My daughter's allergies leave her with the usual symptoms of congestion, sneezing, headache, etc., but it's the itchiness in her ears and the roof of her mouth that really drives her crazy. She has tried all the prescription and nonprescription medications there are and nothing seems to help. Any suggestions?

Ken

It is a common mistake (made by allergy sufferers and their physicians) to think that allergies may be treated only with medications. Some of the most effective interventions are surprisingly simple. Here are the different approaches that you can take to treat nasal allergies:

• Medications. Before discussing alternative approaches, I think it's worth pointing out that there are a number of different kinds of drugs that can mute allergy symptoms. These medications can be used singly or in combination: antihistamines, nasal corticosteroid sprays and nasal cromolyn spray. Combinations are often effective even each medication fails individually.
  
• Avoidance and elimination. What sorts of allergies does your daughter have? Allergy testing can provide valuable information that will allow your daughter to avoid allergens or eliminate them from her environment. There are two general types of allergy testing: blood tests (to look for antibodies to specific allergens) and skin tests, in which a dilute solution of an allergen is scratched or injected into the skin of the back or forearm.
  It is impossible to discuss the wide range of avoidance/elimination strategies that are available, since much depends upon your daughter's specific allergies. Here are a few examples: use of a HEPA filter in the bedroom; frequent laundering of the bedding and vacuuming of the bedroom (don't forget to vacuum UNDER the bed); elimination of down comforters and pillows; barring pets from the bedroom or even from the home; replacing carpets with tile or wood flooring.

• Dilution. Anything that helps wash the allergen from the nasal cavity and throat will provide temporary relief from the symptoms of allergy. Your daughter can gargle with warm salt water or spray her nose with a saline spray. She can also learn to douche her nose with saline. When she first experiments with this, she may object strenuously; nevertheless, many people do this as a daily ritual -- just like brushing teeth.
  
• Desensitization. Allergy shots WORK. They are safe and effective. By receiving once- or twice-weekly injections of a dilute solution of allergen, the patient eventually becomes desensitized to that allergen. Disadvantages include inconvenience, expense, discomfort and the very real possibility that the patient's spectrum of allergies could change in the future. Thus, it makes no sense to undergo 12 to 18 months of allergy shots if one is planning to move in two years. In another region of the country, one might develop much different allergies.
  

On the other hand, there are many circumstances in which desensitization makes an enormous amount of sense. For example: If you are allergic to cats yet cannot bring yourself to not keep cats, then desensitization is an excellent option.

Many ear, nose and throat doctors specialize in allergy. There is also a specialty devoted to allergy; you may be able to find such a specialist (medical allergist) to care for your daughter.