If a person with allergies is never exposed to the allergen they are allergic to, they won’t have a reaction as the immune system won’t detect the allergen.

This is the core concept behind the current standard of care for allergies. If you prevent exposure to allergy triggers, you will prevent allergic reactions. Simple, right?

Well, unfortunately, there are some drawbacks to this approach despite it being an effective method.

The Omnipresence of Specific Allergens

Allergens such as pollen are everywhere. Even staying locked up in your home does not guarantee that you will be able to avoid pollen; despite your best efforts, you will encounter pollen eventually, making symptoms inevitable. Avoidance is not as effective against allergens that are omnipresent.

Accidental Exposure

Since humans do not have full control over the environment around them and do not have infinite awareness, accidental exposures happen. If you have a peanut allergy and eat a contaminated dish, your intent was to avoid peanuts, but now you are having an allergic reaction. Avoidance is not effective against accidental allergen exposure.

Physical and Mental Toll

Imagine having to avoid gluten every day. You have to be constantly aware of everything you eat and can’t enjoy things others take for granted. No cakes, sandwiches, pizza, donuts, bread, cookies, pasta, beer, cereal, etc. Imagine the energy someone has to use to avoid all of these things and the psychological impact of missing out. Avoidance takes a physical and mental toll on people.

These drawbacks indicate that allergen avoidance cannot be a standalone solution and there need to be other methods, such as medicines, that work alongside to shore up its weaknesses. Despite this, avoiding allergens is the best way someone can improve their quality of life with allergies. Researchers are working on better treatments, but in the meantime, it is important to be executing allergen avoidance as well as possible.

Avoiding Different Allergens

Understanding the different methods to avoid each allergen can help you reduce the levels of exposure to your allergens.

Food

Read allergen labels on food products³³

Food products are required to declare the presence of any of the nine major allergens by saying it “contains” allergens and listing them out. Allergens listed after “may contain” are not intended to be present in the food product, but despite good manufacturing practices, there is still a nonzero chance of the listed allergens being present.

Be extra cautious when eating out

Provide the chef or manager with a “chef card” that outlines foods you must avoid.³⁴

Review the menu carefully to find dishes that don’t signal the presence of your allergens.

Don’t eat at high-risk venues such as:

Buffets: Contain a wide variety of foods that are close to one another and involve people serving themselves, which increases the chance of contamination.

Bakeries: Use many of the nine major allergens and many baked goods are not packaged.

Restaurants that serve pre-made foods: The staff may not have an accurate list of ingredients for pre-made items and the chef does not have the ability to remove the problem ingredient.

Restaurants that use your allergens in most dishes: If you have a fish or shellfish allergy, going to a seafood restaurant increases your chance of accidental exposure.

Cook heat-labile allergens

Heat-labile allergens get destroyed when exposed to high heat, so cooking can remove their allergenic potential. Find out if any of the allergens you are allergic to are heat-labile as you may be able to eat them if cooked. For many of the foods that cause Oral Allergy Syndrome, the cooking process destroys the allergens and prevents reaction upon ingestion.

Pollen and Mold

Wear a face mask

Face masks are commonly used to prevent exposure to airborne illnesses such as COVID-19. Luckily, the same mechanisms that protect you from illness can be used against aeroallergens such as pollen or mold. Wearing a mask during pollen season is an effective option for reducing symptoms in people with pollen allergies.³⁵

There are also other variations that function similarly such as nasal filters³⁶, which are tiny filters placed directly into the openings of the nostrils.

If you also want to shield your eyes from aeroallergens you can wear sunglasses or goggles.

Sinus rinsing

Pouring a saltwater solution into one nostril and allowing it to flow into the other nostril washes out allergens and can help relieve symptoms.³⁷

1. Stand with your head over a sink or in the shower and tilt your head to one side.
2. Using a squeeze bottle, bulb syringe, or neti pot, pour or squeeze the saline solution slowly into the upper nostril.
3. Allow the solution to pour out your other nostril and into the drain. Breathe through your mouth, not your nose, at this time.
4. Repeat on the opposite side.
5. Try not to let the water go down the back of your throat. You may need to adjust your head position until you find the correct angle.
6. Gently blow your nose into a tissue when you’re done to clear out any mucus.

