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Now Playing: The Hives, ‘Antidote’

Urticaria might sound like an abandoned Tolkien character, but it’s actually a lot more familiar than that. More commonly known as hives, urticaria is the medical name for the pale red bumps that appear on the skin often as a reaction to certain allergens, though they can also occur because of the cold, or unknown reasons. In most cases urticaria is classed as ‘acute’, that is, provoked as a temporary reaction to one-time stimuli, but can also manifest as ‘chronic’, lasting over long periods of time for a few different reasons, usually linked to autoimmune reactions and infections.

Today we’re going to be mainly focusing on the short-term, acute cases of urticaria, but much of what will be discussed is also of use for chronic sufferers and can help alleviate symptoms all the same. Urticaria can be a symptom of an allergic reaction; food allergies, allergy to the venom of stinging insects, reactions to medication, latex allergies. When urticaria a symptom of allergic condition it requires assessment by a specialist as the condition might be dangerous or even life-threatening.


Spontaneous urticaria can be inducible by a variety of physical triggers, such as temperature change, pressure or even exercise it is usually not dangerous but very uncomfortable as it can last up to 6 weeks. That being said, around half the triggers of acute urticaria are as yet unknown. Thankfully, there are universal ways of managing these outbreaks regardless of the catalyst.


The good thing to know is that, in acute cases, most instances of urticaria don’t actually require any treatment at all! Simply avoiding the trigger for a few days, or sometimes even only a few hours, can provide enough respite to see the condition subside and normality resume. If it persists beyond this, or if you find it too irritable to cope with, it can be wise to seek advice from a consultant, but there are some things you can do in the meantime to help alleviate your symptoms. As often discussed on this blog, non-sedating over the counter antihistamines will help work wonders in managing your irritation. As the body reacts, it releases histamine that affects blood vessels and nerves resulting in urticarial flares or swellings. Antihistamines will block receptors to histamines on blood vessels and nerves, while not curing the root of the problem, will make the symptoms, such as itching, far more bearable.


If the urticaria persists or is of sufficient intensity, then antihistamines in the standard may not do enough, and in this instance seeing a consultant will be required. Documenting the symptoms in SymTrack hive app on daily basis will be very important in making a decision on the required treatment. In accordance with global urticaria guidelines, your consultant will recommend the course of action.


Urticaria isn’t usually enough to stop anyone in their tracks, but it can be a nasty irritant and leave individuals feeling embarrassed about being seen in public. The important thing to remember is that you are not alone, and in fact, there are dedicated Urticaria Centres of Reference and Excellence (UCARE) that specialise in this condition and even a World Urticaria Day annually on the 1st October. You can visit for more information on this, join their forum to speak to other people, and check out upcoming events too.

Now Playing: The Hives, ‘Antidote’

If you would like help and advice and to better understand your allergies, please book an appointment in our UCARE centre on our website

Hay Fever: The Gift You Didn’t Expect This Christmas

Merry Christmas! This year, many people will find hay fever symptoms below their Christmas tree, ones which several will mistake for a common cold, but contrary to belief, hay fever in winter really does exist. An easy way to differentiate between hay fever or a virus is itchiness. If someone is experiencing itchiness in their eyes, throat, or ears, it is likely that they have hay fever. It is vital for those who typically suffer from hay fever to understand the differences between hay fever and a cold because a majority of people with asthma, also suffer from pollen allergies. Therefore, if they mistake their allergy for a cold, the aftermath can be very bad. Those with asthma and hay fever must pay attention to the early signs to understand how to effectively deal with the possibility of an asthma attack.


Changing patterns of reactions to a variety of pollens are increasingly being reported around the world. Global warming, as well as the use of genetically modified plants, pose unexpected risks to allergy sufferers. Our colleague from Global Allergy Network, Professor Peter Schmid-Grendelmeier, University Hospital of Zurich, Switzerland reported an interesting observation regarding tree pollen allergies.  Hybrid trees were planted, and when they blossomed, combined with high winter resistance, many schoolchildren began to experience unusual allergy symptoms around Christmas time. Find out more


How can you slow your symptoms down?

