Here at the Hudson Valley Sinus Center, allergy doctor Ran Y. Rubinstein has treated countless patients for a frustrating health issue we’re all familiar with – allergies. Whether they’re seasonal, food-related, or even late-blooming, allergies have always been difficult to manage and can easily irritate anyone afflicted with them. Allergies can affect our quality of life to different degrees, ranging from being just a mild inconvenience to seriously life-threatening symptoms.
Luckily, there are treatments and ways to control the severity of your allergic reactions, and even ways to rid yourself of them completely, in some cases. Dr. Rubinstein is an expert allergy doctor from Hudson Valley, who provides not only care for his patients, but several treatments and possibilities to manage allergies or even live an allergy-free life.
What Are Allergies And What Causes Them?
The short answer to “what causes allergies?” is simple: Your immune system.
Allergies are an overreaction by your immune system to something in your environment. The role of your immune system is to shelter and defend your body against unknown forces that could harm you. When you get a cold, it’s because your immune system is battling a virus. When you eat something funny and get a stomach bug, it’s because your immune system is doing what it can to get that bacteria out of your system.
While antibodies produced by the immune system are invaluable when it comes to protecting us from dangers, allergies occur when the immune system produces antibodies to fight off perceived attackers that aren’t actually dangerous. These “perceived attackers” are allergens, and they include pollen from trees and flowers, pet dander, dust, and mold spores.
To protect us from these allergens, the antibodies trigger reactions, ranging from minor irritations like congestion to life-threatening emergencies like anaphylaxis. These reactions, of course, vary from person to person, in both type and severity. Many people end up sniffling, sneezing, and coughing on a chronic basis. Depending on the allergen, you might also get a rash or have another type of physical symptoms.
Getting Allergies As An Adult
Why allergies develop during adulthood isn’t known. One possibility is new or increased exposure to an allergen. If you move to a new state or area and are now open to different types of pollen (or more pollen than your body’s used to), your immune system might respond by creating antibodies as a result of the increased exposure to that pollen. The same thing can occur if you adopt cats or dogs as an adult, having never lived with an animal before.
In some cases, though, adult-onset allergies are more mysterious. You might not have been allergic to cats or dogs as a child. But one day, as an adult, you’re suddenly sneezing every time you see a cat.
There are also instances when a person has had allergies throughout his or her life but mistakenly thought the symptoms were due to persistent colds. Some people seem to develop allergies as adults when in reality they had them all along and just never knew. Your allergy doctor may go more in-depth about this in your consultation.
Types of Allergies
Depending on where you live in the country and what you’re allergic to, you might be in the midst of peak allergy season at this very moment. Allergy season often starts at the end of February for people who are allergic to tree pollen and can continue through November for those who are allergic to ragweed and molds.
Seasonal allergies might be one of the most common allergy types. Usually, people who are allergic to pollen develop symptoms on a seasonal basis, such as in the spring or fall when certain flowers are in bloom. The type of pollen people are allergic to can differ. Some are allergic to tree pollen, others to grass or weed pollen.
A pollen allergy typically causes symptoms associated with allergic rhinitis. People who are allergic to pollen often sneeze, have a runny nose, itchy eyes and congestion.
According to the American College of Asthma, Allergies, and Immunotherapy, around 4 percent of adults and up to 6 percent of children are allergic to certain foods. Though food allergies are more common in young children and infants, they can develop at any age. Even after years of eating a certain food, a person can suddenly become allergic to it.
The symptoms experienced by someone with a food allergy often vary, depending on the type of allergy they have and its severity. While certain food allergies don’t typically result in sinus or nasal issues, it’s not unheard of for congestion and other nasal problems to occur as a reaction.
What Causes Food Allergies?
The cause of food allergies often differs between adults and kids. Eight types of foods are usually responsible for triggering the majority of allergic reactions. These foods are:
- Tree nuts
From these, adults are more likely to have an allergy to shellfish, fish, nuts or peanuts. Children are more likely to be allergic to peanuts, nuts, milk, eggs, wheat or soy.
In addition to these common food allergens, some people have what’s known are oral allergy syndrome or pollen-food allergy syndrome. Oral allergy syndrome occurs because the proteins in some types of fruits and vegetables can trigger the same sort of allergic reaction as certain types of pollen. People who are allergic to certain types of pollen might experience a reaction when they eat some types of raw fruits or vegetables. For example, people with a birch pollen allergy often have a reaction when they eat hazelnuts or cherries.
Like food allergies, drug allergies are relatively rare and only affect a small number of people. Sometimes, people might have an adverse reaction to a medication, but that’s not the same thing as an allergy, which is the immune system reacting to a drug. Signs of an allergic reaction to a drug might include skin irritation, allergic rhinitis, or anaphylaxis.
