What Are Allergies?

One of the marvels of the human body is that it can defend itself against harmful invaders such as viruses or bacteria. But sometimes these defenses are too aggressive, and harmless substances such as dust mites, mold or pollen are mistakenly identified as dangerous.

Allergies are these overly aggressive or abnormal responses by our immune system to an otherwise benign material. This normally harmless substance (pollen, dust mites, cockroach, mold, animal dander, etc) is called an allergen.

When people with allergies come in contact with one of these allergens their immune system releases chemicals to combat this "invader." It is these chemicals that cause a variety of allergy symptoms.

It is estimated that 50 million Americans—about one in five-- suffer with allergies.

What Are The Causes Of Allergic Reactions?

There are hundreds of ordinary substances that can trigger allergic reactions. Among the most common are plant pollens, molds, dust mites, animal dander, foods, medicines, feathers and insect stings. These triggers are called “allergens.” An allergic reaction may occur anywhere in the body, but usually appears in the skin, eyes, lining of the stomach, nose, sinuses, throat and lungs – places where special immune system cells are stationed to fight off invaders that are inhaled, swallowed or come in contact with the skin.

Who Develops Asthma And/Or Allergies?

Asthma and allergies can affect anyone, regardless of age, gender, race or socioeconomic factors. While it is true that asthma and allergies develop more commonly in children, they can occur for the first time at any age or, in some cases, recur after many years of remission. Although the exact genetic factors are not yet understood, the tendency to asthma and allergies is linked to heredity. In susceptible people, factors such as hormones, stress, smoke, perfume or other environmental irritants may also play a role.

This information has been provided by the American College of Allergy, Asthma and Immunology.

Symptoms of Allergies

Allergy symptoms can be categorized as mild, moderate, or severe.


Mild allergy symptoms can include:

  • Rash
  • Itchy, watery eyes
  • Congestion

Mild allergic reactions do not spread to other parts of the body.


Moderate allergic reactions can include symptoms that spread to other parts of the body, including:

  • Itchiness
  • Difficulty breathing

Severe Allergy Symptoms (Anaphylaxis)

Anaphylaxis is a rare, life-threatening emergency in which the body’s response to the allergen is sudden and affects the whole body. Allergy symptoms may begin with sudden itching of the eyes or face and within minutes progress to more serious symptoms, including:

  • Varying degrees of swelling that can make breathing and swallowing difficult
  • Abdominal pain
  • Cramps
  • Vomiting
  • Diarrhea
  • Mental confusion or dizziness

Irritants vs. Allergies

In some people, allergy-like symptoms can be triggered, not by a true "allergen" but by an "irritant." This condition is called vasomotor rhinitis and can be very similar to its cousin allergic rhinitis. Irritants can also trigger asthma-like symptoms as well.

Common irritants include:

  • Smoke—This can be tobacco smoke or smoke from wood burning stoves, grills or fires
  • Diesel or gasoline fumes
  • Strong odors—This can be from perfumes, chemicals, cleaning agents, paint, hair spray, room air fresheners and insecticides
  • Cold air—Cover your mouth and nose with a scarf when going outside into the cold air

While symptoms of vasomotor rhinitis and asthma can be treated with medicines, avoiding the irritant whenever possible is your best first line of defense.

Delayed Hypersensitivity (Allergic Contact Dermatitis)

In most instances, people with allergies have an immediate reaction when their body comes in contact with or ingests certain allergens. Someone that is peanut allergic will have an immediate reaction if they mistakenly ingest peanuts. Someone that is allergic to cats may immediately start sneezing when they come in contact with cats.

There are other allergens that can produce a delayed response in people that are allergic. This reaction may occur within two to four days after the initial contact. This type of allergic reaction typically occurs when the person's skin comes in contact with a particular allergen. Skin irritation may develop in the area of the initial contact then spread to other parts of the body. This rash is referred to as contact dermatitis.

Common allergens that produce a delayed hypersensitivity include:

  • Nickel—This is a white metal that is used in jewelry and clothes fasteners
  • Perfumes
  • Rubber and other chemicals—shoes, tires, clothing
  • Medications—lanolin, neomycin, steroid creams
  • Epoxy resins—glue used in hobbies
  • Plants—both direct contact and by airborne particles- poison ivy, oak or sumac

Testing for delayed hypersensitivity is performed using a "patch test." A panel of 65 different allergens is placed on the patient's back and secured with tape. The patient returns in 48 hours when the panel is removed and any skin reactions are noted. The patient returns again in another 48 hours when skin reactions are documented again. Results are reviewed with the patient and avoidance measures discussed.

