Allergy Treatment — Skin, Food and Seasonal Allergy in Pakistan

What Is an Allergy?

An allergy is an overreaction of the immune system to a harmless substance (allergen) — such as pollen, dust, food, or medication. The body releases a chemical called histamine, which causes the familiar allergy symptoms.

Types of Allergy and Their Symptoms

1. Allergic Rhinitis (Nasal Allergy)

• Blocked or runny nose
• Sneezing
• Itchy, watery eyes
• Itchy throat

2. Skin Allergy (Eczema, Hives, Contact Dermatitis)

• Rash (urticaria/hives)
• Itching
• Red, dry skin
• Swelling
• Burning sensation

3. Asthma

• Difficulty breathing
• Wheezing (whistling sound when breathing)
• Cough (worse at night)
• Chest tightness

4. Food Allergy

• Swelling of the mouth and lips
• Stomach pain, vomiting, diarrhoea
• Skin rash
• Severe: Anaphylaxis

5. Anaphylaxis (Emergency!)

• Extreme difficulty breathing
• Widespread swelling throughout the body
• Throat closing up
• Falling blood pressure, loss of consciousness
• Call 1122 immediately

Allergy Treatment

1. Avoid the Trigger

The most important step. Identify what causes your allergy and reduce exposure as much as possible.

2. Antihistamines (First Line)

Non-Sedating (Modern, Suitable for Daytime):

• Fexofenadine (Telfast 120/180 mg): Most prescribed in Pakistan
• Cetirizine (Zyrtec, Cetzine 10 mg): Affordable and effective; mild drowsiness
• Loratadine (Claritin 10 mg): Safe for daytime use
• Desloratadine (Aerius 5 mg)

Sedating (Better for Night-Time):

• Diphenhydramine (Benadryl)
• Hydroxyzine (Atarax 25 mg) — strong, also used to aid sleep
• Chlorpheniramine (Polaramine)

3. Nasal Sprays

• Steroid sprays: Nasonex, Flonase, Beconase — safe for long-term use; best treatment for allergic rhinitis
• Saline rinse: Salt-water nasal rinse — very helpful in Pakistan's dusty environment
• Decongestant: Otrivin (xylometazoline) — for 3–5 days only; can become habit-forming

4. Eye Drops

• Antihistamine: Patanol, Zaditen
• Mast cell stabiliser: Cromolyn

5. Topical Steroids (Skin Allergy)

• Hydrocortisone 1% (mild) — available over the counter
• Betamethasone (Betnovate) — moderate strength; prescription required
• Clobetasol (Dermovate) — potent; short-term use only

Caution: Long-term steroid cream use on the face is harmful. Avoid so-called "whitening creams" such as Faiza in Pakistan — they contain hidden steroids and cause permanent skin damage.

6. Severe Cases

• Oral steroids (Deltacortril, Solu-Medrol): For acute flare-ups; prescription only
• Immunotherapy (allergy shots): Long-term solution; requires an allergist
• Biologics (Xolair, Dupixent): For severe asthma or eczema

Seasonal Allergy (Hay Fever) in Pakistan

In Pakistan, March–April sees peak pollen from paper mulberry, plane trees, and grasses. September–October brings ragweed and wheat pollen.

Tips:

• Reduce outdoor activity in the morning and evening (peak pollen times)
• Shower and change clothes after coming in from outside
• Keep windows closed during peak season
• Use air conditioning with a HEPA filter
• Take a daily antihistamine (Telfast/Zyrtec) throughout the season
• Use a saline nasal rinse daily

Dust Allergy

Dust allergy is very common in Karachi and Lahore. Dust mites thrive in bedding.

Tips:

• Wash bed sheets and pillow covers in hot water weekly
• Use anti-allergen pillow covers
• Minimise carpets — hard floors are better
• Use a HEPA air purifier
• Vacuum with a HEPA-filter vacuum cleaner
• Air pet bedding and carpets in the sun outdoors

Skin Allergy / Eczema

• Moisturise: Cetaphil, CeraVe, Eucerin — apply daily
• Mild soaps: Dove, Cetaphil — sulphate-free
• Hydrocortisone 1% for mild cases
• Stronger steroids short-term on prescription
• Cool compresses for itching
• Keep nails short to avoid scratching damage
• Wear cotton clothing (synthetic fabrics cause irritation)

Food Allergy

Common allergens in Pakistan: peanuts, eggs, fish, wheat (coeliac disease), and milk.

Diagnosis:

• Keep a food diary
• Skin prick test or IgE blood test
• Elimination diet

Severe food allergy: Always carry an EpiPen (epinephrine auto-injector) — availability is limited in Pakistan. Specialist consultation is essential.

Drug Allergy

Common culprits: penicillin/amoxicillin, sulpha drugs, aspirin/NSAIDs, contrast dye.

Symptoms range from a rash and hives to anaphylaxis in severe cases. A medical alert bracelet is recommended in Pakistan.

Smog and Allergy in Pakistan

• Wear an N95 mask outdoors
• Use a HEPA air purifier indoors
• Seal windows during smog season
• Vitamin C and omega-3 supplements help reduce inflammation
• Stay well hydrated daily

When to Go to the Doctor or ER Immediately

• Extreme difficulty breathing
• Swelling of the throat or tongue
• Widespread hives with weakness
• Falling blood pressure or loss of consciousness
• Skin rash accompanied by fever
• New food reaction in a child
• Symptoms persisting for more than 2 weeks

Conclusion

Allergy is treatable — but prevention is the most important strategy. Antihistamines are safe and effective, but avoiding the trigger is the true long-term solution. Do not ignore signs of anaphylaxis (difficulty breathing, swelling) — it is a medical emergency. On Ilaaj AI, you can consult an allergist for testing and a tailored treatment plan, from home.