An allergy is an overreaction of the immune system to something that poses no threat to most people. That's why it can be so confusing: for some, it ends with a runny nose and watery eyes, while for others, symptoms can be much more severe. 

Patients often grapple with similar questions: is it really an allergy, what am I allergic to, and what tests should I take? Then there are questions about treatment: is avoiding the allergen enough, are medications necessary, or is desensitization worth considering? In practice, a calm transition from symptom observation, through diagnosis, to the decision on treatment is crucial.

Experts point out that winter is a good time to plan diagnostics, discuss the purpose of therapy, and prepare for the next season, instead of reacting only when the symptoms return with a vengeance.

Allergy year by step: from diagnosis to desensitization and treatment. 

The text is based on an interview with Dr. Kamil Bar in the medical podcast CO NA TO WOJ ELEKARZ. 

This material is for educational purposes only and does not replace an individual medical consultation. If you are concerned about your health, seek medical advice!

Step 1: Notice the pattern of symptoms and name the problem

Start with simple questions that clarify the situation:

• When do symptoms appear: seasonally or year-round?
• Under what circumstances: after contact with an animal, after eating a specific food, at home, outdoors?
• How much do they affect everyday life and quality of life?

This is important because having an allergy (or a condition within the allergic spectrum) doesn't always mean you can easily escape the trigger. The situation is different when symptoms appear infrequently and under predictable conditions (e.g., occasional contact with an animal) than when we're dealing with exposure that's difficult to limit.

Step 2: When to seek medical attention?

The conversation strongly emphasizes a practical approach: it is worth seeking help when:

• you are not sure what is causing your allergy and the symptoms keep coming back,
• the symptoms are so bothersome that they require ongoing treatment,
• you suspect that avoiding the allergen is unrealistic or very difficult.

The doctor helps to sort out the symptoms and assess whether we are talking about an allergy as such or a disease from the group of allergic diseases, which cannot always be "caught" in standard tests.

Step 3: Understand what tests can (and can't) show

Most often we think about:

• skin tests,
• blood tests: specific IgE antibodies.

The expert points out that these methods only detect one type of allergy: IgE-dependent. However, there are more mechanisms involved, so the diagnostic scope can be broader.

Step 4: Other diagnostic methods. 

Depending on the suspicions, the doctor may resort to:

• patch tests (e.g. when contact allergy to metals or chemical ingredients present in everyday products is suspected),
• provocation tests are considered a very valuable diagnostic tool.

Provocation tests involve the controlled "exposure" of a patient to a suspected factor and observation of the patient's reaction. It was emphasized during the interview that in selected, milder situations (after medical evaluation), they can even be performed at home. However, it is important to always discuss them with a doctor.

Step 5: Choosing a strategy: avoidance, symptomatic treatment, and sometimes causal treatment

Three pillars of conduct emerge in the conversation:

Allergen avoidance

This is the simplest method when contact is rare or can be realistically limited.

Symptomatic treatment

In inhalant allergies, it's important to distinguish whether the allergen is seasonal or year-round. The expert also discusses some practical rules:

• during times of high allergen concentration, limit exposure (e.g. less airing),
• choose the time of your walk when there are fewer allergens in the air (e.g. after rain),
• If the symptoms are particularly bothersome, sometimes a change of environment helps (e.g. a trip to the seaside during a difficult period).

There's also an important tip regarding symptomatic medications. Patients often start using them only "mid-season," while some treatments work best after regular use over a period of time. Therefore, if you know a difficult period is approaching, it's worth planning your treatment in advance and maintaining it consistently throughout the exposure period.

Desensitization (specific immunotherapy)

This method was mentioned in the conversation as treating the cause of the allergy. However, it requires:

• determining what exactly the desensitization is to be performed for,
• confirmation of validity (among other things, to ensure that the therapy makes sense),
• awareness that the standard cycle lasts 3–5 years.

Managing allergies rarely comes down to a single decision or a single test. A calm, step-by-step approach is most helpful: recognizing the symptom pattern, consulting, appropriately selected diagnostics, and then consciously choosing a strategy. From allergen avoidance, through symptomatic treatment, to desensitization if indicated.

And here we come back to winter. For people with seasonal allergies, it's often the best time to go to an allergy clinic, discuss the action plan and prepare for the season.