Sometimes people develop an allergy to natural rubber or latex. People who have had a lot of surgeries or who work in settings where latex gloves are worn are more likely to develop an allergy to the material. It’s also possible for someone to have irritation or sensitivity to latex, but not have an allergic reaction to it.
Symptoms of a latex allergy can range from mild to severe. In cases of a mild reaction, someone might have some irritation or swelling in the area of contact after exposure to something that contains latex. In more severe cases, asthma symptoms or allergic rhinitis can occur. The most severe cases result in a person going into anaphylactic shock.
Problems Caused By Allergies
The symptoms you experience will vary on the allergy type. For example, we normally characterize hay fever (allergic rhinitis) by:
- Stuffy or runny nose
- Itching or swelling of the mucous membranes around your mouth, nose, and eyes
Allergies to foods or beauty products may cause itching, tingling, hives, and flaky or peeling skin. Consuming food or drugs you’re allergic to can lead to severe swelling in your mouth or throat, which can be dangerous.
There are also very serious reactions that some people have to food, insect venom, and medication. One of the most severe reactions is anaphylactic shock, which can be deadly.
For many, allergies can be the main cause of recurring and chronic sinus infections. Different allergies, like food allergies, for example, may cause recurring cases. Although rarely associated with sinus issues, it is possible to have symptoms such as congestion and inflammation because of a food allergy. Usually, sinus symptoms will quickly occur if you ingest food that may be an allergen.
If not treated quickly enough or ignored, constant allergies can block the sinuses and increase the risk for ongoing infection. Immunotherapy can reduce allergy-related symptoms so much that any problems a person has with his or her sinuses also resolves. People who have had sinus surgery can better enjoy the results and benefits of the surgery if they also undergo immunotherapy to control their allergies.
Dr. Rubinstein will allergy test most of his patients who present with recurring sinus infections. If identified early, before the sinuses become blocked, the treatment of allergies can decrease the frequency of infections and prevent the progression to chronic sinusitis and the development of nasal polyps.
For those whose sinus disease has progressed to the point of needing sinus surgery, allergy identification and treatment will often prevent recurrence of their sinus disease and delay the regrowth of their nasal polyps.
Allergy Testing with your Doctor in Hudson Valley
Before you can treat your allergies, you need to figure out what exactly is causing your allergic reactions. Allergy testing is a process that requires some steps, depending on the severity of the allergy.
The first step in diagnosing an allergy is taking a detailed medical history that includes all relevant symptoms as well as potential triggers. You and Dr. Rubinstein will discuss this during your allergy testing consultation at his Hudson Valley office.
In the second step, Dr. Rubinstein will scratch a small amount of a possible allergen into your skin. Skin tests are generally the most common way to test for allergies. A tiny amount of the proteins that make up a potential allergen will be applied to each spot, with a different allergen used each time. A raised bump forming generally indicates an allergy to the substance applied at that spot. This type of test is often performed using indoor and outdoor allergens, as well as airborne allergens.
Another step of allergy testing involves injecting a small number of various allergens into the arm, just beneath the skin. This type of test is often used for food allergies but can be used for other allergens as well. In many cases, if you are allergic, you’ll see a reaction within about 20 minutes. Some people do have a delayed reaction and don’t see any changes, such as swelling or redness, until several hours or even up to 48 hours after the test.
People who have sensitive skin might not be good candidates for a skin allergy test. If your skin reacts to pretty much anything, it will be difficult to tell what you’re allergic to. For that reason, Dr. Rubinstein might order a blood test or RAST (radioallergosorbent test), instead of a skin allergy test. He might also recommend a blood allergy test if you’re taking a medication that will interfere with the skin test and you’re unable to pause the medication.
It takes a bit longer to get results from a blood allergy test than it does from a skin allergy test. Dr. Rubinstein will draw a sample of your blood and send it to an outside lab or you’ll visit the lab directly for the blood draw. There, they will test the sample with a range of allergens to identify which ones provoke a reaction. This process can take a few days. Once they have tested your blood, the lab will report any findings to Dr. Rubinstein.
Steps After Testing
Once you and Dr. Rubinstein know what substances you’re allergic to, he’ll put together a plan for treatment. Often, avoiding the allergen is the first recommended course of action. Other options include immunotherapy to help your body learn not to react to the substance or taking medications to reduce your body’s allergic reactions.
If he suspects a food allergy, Dr. Rubinstein may also suggest an elimination diet. An elimination diet cuts out suspected allergens from your diet for a while before you reintroduce it to see if it still triggers a reaction.
