Skin Test

Walking into our office for the first time, some people might not know what to expect.

One of the first things that needs to be done is to identify what allergies you suffer from. This is where the skin test comes in. A skin test is a simple procedure that allows us to assess what you may be allergic to and then create a treatment plan that is tailored specifically for you. Because everyone has specific allergy triggers, knowing what you are allergic to as early as possible is important to determine an effective treatment plan.

You may be asked to stop taking antihistamines or other decongestant drugs prior to your visit. Some drugs may interfere with the results of the skin test and prevent us from getting the most accurate (and helpful) assessment for you.

A skin test takes approximately two to three hours from start to finish. A series of tiny scratches are made on the surface of the back. The scratches are conducted with a small instrument similar to a plastic toothpick, which contains trace amounts of a single allergen, such pollen or mold. If you are indeed allergic to any of the allergens, a small mosquito bite-like bump will appear.

But are there any side effects? It is highly unlikely that you will experience any side effect beyond the small bump to the tests that you are allergic to. The size and redness of the bump will depend on the severity of your allergy. Some mild itching may occur, but a topical cream can be applied to reduce any discomfort. This type of reaction is normal and typically clears up in about 20 minutes.

Following the skin test, we will review the results with you and determine the treatment plan that is best for your profile. The skin test is just the first step in seeking relief from allergies. Further care includes trigger avoidance, medications and check-ups. Schedule an appointment with us today and take the first step towards diminished allergy symptoms.

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Asthma Triggers

It is estimated that 25 million people in the United States are currently living with asthma. That equals out to one in every 12 people or about 8% of the population. That’s a lot of people. But for a disease that is so common, symptoms and triggers can be confusing. Let’s shed some light on asthma.

Asthma Symptoms

inhalerThe symptoms of asthma can be vast and varied but typically include shortness of breath, wheezing while breathing, tightness in the chest and excessive or painful coughing. If you experience any of these symptoms, be sure to visit your allergist to determine causes and triggers. Left untreated, allergies can also develop into asthma. Be safe and consult your allergist early on.

Symptoms of an asthma attack are caused by constriction (tightening of the muscles) and inflammation (swelling and irritation) of the airways. During an attack the muscles around the airways spasm,  the mucosal membrane lining the airways gets inflamed, and excessive amounts of mucus flow in the airways all contributing to the narrowing of the airway. This increases constriction and makes breathing very difficult.

Types of Asthma and Causes

Depending on each person, asthma attacks can be caused by either internal and/or external triggers. Asthma is commonly categorized by symptom triggers. These categories include:

Allergic Asthma triggered by allergic reactions to allergens such as pet dander, dust or dust mites, mold or pollen.

Seasonal Asthma triggered by seasonal allergic reactions to allergens such as trees, grasses, or weeds.

Non-Allergic Asthma triggered by irritants in the air that you breathe such as tobacco smoke, wood smoke, room deodorizers, fresh paint, and perfume.

Exercise-Induced Asthma triggered by exercise or physical activity.

Nocturnal Asthma can occur in a patient with any of the aforementioned types of asthma, though the asthma symptoms will increase or worsen at night.

Asthma is the most common chronic illness among children. If a child’s asthma is left untreated, it can result in loss of sleep, exercise limitations, absenteeism, emergency room visits and, in a few cases, death. Asthma in both adults and children can be effectively managed with medications and “trigger” avoidance.

Receiving medical help for asthma is essential. If you’re concerned that you or a loved one is showing signs of asthma, please consult your allergist.  Live in the NYC area, call my office to arrange a consultation,  (212) 247-7447

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Hygiene Hypothesis & Dishwashing

The Hygiene Hypothesis is raised again, this time in regard to sanitized dinnerware.

If you remember, the Hygiene Hypothesis determines that children exposed to innocuous bacteria are less likely to develop allergies; children raised on farms, children who eat foods purchased directly from farms, or eat fermented foods.

handwashing dishes to reduce allergiesA study released in February now adds dishwashing practices to that list.  Parents who wash their dishes by hand, rather than in dishwasher, may also be lowering their children’s chances of developing allergies.

Following 1,000 young Swedish children, researchers monitored certain parental behaviors like; fed their children foods from farms, such as eggs, meat,  unpasteurized milk,  fed children fermented foods (probiotic bacteria) and lastly if they washed their dishes by hand or used a dishwasher.

The researchers then recorded if the children had allergies including asthma, eczema and hay fever.

Children in households where dishes were always washed by hand had half the rate of allergies, that rate diminished even more if the children ate fermented foods and foods purchased directly from local farms.

These findings, interesting to discuss are associative, not cause and effect. It is not clear that washing dishes by hand leads to fewer allergies. The Hygiene Hypothesis has been bantered around for a number of years, and the research to identify cause and effect has yet to be established.

