Chuang Gung Medical Foundation, Division of Pediatric Allergy, Asthma and Rheumatology - UNREGISTERED VERSION

Allergy FAQ:

by: Jhong-Yung Wu, M.D.

Q:
My son is a one-year-old boy – does he really have asthma?

A:
The diagnosis of asthma in infants or young children is quite difficult and different from that for older children or adolescents. In physical examinations, wheezing is a hallmark of asthmatic children, but it also occurs in children younger than 2 when they have respiratory tract viral infections. Furthermore, doctors need to exclude congenital anomalies of airways, foreign body aspiration, vascular anomalies, immunodeficiencies and gastroesophageal reflux disease. Doctors will take a detailed history, make a detailed physical examination, and arrange reasonable tests. Some examination procedures such as the traditional lung function test cannot be performed for this age group.
If the abovementioned diseases have been excluded, doctors might embark on a therapeutic trial with a bronchodilator or corticosteroids , while closely monitoring a patient’s response.

Q: Do probiotics prove beneficial for asthma or allergic rhinitis?

A:
Research about the efficacy of probiotics in allergic disorders is growing and ongoing. There are a few reports to claim that probiotics is beneficial in treating asthma or allergic rhinitis. However, taking all reports together, the efficacy of probiotics still lacks evidence. Furthermore, probiotics may be expensive and there may be certain adverse effects, such as infection and  the development of resistant strains.
There are a growing number of safe asthma medications, and many medications have been confirmed to be as equally effective and safe in children. Thus, we do not encourage the use of probiotics in treating asthma or allergic rhinitis.

Q: Do  inhaled corticosteroids have serious adverse effects?

A: Inhaled corticosteroids (ICS) is the drug of choice for persistent asthmatic children. However, one of the misconceptions concerns the adverse effect of corticosteroids such as a “moon face” or a negative influence in body height. However, the above adverse effects usually happen in patients using oral (systemic) corticosteroids over a long term. ICS has no such adverse effect s and does not affect an individual’s final height.

Q: How to find the allergens in atopic dermatitis patients?

A:
The first step is to have your doctor take a detailed history, with emphasis on finding possible links between allergens and each flare-up. The doctor can then suggest allergen tests such as serum test or skin test. The most common allergens include milk, egg white, peanuts, soy, and seafood (crab, shrimps).

Q:
How to manage and moisturize skin at home?

A:
The most important concepts in baseline management for atopic dermatitis patients is soaking and sealing. Patients can bathe or take a shower with warm water, being careful not to overclean the skin. After soaking, the body should be gently tapped with a clean towel. An emollient should then be used as soon as possible. When eczema flares up or a rash occurs, topical steroids or other medications could be used.  

Two kinds of emollient or topical medication should not be used concurrently. Parents should try to avoid allergens and irritants of skin such as chemicals in certain cloth. In summer, it is also important to remove sweat from body.
Stress can also be a trigger for atopic dermatitis. Children should be protected from stress to avoid worsening of the skin condition.