How can I treat my persistent allergy symptoms at 33?
Patient's Query
Hello doctor,
I would like to consult about my persistent allergic flares. I am a 33-year-old female with no known history of hypertension, diabetes, or asthma.
For the past three months, I have been experiencing morning colds, nasal congestion, pruritic rashes, and itchy eyes. I do not have a fever, cough, shortness of breath, headache, or sore throat. I initially took Montelukast plus Cetirizine once a day and applied Olopatadine eye drops four times a day, but these did not relieve my symptoms.
I then added Loratadine 10 mg at bedtime and tried a hypoallergenic diet. After two weeks without relief, I began taking Prednisone 5 mg with a tapering dose for two weeks, but there was still no significant improvement.
Currently, I am still taking Montelukast plus Cetirizine once a day, and Loratadine 10 mg at bedtime, but my rashes and sneezing are worsening.
Please help.
Thank you.
Hello,
Welcome to icliniq.com.
Regarding the treatment, I suggest you continue your current medications. I would like to know how much Prednisolone you initially started with. Additionally, you should start using intranasal steroids to help relieve your nasal symptoms. Use Fluticasone furoate, two puffs in each nostril twice daily. If the antihistamines are making you drowsy, you may take Cetirizine in the evening and Loratadine in the morning.
Apply a mild steroid cream like Betamethasone valerate 0.1 percent to the affected skin. For a long-term solution, you should undergo skin prick testing to determine what you are allergic to. Skin prick testing is more effective than blood allergy testing. Both methods check for food and aeroallergens.
Remember to stop taking antihistamines five days before the test. This will help us identify the offending agent and provide the right advice to avoid that particular allergen. Use mild soap and wear loose-fitting clothes to avoid friction over the affected areas of your skin.
I hope this has helped you.
Please feel free to reach out to me again in case of further queries.
Thank you.
Patient's Query
Hi doctor,
Thank you for the reply.
That was a comprehensive answer. I am just frustrated that the medications are not working, and new lesions are appearing. The pruritus is very disturbing and is affecting my quality of life.
I started with a 5 mg tablet, twice daily for one week, then reduced to once daily. Today, I restarted taking Prednisolone 5 mg again because of the new lesions. The reason I started with a low dose is that I am concerned it might compromise my immune system, especially during the pandemic.
Please help.
Thank you.
Hello,
Welcome back to icliniq.com.
It would be wise to consult a dermatologist as well, just to rule out any fungal cause for your skin issues. The steroid dose you are on is safe and will not increase your susceptibility to the COVID-19 virus. Nevertheless, please keep taking all the necessary precautions.
I hope this helps.
Thank you.
Same symptoms don't mean you have the same problem. Consult a doctor now!
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