Dust Mite Allergy
Dust mite allergy is an allergic reaction to tiny bugs that live in house dust. Symptoms of dust mite allergy are like those of hay fever, such as sneezing and runny nose. Many people with dust mite allergy also have symptoms of asthma, such as wheezing and trouble breathing.
Dust mites are related to ticks and spiders. Dust mites are too small to see without a microscope. They eat skin cells that people shed.
Dust mites like places that are warm and humid. In most homes, they’re in bedding, padded furniture and carpeting.
Reducing the number of dust mites in the home can help control dust mite allergy. Some people need medicines or other treatments to relieve symptoms and manage asthma.
In dust mite allergies, swelling, called inflammation, of the inside of the nose, causes:
- Sneezing.
- Runny nose.
- Itchy, red or watery eyes.
- Stuffy nose.
- Itchy nose, roof of mouth or throat.
- Mucus running down the back of the throat, called postnasal drip.
- Cough.
- Facial pressure and pain.
- Swollen, discolored skin under the eyes.
- In a child, frequent upward rubbing of the nose.
People who have a dust mite allergy and asthma also might have:
- Trouble breathing.
- Chest tightness or pain.
- A whistling or wheezing sound when breathing out.
- Trouble sleeping caused by shortness of breath, coughing or wheezing.
- Coughing or wheezing that a virus such as a cold or the flu makes worse.
A dust mite allergy can range from mild to severe. A mild case of dust mite allergy may cause a runny nose, watery eyes and sneezing. Sometimes, the condition may be ongoing, called chronic.
With a dust mite allergy, symptoms are likely to be worse while sleeping or cleaning. At those times, the dust mite allergens are more likely to be in the air.
An ongoing dust mite allergy can cause repeated sneezing and coughing; stuffy nose; and facial pressure. It also can cause a flare-up of dry, itchy skin, called eczema, or severe asthma attack.
When to see a doctor
Some symptoms of dust mite allergy, such as a runny nose or sneezing, are like those of the common cold. It can be hard to know whether the symptoms are from a cold or an allergy. If symptoms last longer than one week, it might be an allergy.
For severe symptoms, such as a badly stuffed-up nose, wheezing or trouble sleeping, call a healthcare professional. Seek emergency care for wheezing or shortness of breath that gets worse quickly or for shortness of breath with little activity.
Allergies occur when the body’s protective network, called the immune system, reacts to everyday things such as pollen, pet dander or dust mites. The immune system acts as though whatever causes the allergy is harmful, even though it’s not.
The immune system makes proteins called antibodies that protect from invaders that could cause illness or infection. With an allergen, the immune system causes swelling, called inflammation, in the nose or lungs. Long or regular exposure to the allergen can cause the ongoing, called chronic, inflammation linked to asthma.
The following can increase the risk of having a dust mite allergy:
- Having a family history of allergies. Having several family members who have allergies increases the risk.
- Being around dust mites. Having a lot of dust mites around, especially early in life, increases the risk.
- Being a child or a young adult. A dust mite allergy is more likely to come on during childhood or early adulthood.
For people with a dust mite allergy, being around the mites can cause:
- Sinus infections. Swelling in the nose caused by dust mite allergy can block the hollow places called sinuses. This can lead to infections of the sinuses, called sinusitis.
- Asthma. People with asthma and dust mite allergy often have trouble managing asthma symptoms. They might have asthma attacks that need treatment right away.
A healthcare professional might suspect you have a dust mite allergy based on symptoms and your answers to questions about your home.
To confirm the diagnosis, a health professional might use a tool with a light to look at the lining of your nose. If you have an allergy to something in the air, the lining of the nose might be swollen and appear discolored.
Tests might include:
- Allergy skin test. This test looks for certain allergens. An allergy specialist, called an allergist, might do the test.
In this test, tiny amounts of allergens are scratched onto the skin of the forearm or upper back. This includes dust mites. A health care provider checks the skin for signs of allergic reactions after 15 minutes. An allergic reaction is a red, itchy bump where the allergen was put on the skin.
The most common side effects of these skin tests are itching and redness. These side effects usually go away within 30 minutes.
- Allergy blood test. Some people can’t have a skin test because they have a skin issue, or they take a medicine that can affect the results. Instead, they might have a blood test that screens for allergens, including dust mites.
The first treatment for controlling dust mite allergy is avoiding dust mites as much as possible. Being around dust mites less can lead to fewer or less-severe allergic reactions. However, it’s not possible to get rid of all dust mites from the home. Medicines can help control symptoms.
