Blog - Allergy & Asthma Care - Allergy & Asthma Care

Do Air Purifiers Really Work?

Wed, 18 Mar 2026 12:19:53 GMT

Read what Dr. Pedersen and other experts have to say!

Because indoor allergens including dust, mold and pet dander are a major cause of allergy and asthma symptoms, many patients wonder about the utility of indoor air purifiers.

Dr. Pedersen and other experts explain the efficacy of indoor air purifiers. Read more here!

OIT, SLIT, Xolair - The alphabet soup of food allergy treatment

Thu, 09 Oct 2025 18:41:21 GMT

For decades the only available treatment for food allergy has been strict avoidance of the food and emergency treatment (epinephrine) in case of an allergic reaction. Researchers continue to study treatments for food allergy that may decrease the risk of severe reaction from an accidental exposure to a food allergen.

While there is no cure for food allergies, there are now several treatment options that can help prevent severe reactions in case of accidental exposure to the foods. Two of these involve slow and gradual exposure to the foods in order to desensitize the patient. The third option is a medication named Xolair. After going through any of these treatment regimens, people MUST continue to regularly be exposed to their allergen, or receive Xolair to maintain their desensitized state. Epinephrine must remain available at all times.

Treatment of food allergy (beyond avoidance and carrying epinephrine) is optional.

Allergy & Asthma Care offers 3 treatment options for food allergies

Oral Immunotherapy (OIT)

During OIT, people start eating tiny amounts of their allergen and overtime the amount is gradually increased until they are eating a small amount of the food daily at home (for example, a few peanuts). This generally protects them from having a severe allergic reaction if they accidentally take a bite of their allergen during the rest of the day. Allergic reactions can happen with OIT. In studies, allergic reactions occur in about 10-15% of patients who participate in OIT. There are many restrictions surrounding the dosing of OIT that must be followed indefinitely to decrease the risk of severe reaction.

There is one FDA-approved OIT peanut formulation. There are no FDA approved formulations for other foods. At Allergy & Asthma Care, we are using store bought peanut products for OIT. This allows for a more individualized approach to treatment and is a cost savings.

Sublingual Immunotherapy (SLIT)

Sublingual Immunotherapy involves holding a tiny amount of liquid “SLIT solution” under the tongue to absorb the allergen. The SLIT solution is made of the allergen (for example peanut flour) plus a mixture of water and food-grade glycerin or sometimes a liquid form of the allergen (for example, cashew milk). SLIT uses much less allergen than OIT. At the end of SLIT build up, the person is still only ingesting a tiny amount of their allergen every day. While there is still a risk of allergic reaction, the risk of reaction from each daily dose is less than in OIT. The downside of SLIT is that it will likely take longer to achieve full protection from an accidental bite of the food. However, because the amount of protein is so tiny, there are fewer restrictions around dosing with SLIT than OIT.

Xolair (omalizumab)

Xolair is an injectable medication that has been used since 2003 for the treatment of asthma. In 2024 Xolair was approved to treat food allergy in children 1 year and older. Studies showed that after 5 months of treatment with Xolair, patients were able to eat a significantly larger amount of their allergens without reaction. Xolair accomplishes “bite proof” protection for most people in a less targeted way than OIT and SLIT. Xolair has been useful for patients who cannot tolerate the restrictions for OIT/SLIT and for patients with multiple food allergies. Like OIT and SLIT, patients must continue to take Xolair to keep their protection.

At Allergy & Asthma Care we are committed to providing individualized treatment to our patients in a safe environment. We have been slowly expanding the foods that we are offering for use in OIT and SLIT. We also have a number of patients on Xolair for food allergy. If you or your child has a food allergy and is interested in considering OIT, SLIT or Xolair, please call our office to set up an appointment.

Focus on food allergy, part 2: A MOTHER'S STORY

Tue, 22 May 2018 18:56:00 GMT

In honor of National Asthma and Allergy Awareness month, we will share a series on food allergy focusing on everything from myths to personal stories of dealing with food allergy. Today we have a story written by Michele Benyue about her experience with a food allergy emergency.

