The future of allergy care: Can immunotherapy cure allergies?
For many people, allergic symptoms can seriously disrupt daily life – but allergen immunotherapy could be the answer for lasting relief and better symptom control.
For many people, symptoms like sneezing, itchy eyes, or wheezing are more than just a seasonal nuisance – they can seriously affect daily life. While antihistamines and nasal sprays help manage symptoms, they don’t treat the root cause. That’s where allergen immunotherapy comes in.
Immunotherapy is a long-term treatment that works by gradually retraining your immune system to become less sensitive to the substances that trigger your allergies. It’s not a quick fix, but for the right person, it can offer lasting relief. In this blog, we’ll explore how immunotherapy works, who it’s for, the different types available, and what to expect if you’re considering it as part of your allergy care.
What is immunotherapy for allergies?
Immunotherapy for allergies, also known as desensitisation, is a treatment designed to help people with severe or persistent allergic reactions. It works by gradually retraining the immune system to become less sensitive to specific allergens, such as pollen, animals, or dust mites. This treatment is typically offered when standard allergy medications like antihistamines and nasal sprays haven’t provided enough relief, or when someone has experienced a serious allergic reaction, such as anaphylaxis, to a bee or wasp sting.
There are different ways immunotherapy is delivered: subcutaneous immunotherapy (SCIT) which involves regular injections under the skin, sublingual immunotherapy (SLIT) which uses tablets or drops placed under the tongue, and oral immunotherapy (OIT) which involves consuming small amounts of allergenic foods. The goal is to help the immune system build up a tolerance, so it no longer reacts as strongly when exposed to the allergen in everyday life.
While immunotherapy can be highly effective, it’s not suitable for everyone. It’s usually reserved for people with specific allergies that significantly impact their quality of life or pose a serious health risk. The treatment is carefully monitored, especially in the early stages, to manage any potential side effects, which can range from mild local reactions to more serious allergic responses. However, with proper medical supervision, immunotherapy can offer long-term relief.
What types of allergies are suitable for immunotherapy?
Immunotherapy is most suitable for people with specific allergies that have a significant impact on quality of life or have not been successfully treated with standard medications. The types of allergies treated with immunotherapy include:
- hay fever (allergic rhinitis) due to pollen allergies – especially when symptoms are severe, persistent, and not effectively controlled by standard treatments like antihistamines or nasal sprays
- food allergies – including peanuts, tree nuts, sesame, wheat, eggs, cow's milk, and pulses
- house dust mite allergy
- animal dander allergies (cats, dogs, and horses)
- insect venom allergies – particularly life-threatening reactions to bee or wasp stings
Immunotherapy is not suitable for all allergy types. For example, it is generally not used for eczema, multiple food allergies, or non-IgE-mediated reactions such as food intolerance reactions. A thorough allergy assessment, often including skin prick tests or blood tests, is essential before starting treatment.
How does immunotherapy for allergies work?
Immunotherapy for allergies works by gradually retraining the immune system to become less reactive to specific allergens. It’s a long-term treatment that can significantly reduce symptoms and, in some cases, prevent the allergy from worsening or triggering other conditions like asthma.
In people with allergies, the immune system mistakenly identifies harmless substances – like pollen, dust mites, or insect venom – as threats. It produces IgE antibodies, which trigger the release of chemicals like histamine, leading to symptoms such as sneezing, itching, or even severe reactions like anaphylaxis.
Immunotherapy involves giving the patient very small, controlled amounts of the allergen – either by injection (subcutaneous immunotherapy) or under the tongue (sublingual immunotherapy). These doses are gradually increased over time.
With repeated exposure, the immune system begins to shift its response. Instead of producing IgE antibodies, it starts generating regulatory immune cells that help suppress the allergic reaction. Over time, this leads to reduced sensitivity to the allergen.
Once the target dose is reached, patients enter a maintenance phase, where they continue receiving regular doses for several months or years to maintain the tolerance achieved. The benefits of immunotherapy can last long after treatment ends, offering long-term relief and even reducing the risk of developing new allergies.