If you also want to rinse your eyes, you can gently rinse them with water or wipe them with a wet washcloth.

Check pollen and mold count

You can check the pollen and mold count for where you live, which can give you an idea of how much is outside. This data can signal the beginning or end of the pollen season, or give you a heads-up to alter your outdoor activities or preparation.

https://www.pollen.com/map - Provides a daily national allergy map and a local allergy report to help you keep informed on current pollen counts.

https://pollen.aaaai.org/ - Another option is the National Allergy Bureau, which provides accurate pollen and mold levels using different stations across the United States. Log into your account and select the locations you want to monitor. It appears some stations have stopped reporting data, so check the date to determine the accuracy of the data.

Proper ventilation

Keeping the windows shut will help keep outdoor pollen and mold from entering the home. Unfortunately, an airtight home can result in worse air quality due to indoor pollutants and high humidity. A good middle-ground solution would be using an air purifier in your airtight bedroom or office to minimize pollen and mold while ventilating the rest of the home to minimize indoor pollutants and keep indoor humidity below 50%. If your only concern is to minimize pollen exposure in the home, then keeping all the windows shut would be the best solution.

Shower before bed

Pollen collects in your hair, on your skin, and all over your clothes throughout the day. Washing off all the pollen by getting a shower and changing into clean pajamas helps keep your sleep pollen-free.

Clean up water leaks

It is important to clean up any moisture, water leaks, or water damage in the home to prevent indoor mold growth.

Relocate to locations that have less pollen and mold

Relocating to an area that has a lower concentration of your pollen or mold trigger can help reduce allergy symptoms. This could be a permanent move across the country or just a temporary vacation.

There is no pollen during the winter, so living in a location where there is a long winter would decrease the number of days you are exposed to pollen. Outdoor mold can be a problem on damp leaves or on grasses with melting snow, but during the heart of winter, it is not a concern.

Living near the ocean or other large bodies of water can result in lower outdoor exposure. Ocean breezes contain less pollen and mold than inland breezes because there is no pollen or mold out at sea to be transported by the wind. Also, if you like to swim in the ocean, you may get frequent sinus rinses from the waves.

Living in the mountains or other areas of higher elevations can help reduce exposure as pollen counts are typically lower at higher elevations.

Insects and pests

Relocate to locations that have fewer insects and pests

Relocating to an area that has a lower population of your insect and pest triggers can help reduce allergy symptoms.

In low-humidity environments such as mountains or deserts, there are lower populations of dust mites and cockroaches. Keeping your home at a relative humidity of 50% or less will help reduce the number of dust mites and cockroaches as these pests depend on water for survival.³⁸

During the winter, the majority of stinging and biting insects hibernate or die off, so your risk of encountering these insects is near zero. Living in a climate with a long winter would decrease the number of days you could encounter problematic insects.

Control dust and clean your home

Regularly dusting, using a vacuum with a HEPA filter, and using air purifiers help lower dust levels in the home. This reduces the amount of dust mite and cockroach allergens and the amount of food available to these pests.

Mattresses, sheets, pillows, and carpets are great homes for pests. Reduce or regularly wash these items in your home.

Don’t leave out food or crumbs as they can attract pests like cockroaches.

Seal your home

Use window screens with open windows and seal any cracks or gaps around the house to prevent pests and insects from entering the home.

Repellents and insecticides

If you have openings or a current infestation, lay food-grade diatomaceous earth in areas of concern that will not be disturbed easily by human or pet activity. Diatomaceous earth is a sedimentary rock that can eliminate insects with an exoskeleton when crumbled into a fine white powder. It works by attaching to the insects’ cuticle, piercing the exoskeleton, and causing death by desiccation (extreme dehydration). Diatomaceous earth works best when it is completely dry, so don’t get it wet or expose it to high humidity.³⁹ It is best practice to wear gloves, a face mask, and goggles while applying diatomaceous earth to prevent contact or inhalation as it can cause adverse health effects.