The sanitizing effect of dishwashers serves well to reduce germs and bacteria found on dishware.  And while this is an interesting finding, it has yet to be confirmed.

If you have questions regarding an allergic condition, I invite you to come in for a consultation. For more on allergy triggers, visit my website and click on Common Allergies.

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Childhood Stress Linked to the Development of Allergies

A study recently published in Pediatric Allergy and Immunology showed correlated link between childhood stress and an increased risk of developing allergies later on in life by a research group in Germany who had conducted long-term research.

Over 3,000 newborn children were recruited between 1997 and 1999. Parents were interviewed about lifestyle-related factors. Blood tests were drawn. A total of 565 children were examined up to the age of six, and for 234 participants, blood analyses of stress and immune parameters were carried out.

Blood samples drawn from 234 6yo showed that children who experienced stressful situations like moving or being separated from parents had  higher levels neuropeptide vasoactive intestinal polypeptide (VIP) in their blood suggesting that the neuropeptide could be influencing the regulation of immune responses.

Stressful events occurring during childhood are increasingly suspected of playing a crucial role in the later development of asthma and allergic skin disorders. For children, stressful situations can include the serious illness of a family member to seemingly harmless situations such as moving house.

Stress has been known to exhibit influence over the development of allergies. Unknown is the mechanism behind the phenomenon. This investigation during early childhood can play a large role in understanding the correlation between immune and stress markers.

Keep in mind, that the even though there were a comparatively small number of children affected, the results can still provide valuable insight into what exactly happens to the body through stress. More studies are required and are currently in process.

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Allergy Season Survival Tips

If the weatherman holds true, spring will be coming to NYC this week.

With the rain and warmer temperatures in the forecast, trees and grasses will begin their seasonal production of pollen.  Once that pollen catches a breeze, allergy season opens.

How were your allergies last year? If you find yourself already dreading spring, you aren’t alone.  I am constantly asked “How can I stay ahead of my allergies?”

To answer that question, I’ve compiled a list of suggestions that may help you avoid your allergy trigger.  If these actions don’t satisfactorily ease your symptoms, give me a call – there are many new treatments and medications available. You may find relief is possible without a battery of allergy shots.

The first – Know what triggers your symptoms.  Early spring symptoms can be triggered by tree pollen, grasses, mold and even dust mites (stirred up from spring cleaning). If you aren’t certain what’s causing your discomfort, get a skin test.  A skin test can assist in proper diagnosis and treatment. Allergy drops and tablets (called sublingual allergy treatment) are great solutions for grasses and even some pet allergies.

Next – avoid being outside when pollen level are at their peak.  The best times for outdoor activities are before dawn, late afternoon and early evening.

Something else to consider, the material making up your clothing, synthetic fabrics coupled with movement (fabric rubbing against itself) can create a small electric charge. This charge can actually work as a magnet, drawing pollen to the “charged” fabric. Consider natural fibers during allergy season.

If you are heading out, gardening or doing some yard work, take an antihistamine ½ hour before going outside.  An antihistamine can offer some support by blocking your body’s allergy response, suppressing your allergy symptoms. A mask can also help. Use a mask rated 95 by the National Institute for Occupational Safety and Health (NIOSH) for the best protection.  Do not touch your eyes.  Again, if you find the antihistamine makes you drowsy, there are alternatives available to you without the OTC antihistamine side effects.

When you come in from the outdoors, leave your shoes at the door and shower, making certain to wash your hair. Wash your clothes.  Vacuum often and use machine washable furniture and floor coverings.

We’ve had a long winter, and springtime in New York is not to be missed – or observed from afar.  If these tips don’t ease your symptoms, or if you find your allergies are affecting your quality of life, see an allergist (I welcome you to contact me for a consultation). There are a number of good treatment options that are unobtrusive yet effective that can get you back outside.

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About LEAP and Its Consequences in Medical Practice & Prevention and Lifestyles

The study I touched on in my previous post, Learning About Peanut Early, confirmed that early exposure to the product, in controlled doses, can actually significantly reduce the risk of an allergic onset later on in life. The test was carried out on children who were considered at-risk of developing peanut allergies later in life, based on skin-prick tests and their allergies to things like milk and eggs.

Experts quickly jumped onboard and started debating the ways through which not only medical professionals should approach the findings, but also about how they should be implemented worldwide. The same experts continuously warn parents that the study is not a base for giving their children peanuts or products containing them, unless they were instructed to do so by their physicians or pediatricians and the practice is done in a controlled environment that disposes of the necessary equipment to deal with emergencies.

The problem arising from the study is that medical professionals from around the world would need to be instructed in finding new approaches in dealing with peanut allergies. Skin-prick tests are crucial, and without them, the study wouldn’t have been possible in the first place. So getting those tests in areas where there are none is a huge priority.