It was a typical Friday night and my children were asking for ice cream. Because of our oldest son’s food allergies, we always buy the same kind. I never thought to check the ingredients on this unopened container. It looked the same as always. Shortly after eating his scoop, my son told me he had a fat lip. He is 6, so I didn’t think much of it. I asked what he bumped his lip on and he said he didn’t bump it on anything. I took a peek and shrugged it off. A few minutes later he started coughing uncontrollably and telling me that maybe he was getting the flu because his stomach and throat hurt. It was in that moment that a light bulb went off. I asked him to come into the bathroom and I looked at his lips.

Not only were they swollen, but it looked like giant bubbles forming. I asked my husband to check the ingredients on the ice cream container. Sure enough, the ice cream wasn’t the same one I usually buy and it contained eggs. At that moment, my son began to vomit so I yelled to my husband to get the Epi-pen while I called 911. It was our first time having to use it. We felt uncertain and scared. As soon as the Epi-pen was administered, my son stopped coughing and the swelling on his lips went down a little. First responders arrived in under 10 minutes. At the hospital my son was given Benadryl and Prednisone and stayed for a few hours for observation. This was by far my worst mom moment. I was terrified and felt horrible guilt. I always read ingredients carefully but on this particular night I was exhausted and assumed the ice cream was safe. My assumption was the reason my son had to go through this. The reaction happened very quickly, though everything seemed like it was going in slow motion. My son is doing great now and I am working on getting over my guilt. I definitely learned my lesson and will always check ingredients carefully.

Comments from Dr. Accetta: Mrs. Benyue made a very common mistake: assuming that just because the name of a prepared food was the same, the ingredients were also the same. Always read the label! We asked Mrs. Benyue to share her story because once the reaction started, she did everything right: She recognized that her son was probably having an allergic reaction, she used the EpiPen, and then immediately called 911. She never hesitated and did not second guess herself! The other reason we asked her to write this story is to show not only how quickly the reaction occurred, but also to show how quickly the epinephrine injection worked.

Focus on food allergy, part 1: COMMON MYTHS

Wed, 16 May 2018 16:42:00 GMT

In honor of National Asthma and Allergy Awareness month, we will share a series on food allergy focusing on everything from myths to personal stories of dealing with food allergy.

There is a substantial amount of false information available on the internet and it can be very difficult to separate fact from fiction in food allergy. This post will try to correct some of these myths. (This article is adapted from “Common questions in food allergy avoidance”, written by Maureen Egan, MD & Matthew Greenwalt, MD and published in the Annals of Allergy, Asthma & Immunology, March 2018.)

MYTH: MY CHILD HAS A PEANUT ALLERGY, SO I NEED TO REMOVE ALL PEANUT PRODUCTS FROM MY HOME.

FACT : If a food allergic person touches a surface (such as a table top) that has remnants of the food still on it and then puts the hand into their mouth or touches their eyes, a reaction can occur, but this is considered an ingestion (eating it), not an inhalation (breathing it) reaction. Some families may choose to be peanut free at home, but that is a personal decision. If a family chooses to keep peanut (or any allergen) in their house, they should wash their hands with soap and water after eating it, and clean the table top with cleaner or commercial wipes. Hand sanitizer does not remove food proteins.

MYTH: IF A PERSON WITH A PEANUT ALLERGY SMELLS PEANUT BUTTER, A REACTION CAN OCCUR.

FACT: It is a common myth that if peanut is present in a room, it can be inhaled and will trigger a serious allergic reaction. This is not true. Allergic reactions happen due to the protein in the food - the odor from peanut butter is not a protein so a reaction will not occur. While touching peanut protein may cause symptoms such a rash on the area where it was touched by the peanut butter, a serious reaction should not occur unless peanut protein is eaten, or touches the eyes, mouth, or inside of the nose. Shelling peanuts may cause some protein to go into the air, but it becomes nearly undetectable within moments after the person finishes shelling peanuts. However, it is not uncommon that there is anxiety around the odor of peanuts. A proximity challenge can be done to assure the person that there is no reaction from being in the room with peanut products if necessary. [ NOTE: Cooking foods can release proteins into the air. People with shellfish allergy, for example, can have severe allergic reactions from being near cooking shellfish.]