The correct course of treatment will depend on your specific allergy. If you have a certain food or medication affliction, allergy doctor Ran Y. Rubinstein may prescribe avoidance plus an epinephrine injector for use in emergencies or a rotation diet to minimize your symptoms.
For other allergies, such as pollen or household dust, steering clear of allergens isn’t very realistic. Sometimes, over-the-counter medications (such as antihistamines and decongestants) or stronger medications (prescribed by us) can control these allergies. In severe instances, where allergy episodes significantly affect one’s quality of life, a treatment called immunotherapy may be helpful.
In the case of other allergens like pollen or pet dander that are less easily avoided, over-the-counter or prescribed medications like antihistamines and nasal sprays are a good option.
Food Allergy Treatment
If you fail to follow your diet, it may seem like your allergy shots are not effective due to the persistence of symptoms.
Treating food allergies is slightly different from other forms of allergy treatment. The best thing people with a food allergy can do is to avoid eating the food that triggers an immune response. Following your prescribed “rotation diet” will help alleviate symptoms from food allergies.
If you do ingest a food you’re allergic to, how you should respond will depend on the severity of the symptoms. If you have a mild reaction, such as some congestion or itching, an antihistamine might be sufficient. Since there’s a risk that the reaction a person has to a food allergen will be severe and life-threatening, some people need to steer clear of their known allergens.
More severe reactions, including anaphylaxis, typically require emergency treatment. You might need to go to the ER or to use an epinephrine auto-injector.
Allergy shots and immunotherapy aren’t typically used to treat food allergies, although research has been conducted on using exposure to food allergens to help reduce people’s reactions to them. Any questions regarding food allergies can be discussed with Dr. Rubinstein during your consultation.
Immunotherapy/ Allergy Shots
For patients suffering from more severe allergies that occur for a significant portion of the year and are not easily controlled with other medications, immunotherapy can be a valuable option.
Immunotherapy is most successful with allergies such as pollen, mold, animal dander, and dust mites. By injecting the patient with small amounts of the irritant, immunotherapy allows one’s body to gradually develop immunity to the proteins that bring about the allergic reaction. Most cases start with weekly shots for about a year.
We then start delivering a slightly higher dose each week until you reach the maximum dose of the allergen, giving you the switch to manage your new level of immunity. Because this therapy relies on a higher dosage over time, consistency is necessary for immunotherapy’s effectiveness.
What Happens After Immunotherapy?
Once your maintenance level of the dose has stayed the same for four weeks, your allergy doctor will reduce the frequency of the treatment. In most cases, this means your injections will be every other week during the second year. We will closely monitor your case during this period to ensure your symptoms do not reappear. As long as the symptoms do not come back, you can have the shots every third week during the third year, and opt for monthly shots in the fourth year.
Sometimes, especially during allergy season, symptoms can return despite the injections having been cut down to every three or four weeks. If this happens, your allergy doctor will move you to a more frequent shot schedule to eliminate your allergy symptoms. In most cases, though, we can decrease the treatment frequency every year for 3-5 years. After that point, we may discontinue the treatment entirely for 80% of patients, without the return of symptoms.
Once you have completely stopped treatment, you’ll have follow-up appointments every six months to be sure that your allergies have not returned. While the injections can always be restarted as needed, most patients will be able to live allergy-free after their course of immunotherapy. For the other 20% or so of patients, they will be able to remain symptom-free but must continue with treatments every 2-4 weeks indefinitely.
Dr. Rubinstein makes allergy testing and immunotherapy convenient and comfortable for his patients. He offers his patients flexible times to come for their shots through a private entrance and waiting area. Treatments are administered by highly skilled nurse practitioners and nursing staff all supervised by Dr. Rubinstein.
Why Choose Dr. Rubinstein as your Allergy Doctor?
Patients choose Dr. Ran Y. Rubinstein for his extensive training in intricate facial surgery and ENT disorders, his excellent track record, and his dedication to improving his patients’ quality of life. If you are suffering from allergies, Dr. Rubinstein will walk you through the entire process and answer any questions you may have along the way. Dr. Rubinstein is:
- A respected surgeon with over 20 years of experience
- An allergy and sinus doctor
- Double board-certified by the American Board of Facial Plastic Surgery and the American Board of Otolaryngology-Head and Neck Surgery
- One of New York’s top facial plastic surgeons
- Assistant professor at
- Has performed extensive research, given many lectures, and published numerous papers within the medical community
Schedule a Consultation with your Allergy Doctor today
If you’re looking for an experienced allergy doctor, Hudson Valley’s Dr. Rubinstein will provide the treatment best suited for you to improve your quality of life. Call our offices at 845-562-6673 for an appointment, or fill out our contact form for more information.