Allergic reactions are sensitivities to substances called allergens that come into contact with the skin, nose, eyes, respiratory tract, and gastrointestinal tract. They can be breathed into the lungs, swallowed, or injected.
Allergic reactions are common. The immune response that causes an allergic reaction is similar to the response that causes hay fever. Most reactions happen soon after contact with an allergen.
Many allergic reactions are mild, while others can be severe and life-threatening. They can be confined to a small area of the body, or they may affect the entire body. The most severe form is called anaphylaxis or anaphylactic shock. Allergic reactions occur more often in people who have a family history of allergies.
Substances that don't bother most people (such as venom from bee stings and certain foods, medications, and pollens) can trigger allergic reactions in certain people.
Although first-time exposure may only produce a mild reaction, repeated exposures may lead to more serious reactions. Once a person has had an exposure or an allergic reaction (is sensitized), even a very limited exposure to a very small amount of allergen can trigger a severe reaction.
Most severe allergic reactions occur within seconds or minutes after exposure to the allergen. However, some reactions can occur after several hours, particularly if the allergen causes a reaction after it has been eaten. In very rare cases, reactions develop after 24 hours.
Anaphylaxis is a sudden and severe allergic reaction that occurs within minutes of exposure. Immediate medical attention is needed for this condition. Without treatment, anaphylaxis can get worse very quickly and lead to death within 15 minutes.
Common allergens include:
Common symptoms of a mild allergic reaction include:
Symptoms of a moderate or severe reaction include:
For a mild to moderate reaction:
Calm and reassure the person having the reaction, as anxiety can make symptoms worse.
Try to identify the allergen and have the person avoid further contact with it. If the allergic reaction is from a bee sting, scrape the stinger off the skin with something firm (such as a fingernail or plastic credit card). Do not use tweezers; squeezing the stinger will release more venom.
For a severe allergic reaction (anaphylaxis), check the person's airway, breathing, and circulation (the ABC's of Basic Life Support). A warning sign of dangerous throat swelling is a very hoarse or whispered voice, or coarse sounds when the person is breathing in air. If necessary, begin rescue breathing and CPR.
Call for immediate medical emergency assistance if:
Schwartz LB. Systemic anaphylaxis, food allergy, and insect sting allergy. In: Goldman L, Schafer AI, eds. Cecil Medicine. 24th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 261.
Wasserman SI. Approach to the person with allergic or immunologic disease. In: Goldman L, Schafer AI, eds. Cecil Medicine. 24th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 257.
Updated by: David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine. Stuart I. Henochowicz, MD, FACP, Associate Clinical Professor of Medicine, Division of Allergy, Immunology, and Rheumatology, Georgetown University Medical School. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M. Health Solutions, Ebix, Inc.
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