Allergy & Sinus

Allergies occur when your immune system overreacts to substances that are normally harmless to most people. However, in people with allergies, these substances trigger an immune response that leads to inflammation and uncomfortable allergy symptoms. 

These substances, known as allergens, can be inhaled, ingested, or come into contact with your skin.

When your body encounters an allergen, your immune system mistakenly identifies it as a threat and produces Immunoglobulin E (IgE) antibodies. These antibodies attach to immune cells called mast cells, which store a chemical called histamine. 

Histamine is a naturally occurring chemical in the body that plays a protective role in normal immune responses and other bodily functions. However, if you are having an allergic response, histamine can cause symptoms like itching, sneezing, and runny nose.

Some common allergy triggers include:

• Pollen – Microscopic particles from trees, grasses, weeds, and flowers that are a major cause of seasonal allergies
• Dust mites – Microscopic organisms commonly found in household dust
• Mold spores – Fungal particles often present in damp or humid environments
• Pet dander – Minute flakes of skin shed by cats, dogs, and other furry animals
• Certain foods – Items such as nuts, dairy, shellfish, or eggs
• Insect stings – Proteins in the venom of insects like bees or wasps
• Medications – Reactions to antibiotics or other drugs

Managing allergies often starts with identifying your specific triggers. From there, treatment may involve reducing exposure to triggers and medications to reduce symptoms.

The sinuses are air-filled cavities located within the facial bones, surrounding the nose, eyes, cheeks, and forehead. These spaces play an important role in your respiratory system. They help warm and moisten the air you breathe and produce mucus that traps dust, allergens, and other particles. 

The sinuses connect to the nasal passages through small, narrow drainage channels. When these pathways remain open, air flows freely and mucus drains smoothly, keeping the sinuses clean and healthy.

However, when these drainage channels become blocked due to inflammation, infection, or structural issues, mucus can build up inside the sinuses. This creates pressure and allows bacteria or viruses to multiply, leading to sinusitis, also known as a sinus infection. 

Sinusitis can be of two types.

• Acute Sinusitis – Usually triggered by a cold or upper respiratory infection and lasting less than four weeks.
• Chronic Sinusitis – Persistent inflammation lasting 12 weeks or more, often associated with allergies, bacterial infection, or structural problems.

Common causes of sinus blockage or inflammation include:

• Upper respiratory infections - Illnesses such as the common cold or flu (influenza) that cause swelling in the nasal passages.
• Bacterial infections – Infections caused by bacteria, such as Streptococcus pneumoniae, Haemophilus influenzae, and Moraxella catarrhalis.
• Allergic rhinitis - Inflammation of the nasal lining triggered by allergens like pollen, dust, or pet dander.
• Nasal polyps - Soft, noncancerous growths in the nasal passages or sinuses that can obstruct drainage.
• Deviated nasal septum - A condition where the wall dividing the nostrils is displaced to one side, narrowing the nasal passage and disrupting normal airflow and sinus drainage.
• Environmental irritants - Substances like cigarette smoke, strong odors, and air pollution that can inflame the sinus lining.
• Dry or polluted air - Prolonged exposure to dry climates or polluted environments that can dry out or irritate the nasal and sinus tissues.

In many cases, allergies and sinus issues go hand in hand. For example, chronic allergies can lead to ongoing inflammation in the nasal passages, which in turn increases your risk of developing sinus infections.

The diagnostic process begins with a detailed discussion of your symptoms, including:

• When they started
• How often they occur
• What seems to make them better or worse
• Any patterns related to the seasons, environment, or exposure to animals, dust, or certain foods

We will conduct a targeted physical exam to evaluate signs of inflammation, congestion, or infection. This may include:

• Checking your nasal passages with a light to look for swelling or blockage
• Gently pressing on your forehead, cheeks, and around your eyes to check for sinus tenderness or pressure
• Examining the inside of your nose and throat for inflammation or mucus buildup
• Listening to your breathing to detect signs of wheezing or congestion

This assessment can help us differentiate between allergic rhinitis, sinusitis, or other upper respiratory issues.

