From the Guidelines
To manage dust mite allergies, a multicomponent allergen-specific mitigation strategy is conditionally recommended, including the use of impermeable pillow/mattress covers as part of this approach, but not as a single-component intervention. This recommendation is based on the most recent and highest quality study available, which emphasizes the importance of a comprehensive approach to reducing exposure to dust mites 1. The use of impermeable pillow/mattress covers is specifically recommended as part of a multicomponent strategy, rather than as a standalone measure, as supported by the Expert Panel's conditional recommendation with moderate certainty of evidence 1.
Key Components of a Multicomponent Strategy
- Encasing mattresses, box springs, and pillows in allergen-proof covers
- Washing bedding weekly in hot water (at least 130°F)
- Using a vacuum with a HEPA filter
- Considering removing carpeting if possible
- Keeping indoor humidity below 50% using a dehumidifier
Medication Options
- Over-the-counter antihistamines like cetirizine (Zyrtec), loratadine (Claritin), or fexofenadine (Allegra) taken daily
- Nasal corticosteroids such as fluticasone (Flonase) or triamcinolone (Nasacort) used daily as directed
- Allergen immunotherapy (allergy shots) for severe allergies, which gradually desensitizes the immune system
Additional Measures
- Using air purifiers with HEPA filters in bedrooms to remove airborne allergens
- Reducing exposure to dust mites by controlling humidity and removing allergen sources
By implementing a multicomponent allergen-specific mitigation strategy, individuals with dust mite allergies can effectively reduce their exposure to these allergens and alleviate symptoms, ultimately improving their quality of life and reducing morbidity and mortality associated with allergic reactions 1.
From the Research
Recommendations for Allergies to Dust Mites
- Effective house dust mite allergen avoidance is crucial to prevent and treat allergic diseases, as exposure to high indoor aeroallergen levels is an important environmental risk factor for allergic sensitization and the subsequent development and exacerbation of asthma 2.
- Various methods are required to affect the multiple factors that facilitate high indoor allergen levels, and education of the patients and their families is also an important component of environmental control strategies 2.
- Treatment options for house dust mite allergy include:
- Allergen avoidance, which is widely recommended as a strategy, although evidence for its efficacy is variable 3.
- Pharmacotherapy, such as oral and intranasal antihistamines, intranasal corticosteroids, and leukotriene receptor antagonists, which can provide symptom relief but does not extend beyond the end of treatment 3, 4.
- Allergen immunotherapy, which has a poor but improving evidence base and its benefits last after treatment ends 3.
- It is essential to note that the geographic and seasonal distributions of dust mites are determined by their need for adequate humidity, and their distribution within substrates is further determined by their avoidance of light 5.
- Clinical conditions resulting from mite sensitization and exposure include rhinitis, sinusitis, conjunctivitis, asthma, and atopic dermatitis, and systemic allergy symptoms can also occur from the ingestion of cross-reacting invertebrates or mite-contaminated foods 5.