Did You Know?

  • An estimated 50 million Americans suffer from all types of allergies including indoor/outdoor, food and drug, latex, insect, skin and eye allergies.
  • Each year, allergies account for more than 17 million outpatient office visits, seasonal allergies account for more than half of all allergy visits.
  • Allergies can be managed with proper prevention and treatment.

Pediatric/Teen Allergy and Asthma Care

Seasonal allergies and childhood asthma can really make kids feel bad and keep them from doing the things they love. Don't let them suffer. Relief is possible. Covenant specializes in the testing and treatment of children who suffer from all kinds of allergies and asthma. Whether its food allergies, seasonal allergies or asthma, we can take care of your babies and your teenagers and all those in between.

At Covenant, we understand that treating children is different than treating adults. They have special needs and respond differently to testing and treatments than adults. Dr. Raschal has many years of experience as a pediatric allergist and is also is a mother herself with children who have asthma and allergies. She knows firsthand the concern a parent has for a child with these conditions. As a board-certified allergist, she is trained specifically in diagnosing and treating all types of allergies and asthma.


Symptoms of pediatric allergies are often confused with symptoms of common pediatric ear, nose and throat conditions. Often, children diagnosed with frequent cold or sinus infections are suffering from allergies. Allergies can also contribute to other common pediatric problems such as ear infections. Allergies are most typically present in childhood. It is critical to have your child evaluated by a board-certified doctor specially trained to recognize common pediatric respiratory illnesses and potential causes.

Inhalants such as dust, ragweed, pollen and animal dander can contribute to irritating the sensitive membranes covering the nose and throat. If allergies run in a family then the potential for children to be sensitive to allergens is much higher. Often when children are diagnosed with multiple ear, sinus or throat infections, inhalant allergies are at the root of the problem.

What Should I Watch For?

  • Skin reactions such as rashes, itching, hives or eczema.
  • Gastrointestinal reactions like diarrhea or nausea.
  • Respiratory reactions may be expressed by coughing, nasal congestion or wheezing.

Food Allergies

How Will I Know If It's a Food Allergy?
Food is supposed to help children grow up healthy and strong. But for some, a simple peanut butter sandwich, scrambled egg, or glass of milk can cause problems. Between 6 and 8 percent of children younger than age 5 are allergic to specific foods, and those numbers are expected to increase.

How Will I Know Whether My Baby is Allergic to a Certain Food?
Food-allergy symptoms typically occur within a few minutes to an hour after eating a food and are unmistakable.

  • hives (red, raised welts)
  • vomiting or diarrhea
  • wheezing
  • swelling around the lips, tongue, or eyes
  • In severe cases, a person experiences multiple symptoms at once in a life-threatening reaction known as anaphylaxis

Ninety percent of food allergies are triggered by milk, eggs, peanuts, tree nuts, wheat, soy, shellfish, and fish -- known in allergy circles as "the big eight." And if a child is allergic to one food, she's usually allergic to others. Peanuts, tree nuts, and shellfish are the most likely to cause anaphylaxis.

Who's at Risk?

Children are more likely to have allergies if their parents are allergic. A child with one parent who has any kind of allergy, including environmental or seasonal allergies, has a 30 percent chance of becoming allergic. Having two allergic parents increases a child's risk to 60 percent.


At Covenant, Dr. Raschal evaluates, diagnoses and treats pediatric allergies. Often our patients are referred to us for common pediatric illnesses, such as frequent ear infections or sinus infections. We recognize the underlying cause may be inhalant allergies, and can test and evaluate for possible triggers the same day as your appointment.

Dr. Raschal may recommend several treatment options for pediatric allergies including:

  • The use of daily oral medication like antihistamines or a nasal steroid spray
  • Decongestants to minimize the mucous
  • Nasal rinses
  • Behavioral changes including removing allergy triggers from the child's environment (dust mite encasement covers, removing pets or stuffed animals from child's room, etc)
  • Immunotherapy (injection)

Just for Kids

Covenant has a play area for children in the waiting area and toys in every exam room to keep little ones entertained before and after exams.

Covenant also has extended hours for appointments and allergy shots on Thursday evenings and Saturdays to work around school schedules.

Our team believes that pediatric allergies and pediatric asthma can be successfully treated and controlled—so a kid…can be a kid.