A yacht, a Birkin bag, Gucci loafers, and hay fever. One of the above doesn't seem to belong with the others, though a local allergist says that, recently, they all could be found in only the most exclusive circles.
"When one goes back and reads the literature from a decade ago, allergies were considered a rare disease, only of the privileged class," explains Dr. Phillip Lieberman, longtime Memphis allergist and immunologist. "We're in an epidemic of allergic disease. The incidence has quadrupled since the 1940s."
The spread of allergies does not, however, indicate an expansion of the privileged class. Instead, it may be a side effect of advanced medicine.
Allergists explain this development with the "hygiene hypothesis," among others. "We are now so good at taking care of infectious diseases and eliminating parasites, that the immune system isn't stimulated to fight infections to the degree that it once was," Lieberman adds. "It's left to react to things that it would not normally react to, innocuous things like pollen and food. Now 15 to 20 percent of people suffer from allergies of some sort."
The top allergens in the Mid-South include tree and grass pollen in spring, and ragweed in fall. Foods, pet dander, dust mites, and mold round out the list of common allergens. While it's easy enough to recognize that you're suffering with allergies, the first step toward treating them is identifying exactly what you're reacting to.
Allergists like Lieberman use skin tests, a process that involves small injections of common allergens, to figure out what substance causes a patient's eyes to water, nose to run, or skin to break out in an itchy rash.
Less conventional allergies can prove difficult to identify and treat, since a limited number of potential culprits is administered in the skin test. A friend of mine swears that he's allergic to Jheri curl, an ethnic hair-care product. Though Lieberman says it isn't among the standard allergens that he tests patients for, allergists may customize allergy tests, though it's the patient's responsibility to ask.
The next step in allergy treatment can require years of dedication. Though simple measures like a dose of antihistamine, or avoidance of an offensive food might alleviate the problem, many allergy sufferers must commit to a long-term treatment and exposure to the offensive allergen.
"Allergy immunotherapy takes a little bit of the hair of the dog that bit you," explains Lieberman, "and we inject it [into the patient]. When you inhale an allergen, it reacts directly with the respiratory tract to introduce disease. When you inject the same allergen carefully, it builds up an immunity over time to the disease."
He's not kidding about the immunity taking time to build up. "In most instances it's a three-to-five-year program," Lieberman says. "The first year to two consisting of weekly injections, and then a gradual diminution to the frequency of injections — we'll go to one every two weeks, then one every three, and finally one a month for the next year and a half or so."
The success of the treatment depends on the allergen and the symptoms. Results for the treatment of seasonal hay fever, "the classic allergy," as Lieberman calls it, are quite good. "With the vast majority of people seeing a marked decrease in symptoms, and, in some cases, becoming symptom-free," he says. "We have about the same success with allergic asthma."
Homeopathic allergy therapies, like ingesting a teaspoon of locally produced honey every day, have grown popular as the incidence of allergic disease has spread, though Lieberman says there's nothing medical to them.
"There is an up and coming form of desensitization that is being researched now," explains Lieberman, "known as SLIT: sublingual immunotherapy. The allergen is placed in the mouth and absorbed. If that form of therapy works, we will be able to treat people orally. We haven't given up on that," he says, "but honey would not contain enough of the allergen to have any effect."
Finally, Lieberman says that he can't test a theory popular among those unaffected — that allergies are all in our minds. "I wish I could," he says.