Subcutaneous immunotherapy (SCIT)
This is the most common form of immunotherapy and involves regular injections of the allergen under the skin, usually in the upper arm. The treatment starts with a build-up phase, where doses are gradually increased, followed by a maintenance phase that can last 3 to 5 years. SCIT is typically used for hay fever (allergic rhinitis), house dust mite allergy, animal dander allergy, and insect venom allergy.
Sublingual immunotherapy (SLIT)
SLIT involves placing a tablet or liquid containing the allergen under the tongue daily. It’s a convenient alternative to injections and can be taken at home after the initial dose is given under the supervision of a special allergist. SLIT is available for grass and tree pollen allergies, house dust mite allergy, and some animal dander allergies.
Oral immunotherapy (OIT)
OIT involves gradual, carefully controlled exposure to foods (like peanuts or milk) in a clinical setting with the aim of reducing sensitivity in those allergic. At Cromwell Hospital, OIT is provided for peanuts, tree nuts, sesame, wheat, eggs, cow's milk, and pulses.
Each type of immunotherapy carries risks and requires careful medical supervision. It’s generally reserved for patients with severe, persistent, or life-threatening allergies that don’t respond well to standard treatments.
Side effects of allergen immunotherapy
Allergen immunotherapy is generally safe when administered under medical supervision, but like any medical treatment, it can cause side effects. These vary depending on the type of immunotherapy and the individual’s sensitivity to the allergen.
The most common side effects are local reactions at the site of administration. For injections, this might include redness, swelling, or itching at the injection site. These symptoms are usually mild and short-lived. For sublingual immunotherapy, patients may experience itching or irritation in the mouth or throat, especially during the first few doses.
Some people may experience generalised allergic symptoms, such as hives, sneezing, or mild asthma symptoms. These are less common but should be reported to your consultant. In rare cases, more serious reactions can occur, including anaphylaxis – a severe allergic response that requires immediate medical attention. Consultants typically monitor patients for at least 30 minutes after an injection to manage any such reactions promptly.
Occasionally, patients may experience delayed symptoms, such as hay fever-like reactions or skin rashes several hours after treatment. These are usually mild and can be managed with antihistamines.
Because of these risks, allergen immunotherapy is only offered in specialist settings and is carefully tailored to each patient’s allergy profile. The benefits, such as long-term symptom relief and reduced reliance on medication, often outweigh the risks for those with severe or persistent allergies.
How can I access immunotherapy for allergies?
Accessing immunotherapy for allergies starts with a referral to an allergy specialist. If you’re using private medical insurance, you can ask your GP for a referral. If you’re paying for your care, you can contact our Self-Pay team directly to book an initial consultation.
Once referred, you’ll undergo a comprehensive assessment by an allergy specialist. This usually includes a detailed medical history, skin prick tests, or blood tests to identify specific allergens, and sometimes lung function tests if asthma is involved. If your symptoms are clearly linked to a specific allergen and meet the clinical criteria, the specialist may recommend immunotherapy.
The treatment is typically offered for allergies such as grass or tree pollen (hay fever), house dust mites, animal dander, and insect venom (like bee or wasp stings). Cromwell Hospital also offers oral immunotherapy for certain food allergies. If you’re eligible, the specialist will explain the treatment options along with the potential risks, benefits, and the expected duration of treatment, which is usually three to five years.
The first dose of immunotherapy is always given under medical supervision in a hospital or clinic to monitor for any adverse reactions. After that, depending on the type of treatment, you may continue with regular clinic visits (for injections) or take daily doses at home (for tablets or drops). Oral immunotherapy for food allergies is always delivered under medical supervision.
How to book an appointment
You will need an initial consultation with an allergy specialist to determine whether allergen immunotherapy is right for you.
If you have received a referral from your GP and are using private medical insurance, please contact us on 020 7460 5700 to book your appointment.
If you are paying for your own care, you don’t need a GP referral. Simply contact our Self-Pay team on 020 7244 4886 to book a consultation with an allergy specialist directly.
