Nasal and Sinus Symptoms (allergic and nonallergic rhinitis)

Dust mites (house dust), pets, mold spores, tree pollens, grass pollens, and weed pollens may be triggering your or your child’s runny, stuffy, itchy, and sneezy nose, post nasal drip, sinus pressure, headaches, and even nosebleeds.

Learn more about allergic rhinitis and sinusitis.

We can find out what you or your child is allergic to by having an in-depth discussion about symptoms followed by needle-free skin prick testing or lab testing if necessary.

Did you know that changing the time of day you run or walk your dog could have a significant impact on seasonal allergy symptoms? Did you know environmental allergies may contribute to your child’s ear infections? Based on your symptoms, triggers, testing results, and treatments you’ve already tried, our ABAI-certified allergists can work with you to make an individualized treatment plan that might include allergen avoidance measures, oral medications, nasal sprays, and immunotherapy (allergy shots or allergy drops under the tongue). Immunotherapy shots or drops can retrain your immune system to stop overreacting to these harmless allergens in your environment. Allergy shots are given in the office because of the risk of allergic reactions (assuming they are strong enough to be effective), while allergy drops can be given at home.

We don’t do environmental allergy testing with needles (intradermal testing, end-point titration testing, etc.) because it isn’t reliable and gives way too many false positives. We DO NOT recommend seasonal food avoidance diets for allergic nasal and sinus symptoms because there is no high-quality medical evidence to show that they work… because they don’t.

Check out the ACAAI and AAAAI pages (under evidence-based links) to learn more.

Learn more about nonallergic/vasomotor rhinitis.

Do you have annoying congestion or post-nasal drip with changes in weather, temperature, or barometric pressure? What about only after eating or drinking? You may have vasomotor or gustatory rhinitis… Don’t worry; there are medications to help.

Read more about these topics on the ACAAI and AAAAI pages (under evidence-based links).

Food Allergy

Real IgE-mediated food allergies can be life-threatening but also life-changing. As ABAI-certified allergists, we understand the impact food allergies have on patients and their families.

Learn more about IgE-mediated food allergy.

Patients with food allergies should have a clear food allergy action plan and an epinephrine auto-injector available at all times. With an evidence-based approach to the interpretation of food allergy testing in the context of a patient’s symptoms, we can minimize the risk of over-diagnosing food allergy. Food allergy testing panels for several foods are rarely (if ever) indicated. They are expensive and typically useless. Have you ever had food allergy results that don’t make sense to you?

Does your mouth itch when you eat fresh fruits or vegetables? This might be due to oral allergy syndrome because of your seasonal pollen allergies!

Read more about these topics on the ACAAI, AAAAI, and FARE pages (under evidence-based links).

Learn more about non-IgE-mediated food allergy.

Less common types of non-IgE mediated food allergies, such as eosinophilic esophagitis, food protein-induced enterocolitis (FPIES), or chronic FPIES, have different symptoms than what most people think of when they think of “food allergy.” Do you have trouble swallowing bread, meat, or dry foods? Has your young child ever had severe repetitive vomiting 1-4 hours after eating or has chronic loose stools?

Read more about these topics on the ACAAI, AAAAI, and FARE pages (under evidence-based links).


Your or your child’s asthma probably isn’t controlled if a rescue inhaler is used more than two days per week or if you’ve had more than one significant exacerbation in the past six months.
Learn more about asthma.

Are you or your child at risk for a severe or even life-threatening asthma exacerbation? What about the risk of permanently decreased lung function? What about the risks of overuse of corticosteroids? Do you know if you or your child has “extrinsic” or “intrinsic” asthma? There are different treatments for different types of asthma. Our ABAI-certified allergists can help you better define your or your child’s asthma, identify triggers, and formulate an individualized treatment plan. Also, there is a class of injectable medications called biologics that are now a mainstay of treatment for persistent asthma.

Read more about asthma on the ACAAI and AAAAI pages (under evidence-based links).

Eczema (Atopic Dermatitis)

Eczema is caused by a disruption in the barrier function of the skin where good things get out too easily, and bad things get in. Have you ever heard of the “atopic march?”

Learn more about eczema and the “atopic march.”

The atopic march refers to the progression of allergic disease beginning with eczema (atopic dermatitis) in infancy, then the development of food allergy, then nasal allergy symptoms, and then finally, allergic asthma or wheezing. Our ABAI-certified allergists can give you the best, evidence-based chance of slowing or hopefully stopping the atopic march.

Your pet or other environmental allergens may be the driving factor of your or your loved one’s eczema. Let our ABAI-certified allergists help you identify eczema triggers and work with you to formulate an individualized treatment plan. For children and adults with annoying eczema, there are injectable medications called biologics that may be life-changing!

Read more about eczema on the ACAAI and AAAAI pages (under evidence-based links).

Chronic Hives

Not all hives are caused by allergies. Either way, chronic hives can be debilitating.

Learn more about chronic hives.

Our ABAI-certified allergists can help you identify allergic triggers of your hives or if you have “chronic spontaneous hives.” Yes, that’s a real diagnosis, and there are more than antihistamines to help!

Read more about chronic hives on the ACAAI and AAAAI pages (under evidence-based links).

Contact Dermatitis

“Hypoallergenic” or “dermatologist recommended”… what does that mean? Nothing. It’s only marketing.

Learn more about contact dermatitis

Almost any type of topical product, such as soaps, lotions, detergents, cosmetics, sunscreens, shampoos, conditioners, hair products, and even different metals/jewelry, can cause itchy and eczematous rashes. Our ABIA-certified allergists can patch-test you to figure out what is making you itch.

Check out the ACDS page (under evidence-based links) to learn more about just how many types of products can cause skin reactions!

Immune Deficiency

When infections are too frequent, severe, or unusual, our ABAI-certified immunologists can check the right tests to make sure your or your child’s immune system is functioning properly.

Learn more about immune deficiency.

For patients with diagnosed immune deficiency, there are treatments available, such as IgG replacement therapy or prophylactic antibiotics, to protect you or your loved ones from dangerous or too frequent infections. Our immunologists love to talk about vaccines, too!

Read more about the warning signs of immune deficiency on the IDF website (under evidence-based links).

Drug Allergy

Did your mother tell you that you were “allergic to penicillin?” Only about 10% of the 10% who report an allergy to penicillin are actually allergic.

Learn more about drug allergies.

It is important to know if you or your child are actually allergic to penicillin (beta-lactam) antibiotics to limit the unnecessary use of broader-spectrum antibiotics. Get the right guidance and testing from our ABAI-certified allergists to make treating future infections with the right antibiotic easier.

You can be “allergic” to almost any type of medication. Do you know the difference between an allergic reaction, a type A adverse drug reaction, and a type B adverse drug reaction? Our ABAI-certified allergists do.

Read more about drug allergy and nonallergic adverse drug reactions on the ACAAI and AAAAI pages (under evidence-based links).