Luckily, there are a few noteworthy medicines and practices that can help anyone suffering from hay fever clear up their symptoms during (and after) the holidays. Hay fever sufferers can opt to take antihistamines, or they can start immunotherapy, which is a method that progressively teaches the system not to react to an allergen by giving specially manufactured allergen the person is allergic to under the tongue. Improvement usually starts after 4-5 month and eventually, after a few years, the immune system will tolerate the pollen and won’t send out signals that it is a strange foreign substance.


Hay fever is a nasty allergy to deal with every winter, spring, summer, or autumn – or all four seasons for the unlucky few. Thus, it is essential for all allergy sufferers to keep up to date with the earth’s changing climate and the research going into new diagnostic methods and treatment options.

For help and advice on hay fever or for more information on immunotherapy please book an appointment with our consultants on our website



Ragweed – New allergen is increasing in the UK

It is that time of year again. The sound of Christmas songs full of cheer and snow fill your ears, but all you can focus on is the never-ending snot dripping out of your nose. Your head is pounding; you want to stick a pencil down your throat and scratch it, and you can’t stop sneezing. It is not precisely the holly jolly Christmas that you expected. Hay fever is becoming more and more common throughout the UK and Europe due to the rise in warmer autumns and winters over the last few years. The increase in temperature is causing a rapid growth of a pesky plant known as ragweed. This herbaceous rebel is wreaking havoc on an increasing amount of citizens each year.

Warmer weather in the UK

The ever-increasing temperatures in summer, autumn, and spring are propelling the growth of ragweed. This October, according to the, the average temperature across the UK was warmer than usual, which is nice for people who enjoy meandering outside, but worrisome for those with pollen allergies and asthma.


Last year, “the UK mean temperature was 5.9 °C, which is 2.0 °C above the 1981-2010 long-term average, and the eighth warmest December in a series from 1910.” Unfortunately, ragweed grows at a much quicker rate under a warmer climate and the allergen-causing plant now, reportedly, is the cause of many prolonged hay fever symptoms worldwide. To make matters worse, ragweed can grow back after it has been removed and its pollen tends to live on for many, many years.


Due to the steady increase in ragweed, hay fever sufferers will experience an onset of symptoms, ones that should not be mistaken for the common cold.


For help and advice relating to hay fever and allergies, please book an appointment with our consultants on our website

The Truth Behind Cow’s Milk Allergy in Infants

A few minutes ago your child consumed their first-ever bottle of cow’s milk-based formula and now you watch as your baby screams, vomits, and develops skin irritations. You frantically search your mind for the reason behind your child’s onset of symptoms. It’s highly likely that your baby is experiencing an allergic reaction to cow’s milk, which is a common allergy amongst newborns and babies. However, there are two major types of allergies in babies: IgE-mediated and non-IgE-mediated. As a parent, it is important to understand the differences between IgE-mediated and non-IgE-mediated reactions.


What are the causes behind your child’s cow’s milk allergy?

During IgE-mediated reaction to milk, the IgE antibodies on allergy cells (mast cell) bind to milk, which propels the cell to unleash a variety of allergic mediators, that cause swelling, rashes and even dangerous systemic reactions. These can occur within minutes of your child consuming cow’s milk. Some children experience a non-IgE-mediated reaction, which results in a slower onset of symptoms resulting in gastrointestinal symptoms (the IgE antibodies do not play the same role during these reactions).


The difference between IgE-mediated and non-IgE allergies

As aforementioned, IgE-mediated allergies cause your child to react within minutes of consuming cow’s milk, whereas non-IgE reactions are delayed by hours to days. IgE-mediated allergies are easy to recognise, as your child will likely vomit, break out in hives, develop a redness on their skin and eczema and the most dangerous is that the child can get massive reaction known as anaphylaxis.

If your child has a non-IgE reaction, it will be less severe, but pretty troublesome and should still be taken seriously. Your child will experience gastrointestinal issues (such as diarrhoea, vomiting, constipation, and there may be blood in the stool for harsher cases), skin irritations, and possible respiratory problems. In milder cases, a non-IgE allergy to cow’s milk may be confused with lactose intolerance (Lactose intolerance is a common condition in adults but not in children). With this in mind, it is important to note that lactose intolerance in children is usually secondary (associated with some other digestive problem) and affects the bowels (diarrhoea, bloating, pain) because the child is unable to digest the sugar in milk: lactose.