Neem oil is a contact insecticide completely safe for humans and contains at least 100 biologically active compounds that repel, make sterile, or eliminate various insects and pests.⁴⁰ You can mix 4 cups of warm water, 1.5 tsp neem oil, and 0.5 tsp gentle dish soap. Shake it and spray on areas of concern.

Avoid high-risk areas

Cover exposed skin and wear shoes when outdoors.

Be careful around flowering plants, tall grass, insect nests, and bodies of water as stinging and biting insects are concentrated in these areas.

Don’t attract, aggravate, or be bait

Avoid using products with strong perfumes, such as soaps, shampoos, and deodorants as these fragrances can attract insects.

Keep calm around stinging insects as panicking and swatting at them only increases your odds of getting stung.

The opposite is true for biting insects. Swatting or clapping not only gives you a chance to disarm the insect but psychologically motivates them to look somewhere else.⁴¹

Pets

The only way to completely avoid pet allergens is to not keep pets that you are allergic to in your home. If this is not an option for you, here are some things you can do to make the best out of a suboptimal situation.

Wash your pet

While not easy, washing your pet twice a week has been shown to reduce the number of allergens from dog hair and dander, and likely translates to other pets as well.⁴²

Isolate the bedroom

Keeping your bedroom air sealed from the rest of the house and preventing your pet from entering can help create an allergen-free environment in the home. This gives you an oasis and ensures you high-quality sleep by limiting allergic symptoms such as congestion.

Using an air purifier in this room or any room in the house can help to reduce the pet allergens that are present.

Clean your home

Regularly dusting, using a vacuum with a HEPA filter, and using air purifiers help lower pet allergen levels in the home.

Avoid direct contact

You should not touch your pet directly as the majority of pet allergens are in their fur and saliva. Wear long sleeves, gloves, and a face mask to minimize direct contact. If you do come in direct contact, quickly wash exposed areas.

Drugs

Inform healthcare workers

All of your allergies, especially drug allergies, should be indicated in your medical records. Keep your medical records accurate and up-to-date. Be sure to inform all of your healthcare providers, such as your doctor, dentist, or any other medical specialist.

Wear a medical alert bracelet

Wearing a medical alert bracelet that identifies your drug allergy can ensure proper treatment in an emergency.

Update your smartphone’s Medical ID

Both iPhone and Android devices give users the ability to create medical profiles that are accessible from the lock screen. In an emergency, this Medical ID would give your caregiver the information needed to administer proper treatment and avoid allergens.

Latex

Inform healthcare workers

Latex is commonly used in health care for gloves or other medical equipment, so it is important to indicate a latex allergy in your medical records.

Look out for labels indicating latex

Some products contain labels indicating the presence of latex in their product or packaging.

Metals

Knowing all of the products that can contain your metal allergens helps you know what to look out for and avoid.

Wear hypoallergenic jewelry

Look for jewelry made from nickel-free stainless steel, surgical-grade stainless steel, titanium, 18-karat yellow gold, nickel-free yellow gold/sterling silver, or non-metal.

Be cautious when getting piercings

Check to be sure that the piercing studio uses hypoallergenic equipment and piercings. Get details on each step of their process and have them provide documentation of metal content for their products.

Use alternative materials

Use hypoallergenic materials (cloth, leather, plastic) for direct contact products that use metals such as watchbands, zippers, buttons, eyeglass frames, etc.

Avoid direct contact

There are two options for avoiding direct contact when interacting with metal products. You can cover your skin with something like gloves before touching the metal, or you can cover the metal with duct tape or a clear barrier such as Nickel Guard™.

Chemicals

Knowing all of the products that can contain your chemical allergens helps you know what to look out for and avoid.

Read ingredient lists

Foods and cosmetic products are required by the FDA to declare their ingredients. Read these ingredient lists and look out for chemical food additives in processed foods, or problematic chemicals in cosmetics.

Use safer alternatives

There is most likely a safer alternative to most chemicals. Source products that don’t use your trigger chemicals.

For example, formaldehyde is a common trigger for allergic contact dermatitis. Sourcing clothing produced without formaldehyde will help prevent reactions.