec, Alermed, Allertec, Amertil, Cetip, Letizen
Loratadine – Claritine, Flonidan, Loratadine, Loratan
Fexofenadine – Fexofast 180, Telfast, Telfexo, Allegra, Allerec
Rupatadine – Rupafin, Rupaller, Rupatadine, Rupiron, Rupoklar, Ruporix
Some medications like astemizole and terfenadine have been withdrawn from the market.
Always consult a doctor before starting any allergy medication.
Prescription Antihistamines (Tablets and More)
Antihistamines can be taken in many forms: tablets, intravenous or intramuscular injections, topical applications, or nasal sprays. Common prescription options include clemastine, hydroxyzine, cetirizine, and ketotifen.
These are usually the first choice in symptomatic treatment of most allergy types, including respiratory, food, and contact allergies. They are especially effective for:
Atopic asthma
Atopic dermatitis
Allergic rhinitis
Allergic conjunctivitis
First-generation antihistamines like clemastine are more often used for skin reactions, while second-generation drugs are preferred for respiratory symptoms.
Prescription Nasal Sprays for Hay Fever
Most antihistamine nasal drops are available over-the-counter. However, corticosteroids for nasal use require a prescription. These powerful anti-inflammatory drugs:
Unblock nasal passages
Reduce nasal discharge
Decrease tissue swelling
Relieve mucosal irritation
These are considered essential medications for hay fever, though they only treat symptoms—not the root cause.
Nasal Drops for Allergies
Allergic rhinitis (hay fever) is an inflammation of the nasal and sinus mucosa. Key symptoms include:
Watery nasal discharge
Nasal congestion
Mucosal irritation, itching, pain
Itchy/red eyes
Cough and shortness of breath (often accompanied by conjunctivitis or asthma)
Modern medicine lacks many causal treatments for hay fever (except for lengthy and inconsistent immunotherapy). Most available options are symptomatic, including nasal sprays and drops.
Choosing the Right Nasal Drops for Allergies
Common medications in nasal allergy drops and sprays include:
Antihistamines (first- and second-generation) – block histamine receptors, stopping histamine release.
Corticosteroids – powerful anti-inflammatory agents that reduce swelling, redness, pain, and mucus. They are more effective than antihistamines but carry a higher risk of side effects (e.g., dryness, irritation, bleeding), especially in children.
Vasoconstrictors like xylometazoline and oxymetazoline – provide rapid but short-lived relief.
Over-the-counter antihistamine nasal drops often include:
Antazoline
Diphenhydramine
Combined with naphazoline, a vasoconstrictor.
These provide quick symptom relief but are not suitable for children.
Nasal Sprays – OTC and Prescription
OTC sprays often contain azelastine, a second-generation antihistamine with fewer side effects. Prescription-only sprays may include corticosteroids like:
Budesonide
Beclomethasone
Fluticasone
Nasal Spray or Drops – What to Choose?
Antihistamines are less potent but safer (especially second-gen). Corticosteroids are more effective but carry higher risks. Often, both are used in tandem. Also, reducing exposure to allergens (dust mites, pollen, pet dander) is key to managing symptoms.
Eye Drops for Allergies
Eye drops are essential for those with allergic conjunctivitis. Common allergens include:
Dust mites
Pet dander
Pollen (especially grasses and birch)
Plant enzymes
Air pollution
Chemicals in household products
Most eye drops treat only symptoms, not the underlying allergy.
Prescription Allergy Eye Drops
These include:
Emedastine – an H1 receptor antagonist that reduces itching, redness, and swelling
Dexamethasone – a strong corticosteroid for allergic eye inflammation
Fluorometholone – another corticosteroid
Caution: long-term use of corticosteroids may cause vision damage or loss.
OTC Allergy Eye Drops
Ketotifen – blocks multiple histamine receptors and reduces symptoms like redness and itching
Sodium cromoglycate – a mast cell stabilizer used for allergic conjunctivitis and corneal inflammation
Allergy Eye Drops for Children
Most allergy eye drops are approved for children over 3. For younger kids, use is generally not recommended due to lack of data—not due to confirmed adverse effects. Always consult a pediatrician.