Another issue is that this whole idea is based on a very strict timeline, so timing, in this case, is the most important factor. Skin-prick tests and other signs like egg allergies can quickly determine whether an infant is prone to developing a peanut allergy immediately. A course of action can only be followed once this has been confirmed, and, once again, only under the strict supervision of a professional healthcare provider.

As these debates unfold and solutions are being brought to the forefront, new studies are called for. Can the practice be applied to children over 1 year of age, and will the results confirm the practice in that case as well? Many more questions remain unanswered, but now that a red flag has been raised, there’s little doubt that steps will be taken in the right direction in due time.

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Breakthrough in Understanding Peanut Allergies

For quite a while now, physicians and healthcare providers have emphasized the fact that people prone to developing a peanut allergy should steer clear of them and products containing peanuts. But a new randomized clinical trial, presented in Houston at this years AAAAI Convention, comes to dispute that concept, clearly showing that children who were served products containing trace amounts of peanuts, even though they were prone to developing an allergy later on, had considerably avoided it.

The study focused on whether adding products which contained peanuts in the first year of life to children prone to developing the allergy would have any effect, positive or negative. Out of the control group who were instructed to give their kids products with peanuts in them at least 2 or 3 times a week, only 3% developed an allergy. In the other group, which completely avoided peanuts and products containing them, a staggering 17% developed allergies.
For everybody else, this is both good and bad news. For starters, medical professionals may have been wrong all this time, advising people to steer clear of products they were prone to develop an allergy to. Inadvertently, they may even have contributed to the spike of people suffering from various allergies. The study clearly shows that introducing these foods early on in life, particularly in the first 11 months of a child’s life, can help them develop the normal immune response and not the allergy outbreak.

A word of caution though – this does not warrant you or your kids eating things you know you’re allergic to, or introducing trace amounts of them into your weekly diets. Research still needs to be made and an appropriate portion determined for your own safety.

If you have question and live in the NYC area, give me a call for a consultation, DO NOT introduce a known allergen into your body without consulting a reputable healthcare provider. Already developed allergies can be managed through avoidance and special medication successfully.

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New Report Links Carbon to Pollen Production

Another impact of climate change was presented today in a paper by the Minnesota Department of Health. The paper reiterates; more carbon, higher temperatures, longer growing seasons for weeds and also adds, carbon dioxide loving plants produce greater amount of pollen. Top on this list is the already prolific ragweed family of plants.  Seems allergy sufferers are getting weigh-laid from the mechanisms behind climate change, increased emissions cause higher temperatures, extending growing seasons and then carbon is triggering some plants create more pollen.

We’ve long surmised allergies are affected by climate change; patients are affected earlier, longer, with more severe symptoms. While estimates of seasonal allergy prevalence is varied,  50 million American are affected by nasal allergies and as much as 10 percent of the population in North America is believed to be allergic to ragweed, tree pollen and grasses. People suffering with asthma are often affected by seasonal allergies that trigger their allergic asthma symptoms. People predisposed to sinus infections also see deterioration in their condition due to increase mucus production.

Medical technologies and treatments are attempting to keep up with the changing landscape of allergy season. We have tablets and drops to control symptoms in mild to moderate grass allergies, but if you have asthma and are prone to sinus infection – don’t wait until your symptoms become severe.  Early control can help you get a jump on the season, lessening the chance asthmatic episodes and sinus infections.

We are all contemplating warmer weather as we bundle up to head outside today, anticipating our beautiful NYC springtime.  Keep in mind this growing season, there are several new tools to control your allergies with very minimal side effects.

Feel free to contact me in advance of the tree, grass and weeds allergy season if you’d like a consultation on how to overcome your seasonal allergy symptoms. Learn more at 



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Shut Inside this Winter?

We shut out winter’s cold by sealing windows, cutting drafts and weatherproofing our living areas.  And as we insulated ourselves from the outdoors, we are also sealing in several allergens that can trigger allergy symptoms despite January’s bitter temperatures.

Pet dander.

Your pets are your babies. They are spending less time outdoors and more time in the same dry air environment drying out their skin and yours. Pet allergy symptoms may increase during winter months. Give yourself a safe haven – don’t let Fifi sleep on your bed or groom herself on the couch. Vacuum more often and have someone less susceptible brush your pets between groomings.


As the heat inside goes up – moisture trapped in walls, basements and bathrooms can trigger mold growth. While most molds are benign, those susceptible to mold spores can find allergy symptoms disarming; troubled breathing, sneezing, runny or stuffy nose, itchy eyes, throat and/or inside of ears, hives, swollen eyelids, coughing, and wheezing.  A simple blood test can confirm if your symptoms are attributed to a mold allergy. If mold is to blame, it is important to remove the source of the mold to successfully eliminate it; repair leaks, ventilate the bathroom, discard old periodicals and newspapers and use a dehumidifier in damp basements.