How can you fix it?

Have no fear! Your child will likely grow out of his or her cow’s milk allergy. But, for now, there is a high chance that you just want to learn how to stop your baby from vomiting all over the carpet. For those with IgE-mediated allergies, it is advised that you switch your baby’s formula to eHF (Extensively Hydrolyzed Formula) or AAF (Amino Acid Formula). If you are breastfeeding, it is essential that you cut out all cow’s milk from your diet. However, before anything, please have your child tested for allergies.


The process of adjusting to your child’s non-IgE-mediated allergy depends on its severity. If your child has more serious symptoms, it is recommended that you follow a similar procedure (the one listed above) for those with an IgE-mediated allergy.


Mothers breastfeeding children with mild non-IgE-mediated allergies can try the process of cutting cow’s milk from their diet. If your child shows no symptoms, you can slowly bring cow’s milk back into your diet. If the child doesn’t react when you begin consuming cow’s milk again, he or she unlikely to have an allergy at this point in time. If the symptoms reappear after you add cow’s milk back into your diet, then it is crucial that you eliminate all cow’s milk from your diet yet again. Your child’s symptoms will likely fade as you do, which is a telltale sign that they do have an allergy. Bring your baby to allergy consultant for testing, before giving any cow’s milk.


Parents who choose to use formula rather than breastfeed can follow a similar route, except you will use an eHF formula for the elimination phase and a cow’s milk-based formula instead of you, yourself consuming cow’s milk.

It is important to note that a cow’s milk allergy is the most common allergy among newborns and your child will most likely grow out of it. However, should problems persist or you would like some help and advice, please book an appointment with our consultants on our website


If you would like further information, click here to find more about food allergy in children and young people from the National Institute for Health and Care Excellence.

Hay Fever Desensitisation

At this time of the year, you might not necessarily be worried about hay fever. Plummeting temperatures and general lack of spore abundant plant life can often make winter an ideal respite for those of us who live in fear of the phrase ‘high pollen count’. However, what you may not be aware of is that the family of hay fever, asthma, and eczema often coexist in the same individuals. Partly because they share many genetic risk variants that can affect immune-related genes. Thanks to research by a consortium of medical researchers, we now understand more about the relationship between these shared genetic origins.


This is the time of the year to start treatment – desensitisation that can change the underlying cause of allergy and prevent you from being a victim to hay fever once the weather warms. With that in mind, we take a look at how to handle your allergies and reduce their impact.


Understanding Hay Fever

Medically speaking, hay fever is a relatively modern development. As medicine improves and changes in lifestyle have helped develop immunology to many chronic infectious diseases. As a result, hay fever has blossomed (if you’ll forgive the pun). The influence of diet and a lack of microbiome diversity have actually contributed to the emergence of hay fever, and its impact can often occur at a very early point after birth. Straightforwardly put, if you have hay fever, it’s likely that you’ve had it almost since you were born.


Managing and Desensitising

So what can be done about it? Thankfully, the worst reactions to hay fever are often at a younger age, but with age comes increased susceptibility to the eczema side of this coin, and such irritations will often first emerge during puberty and can last for several years.


Arguably the first commonly used method for combatting both hay fever is Cetirizine Hydrochloride, more commonly known as a non-drowsy antihistamine. When hay fever strikes, your immune system releases chemicals into your body to expel the allergen. These are known as histamine and other bioactive substances, and their job is to get whatever is irritating you, out of you. All that sneezing, tearing up, and itching is actually your body expelling whatever is causing you grief!

Antihistamines work by reducing or ‘blocking’ the effect of histamine on its receptors on blood vessels and nerves and thus lessens the need to sneeze, rub, or scratch.



Should antihistamines prove ineffective for you, you may want to consider specific immunotherapy that teaches your immune system not to react to allergens. Such therapy has proven incredibly effective against a variety of allergens but is frequently underutilised as a resource. Sublingual allergy treatment is safe and effective. It needs to be started at least four months before the season, and it results in desensitisation by placing medication under the tongue every morning for two minutes, the process is both safe and prosperous.