Allergy Eye Drops in Pregnancy
Pregnancy requires caution with all medications. Corticosteroids should only be used if the doctor determines the benefits outweigh the risks (e.g., birth defects). Antihistamine eye drops should only be used if absolutely necessary and after consulting a physician. Most allergy eye drops are also contraindicated during breastfeeding.
Allergy Ointments
Topical treatments for skin allergies include:
Glucocorticosteroids – powerful anti-inflammatory and anti-allergic agents
Antihistamines – block histamine receptors
These come in oral tablets, creams, ointments, and gels, some of which are OTC, others prescription-only.
OTC Allergy Ointments
Hydrocortisone – the weakest corticosteroid, safe for mild skin conditions like atopic dermatitis
Dimetindene – a topical H1 antihistamine, effective for up to 4 hours
Prescription Allergy Ointments
Stronger corticosteroids like betamethasone dipropionate are available only on prescription. They are also immunosuppressive and reduce overall immune responses to allergens.
Nickel Allergy Ointments
Nickel can cause:
Local contact dermatitis
Widespread contact dermatitis
Systemic nickel allergy syndrome
Treatments include:
Clobetasol propionate
Betamethasone dipropionate
Flumethasone pivalate
Hydrocortisone acetate
Use the weakest effective steroid to minimize side effects.
Sun Allergy Ointments
This isn’t a classic allergy—it doesn’t involve the immune system directly. Typical ointments include:
Zinc oxide
Vitamin A
Prevention with high-SPF sunscreens is key.
OTC Antihistamines
Most over-the-counter allergy medications are second-generation antihistamines, sold in small doses and packaging. They are useful for sudden symptoms or when a prescription runs out, but are often expensive and not covered by insurance. Prescription versions typically come in larger packs with partial reimbursement.
Always follow dosage instructions and consult a pharmacist or doctor. Self-treatment can mask symptoms and delay proper care.
Allergy Desensitization (Immunotherapy)
While allergies are often lifelong, immunotherapy can train the immune system to react less intensely. Though not a cure, it can significantly improve quality of life. After completing therapy, symptoms may persist but will be less severe—possibly allowing for a pollen season without severe hay fever, supported by medication as needed.
Home Remedies for Allergies
Popular home remedies include:
HEPA air filters
Maintaining humidity and cleanliness
Herbal teas, compresses, or DIY antihistamine ointments
However, herbal teas may contain pollen or allergens. For example, chamomile can cause contact allergies, while marigold is less allergenic. St. John’s wort does not help with allergies.
Anti-Histamine Diet
Sometimes symptoms stem from histamine intolerance. The anti-histamine diet avoids foods that are high in histamine or trigger its release, such as:
Spicy foods
Tomatoes
Fermented vegetables
Citrus fruits
Strawberries
Cocoa
Wine
Fresh foods are best. A good anti-histamine diet includes:
Rice, potatoes, millet, buckwheat, quinoa
Oats, flaxseed, sourdough rye bread
Fresh eggs, cottage cheese
Fresh or frozen light-colored fish, poultry, rabbit, game
Most vegetables (except tomatoes, spinach, eggplant)
Fruits like apples, berries, cherries, peaches, apricots, melons, mango
Antihistamines for Children – Use With Caution
Allergy symptoms in children can be tricky to diagnose and treat. Testing for food or milk protein allergies can be done early. Consult a pediatrician familiar with the child’s history. Medications (tablets, syrups, or drops) must be prescribed by a doctor and dosed carefully—never exceed the recommended amount, even during flare-ups.
Allergy Medications in Pregnancy
Severe allergies can endanger pregnancy. If you are allergic and pregnant, talk to your doctor immediately. Gynaecologists experienced in such cases will adjust dosages accordingly—likely lower than usual, possibly with more noticeable symptoms. Share your allergy history during your first prenatal visit.
Treating Allergies Under Medical Supervision
All allergy treatment should be supervised by a doctor. During an online consultation, a physician will assess symptoms and prescribe the appropriate therapy. Only prescription antihistamines and prescription-strength topical treatments can ensure effective allergy management.
Don’t have time for an in-person allergist visit?
At Dimedic.eu, our online clinic offers tailored antihistamine treatment. Existing patients can renew prescriptions without contact. New patients will be called by a doctor for a consultation.