Although there is no “Allergy to People” diagnosis, as we are forced indoors we may find ourselves a little shorter with our coworkers, mates and children. Stress lowers immune responses and can lead to increases in cold and flu and even hives. Winter Blues (more casual connotation) or Seasonal Affects Disorder can be attributed to lack of quality time outdoors and decreased exposure to sunlight. For example, many of us are leaving for work at dawn and home after dark, missing out on sunlight and fresh air.  Maximize your exposure to sunlight, if possible sit near a window at work or lunch. Plan activities and outings to break up your winter routine. Vacation in the summer? Why not take a few days off in the winter to relax and unwind? For more serious depression, see a specialist.

If you have any questions regarding winter allergy symptoms, feel free to give my office a call. I’d be happy to set up a consultation to help improve your quality of life; enjoy winter while waiting on spring.

Having sinus problems? Visit this post for several tips to ease sinus pain









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6 Tips to Ease Sinus Congestion, Pain & Pressure

Cold NYC weather means upping the heat, lowering humidity and for many – painful sinus headaches.

If you are experiencing sinus pain here are 6 Tips that may help.

  1. Recognize what is causing your sinus problems

Are your sinus problems caused by a physical ailment?  Narrow sinus passages, a deviated nasal septum, nasal polyps, allergies, or chronic infections? Each can interfere with sinus drainage. To alleviate pain, congestion and chance of infection, it is important the sinus pathways stay open, uncongested and moist for proper drainage.

  1. Humidify Your Indoor Air

Heated indoor air wreaks havoc on delicate nasal membranes.  As dry air dries out nasal passages, mucus becomes much thicker, clogging sinuses, and resulting in sinus pain and pressure.

A standard recommendation is to use a room humidifier in your bedroom from October until April, maintaining humidity at 30%. Higher humidity levels can aggravate asthma and can encourage mold growth.

  1. Irrigate Your Nasal Passages

Many people find sinus relief by irrigating nasal passages with a saline solution.

Irrigation helps to rinse out allergens, irritants, and excess mucus. There are saline sprays available at your local drugstore, or you can make your own solution at home.  To make your own saline mixture, combine about 16 ounces (1 pint) of lukewarm distilled, sterile water with 1 teaspoon of salt. You can also add 1/2 teaspoon of baking soda make the wash gentler on nasal membranes.  Place the mixture into a Neti pot.  Leaning over the sink at a 45-degree angle, place the spout into your top nostril and gently pour the wash in. The saline water will flow through your nasal cavity into the other nostril and out. Blow your nose to get rid of remaining water. Repeat the steps on your other nostril.

  1. Keep sinuses open and draining

Drinking plenty of fluids will help thin the mucus. A warm, moist washcloth applied to your face several times a day or inhaling steam two to four times a day, can help open spaces in your sinuses. Be cautious when inhaling steam. To avoid burns, try sitting in your in the bathroom with the hot shower running.

  1. Avoid Sinus Irritants

Pollution, cigarette smoke, cleaning products, hair spray, perfumes, air fresheners can irritate your sinuses. If you suffer from allergies, avoiding allergens or allergy triggers is central to keeping inflammation down and sinuses draining properly. During winter months, allergies to pets and mold can be especially hard on those susceptible to dander and mold triggers.

  1. Treat Sinus Problems

Using medications to help control your sinus symptoms can be effective in the short term. Do not use other the counter sprays for more than 3 days or other the counter oral medications for more than 7 days.

Decongestants can help reduce the swelling in your nasal passages along with easing stuffiness and pressure.

Pain relievers and anti-inflammatory medicine can be used to treat the pain of sinus pressure, but be sure to follow the label directions carefully. Again, do not use these medications for more than 7 days.

Allergy medicines, antihistamines can help if your sinus problems are related to allergies. Over-the-counter antihistamines include cetirizine (Zyrtec), diphenhydramine (Benadryl, Genahist, and others), fexofenadine (Allegra) and loratadine (Claritin). It is important to see an allergist for recurring allergy related sinus problems or if your allergic sinus condition leads to reoccurring sinus infections.

Need more help?

If the 6 preceding tips don’t help, we still ease your symptoms.  We can use intranasal or oral steroids to decrease inflammation and mucus production in the lining of the nose. Nasal steroids can also treat nasal polyps that often cause obstruction. While there are OTC steroid nasal sprays, do not use them for over 7 days without consulting a physician.

Take control of your reoccurring sinus problems and remember that you don’t have to suffer with sinus pain, pressure or infections. We have the technology to discover the cause of your sinus condition and the tools to end your pain and discomfort.

Contact my office with your questions or concerns or read more about Allergic Conditions on our website at


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