Allergen-specific immunotherapy involves administering to the patient with gradually increasing doses of the relevant allergen until the patient builds up a tolerance to that allergen. In cases of allergic rhinitis (that’s hay fever, to you and me) this method has been proven an effective treatment to a variety of catalysts, including tree pollen, grass pollen, and even cat and dog allergies. What’s more, studies have shown that the patient’s symptoms often improve even when they were resistant to antihistamines and conventional drug therapy. In some cases, after three to five years of treatment, the allergy is almost entirely overcome.


If you find yourself suffering from hay fever or other allergic problems book an appointment with our consultants. You can contact us on our website

Immunotherapy allergy treatment

International consensus on allergen immunotherapy-II: Mechanisms, standardization, and pharmacoeconomics
This month, JACI presents the second portion of the comprehensive international consensus (ICON) statement on allergen immunotherapy. The ICON statement is an effort of the International Collaboration in Asthma, Allergy and Immunology (iCALL) that includes the European Academy of Allergy and Clinical Immunology (EAACI), the American Academy of Allergy, Asthma and Immunology (AAAAI), the American College of Allergy, Asthma and Immunology (ACAAI) and the World Allergy Organization (WAO). Jutel et al. review the evidence on how allergen immunotherapy (AIT) works and summarize what lies on the horizon (J Allergy Clin Immunol 2016; 137(2): 358-368).

A number of mechanisms underlie an allergic response to a substance such as grass pollen, house dust mites, or bee venom. Allergen immunotherapy involves slowly increasing exposure to an allergen over time, ideally resulting in a patient’s increased tolerance and clinical improvement. The literature indicates that administration of AIT leads to early decreases in the susceptibility of mast cells and basophils to respond to environmental proteins, even in the presence of elevated allergen-specific immunoglobulin (Ig)E. Desensitization is followed by allergen-specific T-regulatory (Treg) and B-regulatory (Breg) cell generation and regulation of allergen-specific IgE and IgG4. In the longer term, changes in memory T- and B-cell compartments and shift in the balance of type 1 T-helper (Th1) and type 2 T-helper (Th2) cells result in sustained improvement.

Effects of Anaphylaxis on the Body

Effects of Anaphylaxis on the Body

Immune System


The Effects of Anaphylaxis on the Body

Written by Ann Pietrangelo | Published on August 25, 2014
Medically Reviewed by George Krucik, MD, MBA on August 25, 2014

You may have a food intolerance or a minor allergic reaction to something you come into contact with, but that pales in comparison to anaphylaxis. Almost any substance can be an allergen, including foods and insect bites or stings. The cause can’t always be pinpointed. The first time you’re exposed to the substance, your immune system learns to recognize the foreign invader. In anaphylaxis, when you’re exposed again, your immune system has an exaggerated response that affects the whole body and may put your life in danger. Symptoms may begin within seconds and they can progress swiftly.

The first line of treatment is usually adrenaline, because it can turn things around quickly. Once you’ve experienced anaphylaxis, you’re always at risk, so you should take great caution to avoid the triggering substance.

– See more at:


Wheat allergy oral immunotherapy for children

Wheat allergy oral immunotherapy for children

“most of the children that received this new oral immunotherapy treatment were able to eat 100 grams of wheat bread without side effects. This result has overcome the risk of accidental ingestion by patients with this allergy. This research could be the basis for large clinical trials with more patients with the aim of assessing the therapeutic benefit of this new approach.

Wheat is one of the most frequent childhood food allergies (about the 35% at the age of 12). ”

Study assesses therapeutic benefits of new oral immunotherapy for children allergic to wheat

Cat Dog pet allergy Treatment

Cat Dog pet allergy Treatment

Consultants in the London Allergy and Immunology Centre can help to diagnose allergy to animals and in many cases advice can be given how to avoid symptoms with  treatment can significantly improve allergy to pets.

Cat Dog pet allergy Treatment

Atopic Dermatitis Food Allergy

Atopic Dermatitis Food Allergy

Loss-of-function variants of the filaggrin gene are associated with clinical reactivity to foods

  1. C.D. van Ginkel1,2,*,
  2. B.M.J. Flokstra–de Blok2,3,
  3. B.J. Kollen3,
  4. J. Kukler1,
  5. G.H. Koppelman1,2,† and
  6. A.E.J. Dubois1,2,†

DOI: 10.1111/all.12569

Atopic dermatitis Food allergy

Atopic dermatitis Food allergy




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