Allergy medicines
The following medicines can help improve nasal allergy symptoms:
- Antihistamines. These medicines relieve itching, sneezing and runny nose. Antihistamine tablets you can get without a prescription include fexofenadine (Allegra Allergy), loratadine (Alavert, Claritin), cetirizine (Zyrtec Allergy). There are antihistamine syrups for children.
Prescription antihistamines taken as a nasal spray include azelastine and olopatadine (Patanase).
- Corticosteroid nasal sprays. These can reduce swelling and control symptoms of hay fever. You can get these medicines without a prescription. They include fluticasone (Flonase Allergy Relief), mometasone (Nasonex 24HR Allergy), triamcinolone (Nasacort Allergy 24HR), ciclesonide (Omnaris, Zetonna) and others.
- Decongestants. These help shrink swollen tissues inside the nose and make it easier to breathe through the nose. Some allergy tablets you can get without a prescription mix an antihistamine with a decongestant.
Decongestants can increase blood pressure. People who have high blood pressure, glaucoma or cardiovascular disease shouldn’t take them. Decongestants also can make an enlarged prostate worse. Talk to a healthcare professional about whether you can safely take a decongestant.
Decongestant nasal sprays may briefly reduce allergy symptoms. But taking decongestant spray for more than three days in a row can make nasal stuffiness worse.
- Leukotriene modifiers. These block certain immune system chemicals. A healthcare professional may prescribe the leukotriene modifier montelukast (Singulair). This comes in pill form. Possible side effects include upper respiratory infection, headache and fever. Less-common side effects include behavior or mood changes, such as feeling anxious or depressed.
Other therapies
Immunotherapy. This is used to train your immune system not to react to an allergen. Immunotherapy involves a series of allergy shots or tablets taken under the tongue, called sublingually. One to 2 weekly shots or tablets give very small doses of what causes the allergic reaction.
The dose increases little by little, usually during a 3- to 6-month period. That’s followed by shots or tablets every four weeks for 3 to 5 years. Immunotherapy is usually used when other treatments don’t help.
- Nasal irrigation. A neti pot or a specially designed squeeze bottle uses salt water to rinse mucus and from the sinuses. To make the rinse, use water that’s distilled, sterile, boiled and cooled, or filtered with a filter that has an absolute pore size of 1 micron or smaller. Be sure to rinse the pot or bottle after each use with the same type of water. Leave it open to air-dry.
References
- Dust allergy. American College of Allergy, Asthma & Immunology. https://acaai.org/allergies/types/dust-allergy. Accessed April 26, 2021.
- Dust mites. American Lung Association. https://www.lung.org/clean-air/at-home/indoor-air-pollutants/dust-mites. Accessed Feb. 17, 2023.
- Dust mite allergy. Asthma and Allergy Foundation of America. https://www.aafa.org/dust-mite-allergy/. Accessed April 26, 2021.
- Sexton DJ, et al. The common cold in adults: Diagnosis and clinical features. https://www.uptodate.com/contents/search. Accessed Feb. 17, 2023.
- Burks AW, et al. Indoor allergens. In: Middleton’s Allergy: Principles and Practice. 9th ed. Elsevier; 2020. https://www.clinicalkey.com. Accessed April 28, 2021.
- Eguiluz-Gracia I, et al. Precision medicine in house dust mite-driven allergic asthma. Journal of Clinical Medicine. 2020; doi:10.3390/jcm9123827.
- DeShazo RD, et al. Allergic rhinitis: Clinical manifestations, epidemiology, and diagnosis. https:// www.uptodate.com/contents/search. Accessed Feb. 17, 2023.
- Zuiani C, et al. Update on house dust mite allergen avoidance measures for asthma. Current Allergy and Asthma Reports. 2020; doi:10.1007/s11882-020-00948-y.
- Allergy testing. American Academy of Allergy, Asthma & Immunology. https://www.aaaai.org/conditions-and-treatments/library/allergy-library/allergy-testing. Accessed April 26, 2021.
- Immunotherapy can provide lasting relief. American Academy of Allergy, Asthma & Immunology. https://www.aaaai.org/conditions-and-treatments/library/allergy-library/immunotherapy-can-provide-lasting-relief. Accessed April 26, 2021.
- Is rinsing your sinuses safe? U.S. Food and Drug Administration. https://www.fda.gov/consumers/consumer-updates/rinsing-your-sinuses-neti-pots-safe. Accessed April 28, 2021.
- Ferri FF. Allergic rhinitis. In: Ferri’s Clinical Advisor 2023. Elsevier; 2023. https://www.clinicalkey.com. Accessed Feb. 17, 2023.
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