Dust mite allergies

People who have a dust mite allergy sneeze a lot, and have a runny or stuffy nose. If their symptoms are more severe, they might also feel weak and tired. Their eyes might water and itch, and they might have swollen eyelids. Asthma-like symptoms such as coughing, wheezing and shortness of breath may occur too.

Dust mite allergies usually cause milder symptoms than hay fever (a pollen allergy) does. But they occur all year round, whereas hay fever is seasonal. The symptoms are typically worse at night and in the morning because dust mites tend to live in mattresses, pillows and bedding.

Allergy symptoms develop when your body overreacts to particular substances that are usually harmless. These substances (allergens) trigger a chain reaction in the immune system. First, the body makes antibodies to fight the allergen, and the antibodies bind to specific cells. If these cells come into contact with the allergen again, they are then able to “respond” by releasing chemical substances such as histamine. These substances then set off an allergic reaction, causing symptoms such as sneezing or itchy eyes.

It is almost impossible to avoid contact with dust. If dust is stirred up – for instance, by a draft of wind or when shaking up bedding – it floats through the air and is breathed in, together with the allergens on it.

Sometimes a higher risk of allergies runs in families. Environmental factors such as air pollution and cigarette smoke can make allergies more likely too.

Allergic rhinitis affects about 1 out of 4 people in industrialized countries like Germany. Most people develop the symptoms before the age of 20.

Dust mite allergies typically first develop in childhood or puberty, and never go away again. If people have allergic rhinitis for many years, the allergy might “move down” into the lower airways (lungs) too, causing asthma.

Sometimes people become allergic to certain foods too after a while (a phenomenon known as cross-reactivity). This is less likely to happen with dust mite allergies than it is with other allergies, like hay fever. But people who have dust mite allergies may become allergic to foods like shellfish and mollusks such as mussels, crabs, lobsters, shrimps or snails.

Severe symptoms may increase the risk of developing other medical conditions such as sinusitis ( inflammation of the sinuses). Allergic rhinitis often makes the mucous membranes that line the airways overly sensitive in general too. As a result, the nose may react more strongly to irritants like dry air in heated rooms and cigarette smoke.

If you see a doctor, he or she will first ask you about your symptoms, circumstances in life, and medical history. The doctor can then do an allergy test (a skin prick test) to find out whether you're allergic to particular substances. This involves placing small drops of various allergens on the skin of your forearm, leaving enough space between them, and then gently pricking the surface of your skin where the allergens are, so the substances go into the skin. If the skin becomes red and swollen (like a big mosquito bite) where it was pricked, it’s a sign that you’re allergic to that substance.

You might also need a blood test or something known as a provocation test. This is where the membranes lining the nose are exposed to extracts of the potential allergen using a nasal spray or drops. If the lining of your nose becomes swollen, you sneeze and your nose starts running, you are likely to be allergic to that substance.

The most effective way to prevent allergy symptoms is to avoid the substances that trigger the allergy. Although dust mites can’t be completely avoided, contact with them can be reduced. Particularly in the bedroom, it may be helpful to combine a number of different approaches: wiping the bedroom floor with a damp cloth, using a mite-proof mattress cover (“encasing”), removing dust traps such as soft furniture and curtains, and regularly washing your bedding at temperatures above 60°C (140°F).

Dust mites survive longer in warm and humid conditions. So it can be a good idea to keep the bedroom temperature constant between about 18 and 20°C (about 64 to 68°F), and regularly open the windows to let fresh air in. Air humidifiers and plants can make it easier for dust mites to thrive, so it’s best to keep them out of bedrooms.

Dust mite sprays containing acaricides (pesticides against mites and ticks) could also help reduce the symptoms. They can be sprayed onto mattress covers, for instance. Special dust mite air filters are available too, but it isn’t clear how effective they are.

Various medications are available for the treatment of allergy symptoms:

• Antihistamines
• Steroids (corticosteroids)
• Chromones (mast cell stabilizers)
• Leukotriene receptor antagonists
• Decongestant nasal drops and sprays

There are also non-drug alternatives such as saline (salt water) nasal sprays and nasal washes (nasal irrigation).

Allergen-specific immunotherapy (also known as desensitization) can reduce your sensitivity to allergens over the long term. A bit like with vaccines, this treatment approach involves exposing people to small amounts of the allergen. Here it is done at regular intervals by either injecting the allergen under your skin or placing it under your tongue. Allergen-specific immunotherapy takes at least three to five years.

When people are ill or need medical advice, they usually go to see their family doctor first. You can read about how to find the right doctor in our topic "Health care in Germany" – and our list of questions can help you to prepare for your appointment.