MYTH: IF I AM ALLERGIC TO PEANUT, I CAN’T EAT FOODS COOKED IN PEANUT OIL.

FACT: There is some truth to this statement because there may be peanut protein in crude or cold pressed peanut oils. However, in general, most peanut oils are highly refined and contain little to no peanut protein. The same is not true for some other oils (This will be discussed further in part 2 of this series).

MYTH: IF I AM ALLERGIC TO PEANUT, I CAN ONLY TRAVEL ON AIRLINES THAT DO NOT SERVE PEANUTS.

FACT: Studies do not support the myth that a peanut allergic person can have a serious reaction if he or she inhales peanut protein on an airplane. Again, if a reaction occurs, it is due to eating or touching a contaminated surface and then touching your mouth, eyes, etc. Wiping down the tray table, armrests, video monitor and window (if the person is at the window seat) with a commercial sanitary wipe (but not hand sanitizing gel) as soon as seated is the best protection. Also, check in the crevices of the seat for any peanut shells or pieces left by a previous passenger. However, it’s always important to pack your epinephrine autoinjectors in your carry-on luggage.

MYTH: I NEED TO AVOID FOODS IF THE LABEL SAYS THAT THE FOOD “MAY CONTAIN”, “MIGHT CONTAIN”, “MADE IN A SHARED FACILITY” OR “MADE ON SHARED EQUIPMENT”.

FACT: The FDA requires that if a food contains milk, egg, fish, crustacean shellfish (but not mollusks), wheat, peanut, tree nuts or soybean, the label must clearly state this. However, there are no regulations defining how or when to use these other phrases which are called Precautionary Allergen Labeling (PAL). While it is commonly recommended that patients with a food allergy avoid foods with a PAL, a number of studies have shown that the risk of a significant food allergy reaction in such patients is low. The decision to eat or avoid foods with a PAL is an individual one and depends on a patient’s (or parent’s) risk tolerance, as well as on how the avoidance of such foods will affect the person’s (and family’s) quality of life.

MYTH: ALLERGEN BANS IN SCHOOL ARE NECESSARY TO PROTECT A CHILD WITH A FOOD ALLERGY.

FACT: This is a very emotional topic for many parents and school personnel. Allergic reactions in school are common and have been reported to occur in 16%-18% of food allergic children. The theory that complete avoidance in schools seems to make sense, but it is nearly impossible to do for a variety of reasons. In addition, there is no evidence that banning a food such as peanut is effective. A 5 year review of the usage of injectable epinephrine (such as an EpiPen) in Massachusetts’ schools showed no difference in the usage of epinephrine to treat food allergic reactions in schools that banned peanut versus those that allowed it into the school. Think about this as well: we do not ban milk in schools, yet many young children have a cow’s milk allergy. A nut free table is an option, especially for young children with a food allergy, but once children are old enough to understand that they should never share another child’s food, there is probably not a need for a nut (or milk, or egg) free table. It can be lonely sitting at the food allergy table. Additionally, as children grow, they need to learn to navigate a world with their food allergen in it. School is a great place to learn to practice safe eating habits in a controlled environment

MYTH: A CHILD’S GREATEST RISK OF A FOOD ALLERGY REACTION IS DURING LUNCH IN THE SCHOOL CAFFETERIA .

FACT: 79% of food allergy reactions occur in the classroom, not the lunch room. This can be due to use of food in classroom projects or celebrations. It is safest to have food-free celebrations and art projects so that all children can participate without fear of reaction.

Stay tuned for Part 2 which will answer some commonly asked questions about food allergy.