If allergies are suspected, allergy testing may be recommended to help identify specific triggers. While not always required for every patient, testing can provide helpful insights, especially if you experience year-round symptoms or reactions in certain environments.

Allergy tests can help pinpoint the substances that are triggering your symptoms by evaluating how your immune system responds to common allergens. By identifying specific triggers, we can create a personalized plan that reduces exposure and provides targeted relief.

Depending on your situation, allergy testing may include:

• Skin prick testing: During this type of test, small amounts of suspected allergens are placed on your skin. The skin is then gently pricked so the allergen enters just below the skin surface. If you are allergic, a small red bump will appear at that spot within 15–20 minutes.
• Blood testing: In some cases, a blood test may be used to measure your immune system’s response to specific allergens. This test involves taking a small sample of your blood and measuring it for IgE antibodies, proteins your immune system produces in response to allergens. Elevated levels of allergen-specific IgE may indicate a greater sensitivity to that particular allergen. Lower levels, on the other hand, mean there is little to no sensitization to that substance. Blood testing is often preferred when skin testing is not possible due to certain skin conditions or medications.

Based on the test results our provider will develop a personalized plan to reduce your exposure and manage your symptoms effectively.

If your symptoms are persistent, severe, or not responding to standard treatments, additional diagnostic tools may be needed to get a clearer picture of what is going on inside your sinuses. In such cases, we may recommend imaging tests, such as a sinus X-ray or CT scan. These studies visualize the sinus cavities and help look for:

• Structural blockages like a deviated septum or nasal polyps
• Signs of chronic inflammation or fluid buildup
• Complications from untreated infections

These imaging results can help determine whether your symptoms are due to chronic sinusitis, nasal polyps, or anatomical problems that might require more specialized care.

For allergies, we may recommend a combination of lifestyle strategies and medications to reduce your immune system’s overreaction to specific allergens. Common allergy treatment options may include:

• Antihistamines – Help relieve sneezing, itching, and a runny nose by blocking histamine, a key chemical involved in allergic reactions
• Nasal corticosteroid sprays – Reduce inflammation in the nasal passages and are effective for congestion, postnasal drip, and sneezing
• Decongestants – Provide short-term relief of nasal stuffiness, especially helpful during allergy flare-ups or sinus pressure
• Leukotriene modifiers – Oral anti-inflammatory medications that can help manage both allergy and asthma symptoms in certain patients
• Allergen avoidance plans – Based on your test results, we help identify your allergy triggers and offer realistic strategies to reduce exposure to them

If your symptoms persist despite medication, we may discuss referral for allergy immunotherapy (allergy shots or sublingual tablets) to gradually reduce your sensitivity to allergens. These treatments gradually train your immune system to become less sensitive to allergens like pollen, dust mites, or pet dander—leading to fewer symptoms over time and often reducing the need for medication.

For sinus issues caused by infection and inflammation, treatment focuses on clearing blockages, improving sinus drainage, reducing swelling, and preventing complications such as chronic sinusitis. 

Our treatment options may include:

• Saline nasal rinses to help flush out mucus, allergens, and irritants to improve sinus drainage.
• Nasal steroid sprays to reduce swelling in the sinus lining and promote healing.
• Antibiotics for bacterial sinus infections, typically when symptoms persist for more than 10 days or worsen after initial improvement.
• Oral corticosteroids may be prescribed in the short term to treat significant inflammation that does not respond to other treatments.
• Pain relievers can help reduce facial pressure, headaches, or fever.

Complex or persistent cases of allergy and sinus issues may require a deeper level of care. 

When needed, we may collaborate with an ENT (ear, nose, and throat) specialist to ensure you get the most comprehensive support possible. Referral to a specialist may be recommended if you:

• Have frequent or long-lasting sinus infections
• Do not respond well to medications or allergy therapies
• Have structural issues like a deviated septum or nasal polyps
• May benefit from advanced procedures like nasal endoscopy, sinus surgery, or imaging studies

Even when an ENT becomes involved, we remain your primary point of care. Our team stays connected with the specialist, shares your medical history and findings, manages your medications, and continues to monitor your recovery.