Perspective of an allergist-mom – part 1: The reaction

Wed, 17 Jan 2018 19:47:00 GMT

(an occasional series by Dr. Pedersen about her experiences with allergy in her family)

Prior to becoming a mom, I was pretty sure that I would be calm, cool, and collected about my kids’ health. After all, I am a board-certified pediatrician and allergist. So, when my picky son (we will call him Mini P) was 9 months old and FINALLY ate a few bites of eggs and then refused to eat any more, I thought it was no big deal. When he got fussier and fussier over the next few minutes and just wanted to be held, I thought he was tired from a long day at daycare. When my husband looked at him and said, “he looks blotchy, and is he itching his ear?” I brushed him off. When Mini P refused his bottle, I figured he was overstimulated and brought him to his room to calm him down. When, as I was changing him into his pajamas, he began to projectile vomit multiple times, I finally realized what was going on.

I yelled to my husband to call 911 because Mini P was having anaphylaxis to the eggs. As we waited for the ambulance to arrive and he vomited again, I wished I had a EpiPen at home, and I hoped that Mini P would come out of this OK. When the EMTs arrived, he looked a little better and part of me wondered if I had overreacted. But as we were getting strapped into the ambulance, he began to look grey and his breathing didn’t seem normal. The EMT said that he was going to give him Benadryl and I told him to give epinephrine. He hesitated. I told him that I was an allergist, and this kid needed epi. Mini P got an EpiPen JR in the leg, and a shot of Benadryl in his arm. A few minutes later, on route to the hospital, he was exhausted but on the mend, and I was changed forever.

I always have prided myself on being an empathetic physician. However, I could not fully understand the sheer terror a parent faces when their child is (or might be) having an allergic reaction. I have had to talk myself off the ledge a few times when my anxious-mommy mode over takes my rational brain, and I have had to call Mini P’s allergist (Dr. Accetta, of course!) when my rational brain can’t yell loud enough to calm my anxiety. Usually, I try to imagine what I would say to any other parent in the situation, and I make myself follow those recommendations like:

Teal Pumpkins?

Wed, 25 Oct 2017 18:38:00 GMT

For children with food allergies, Halloween is not just a time to dress up and have fun, it is yet another experience where they need to be vigilant about their food allergies. FARE (Food Allergy Research and Education) started the Teal Pumpkin Project to make Halloween and Trick or Treating a safe and inclusive event for all children regardless of food allergies or dietary restrictions. Instead of only buying candy to hand out to Trick or Treaters, people who participate in the Teal Pumpkin project also have non-food treats available that eliminate the risk of an allergic reaction. (This also works for people who are worried about too much sugar and junk food being passed out on Halloween!) Some people who participate in the Teal pumpkin project will have pumpkins pained teal outside of their houses. Other people will make or print out signs to show that they are participating. But, if you don’t have time to do that stuff, just having a separate bowl of non-food treats that you offer to trick or treaters will work! Help make Halloween a safe and fun experience for all kids! Sign up on the FARE website to let kids with food allergies know that your house is a safe place for trick or treating this year, and look for other people participating in your neighborhood! Ideas for non-food treats

Back to school asthma

Mon, 11 Sep 2017 17:49:00 GMT

Summer is just about over. Everyone in the family has hopefully been healthy, but now it’s back to school. About 2-3 weeks after the summer school break ends there is always a big increase in children’s asthma symptom, and emergency room visits. In the northern hemisphere (such as the USA, Canada, and Europe) it’s known as the “September Spike ”. It occurs earlier or later depending on when school reopens, but typically 2-3 weeks after the first day of school. In Australia and New Zealand, it happens after the Christmas break (which is the end of their summer recess).

The most likely cause for the “September spike” is viral infections. Once the children are in the classroom it doesn’t take long for the first child to have a cold which then spreads to his or her classmates, and viral infections are one of the most common causes of asthma flare ups.

What you can do to prevent an emergency trip to the doctor for an asthma attack:

The BUZZ about bee allergies

Tue, 18 Jul 2017 19:37:00 GMT

Where are bees found?

Honey bee nests are in tree hollows and old logs and generally they only sting when provoked. They usually leave in the stinger with the attached venom sac (although some yellow jackets also can leave their stinger).

Yellow jackets build nests in the ground, so you’re likely to see them when doing yard work, farming and gardening.

Hornets build large nests in trees and shrubs.

Wasps build honey combed nests in shrubs and under the eaves of homes and barns.

Yellow jackets, hornets and wasps are scavengers, often found at outdoor events where there is food or garbage and are more aggressive than honey bees.

What type of reactions can happen when stung?

The most frequent reaction to a sting is redness, swelling at the sting site and pain. Some people will have a large local reaction where the swelling can increase for 1 or 2 days and take 3 to 10 days to completely go away. The most dangerous reactions are called systemic reactions. Systemic reactions can cause a variety of symptoms such as generalized hives or swelling, difficulty breathing, swallowing or speaking, swollen tongue, hoarseness, dizziness, drop in heart rate, nausea, vomiting, diarrhea, loss of consciousness, seizures and sometimes even death.

What should I do if I am stung?

For the usual or large local reactions use an antihistamine like Benadryl (diphenhydramine), ice and if needed acetaminophen or ibuprofen for pain. If you are stung and start to have symptoms of a systemic reaction call 911. If you have had a systemic reaction, you need to know how and when to use injectable epinephrine and carry it with you.

How can I prevent being stung?

When should I see an allergist?

Anyone who has had a systemic reaction should see an allergist. If a serious reaction has happened, the allergist will likely recommend skin testing for the bees. If the tests are positive, the doctor will probably recommend allergy shots. Once a person is on the top dose, there is less than a 5% chance that he or she will have another serious reaction (versus about a 60% risk if shots are not given). Sometimes, allergy shots may be recommended for a person who has had large local reactions if the person is likely to be stung in the future (such as a landscaper, or builder). Anyone who has had a serious reaction to a bee also needs to carry epinephrine (such as EpiPen, or AuviQ) anytime they are outside during bee season (in New England: from early March until late November).

Thunderstorm Asthma

Wed, 07 Jun 2017 19:16:00 GMT

Although not frequent, severe springtime thunderstorms have been linked to asthma attack epidemics. Last year, more than 8,500 patients overwhelmed hospitals and emergency personnel during a thunderstorm on November 21 (Australia’s springtime) in Melbourne.

So, what happens during a thunderstom that causes asthma to get so bad?

Pollen is carried in the wind, so pollen counts tend to be higher when the weather is dry and windy. Pollen grains are microscopic and can get into the nose and eyes causing typical allergy symptoms, but they are too large to get into the small airways of the lungs. However, during a rainstorm, the pollen grains can swell, causing them to burst. During a thunderstorm, pollen can be taken up into the air and the swollen pollen grains combined with the electricity in the air during a thunderstorm can rupture the pollen grains, releasing allergenic proteins that can penetrate into the bronchial tubes.

Thunderstorm asthma seems to be only caused by grass pollen and mold, and usually only during the spring. It can be severe enough to cause an asthma attack even in people without asthma, but who are allergic to grass. The good news is that these episodes are not common, and if grass or mold allergic persons remain indoors with the windows closed during a very severe thunderstorm, they will not be affected.

What is making me sneeze and wheeze this spring?

Thu, 06 Apr 2017 15:28:00 GMT

We all look forward to the springtime and want to open the windows and be outdoors, but for people with allergies, spring is a mixed blessing, and can mean feeling miserable. However, there are steps you can take to better enjoy this time of year.

What plants pollinate in the spring?

Some of the trees start pollinating in early March, so even if the snow is still on the ground, there can be tree pollen in the air. By mid to late April, when the weather is dry and the wind is blowing, tree pollen counts can be quite high. Trees continue to pollinate through June. The grass generally starts pollinating in mid to late May, but unlike the trees, the grass can pollinate even in April if nighttime temperatures are above 50 degrees. For people who are allergic to both trees and grass, the worst time is usually from mid May through mid to late June because both tree and grass pollen counts are quite high.

Do you know that you are not allergic to any plant that has a pretty flower?

What can I do to feel better?