Sublingual immunotherapy (SLIT) is the newest treatment option for dust mite allergy

For many of us, the presence of dust mites in carpets, beds, or upholstery is nothing more than a yucky thought and only causes some slight nasal congestion. But, for some people, dust mites are responsible for extreme allergic reactions that cause red, itchy, watery eyes, facial pain, coughing, chest tightness, difficulty breathing, and in severe cases, even an asthma attack. Dust mites are, in fact, the most common cause behind respiratory allergies and, if you’re allergic to them, you probably know just how much they can ruin your life. Since dust mites are so small and notoriously difficult to kill, you have to vacuum and deep clean your house regularly, and going on vacations can become an adventure because the mattresses and upholstered sofas in hotels and Airbnbs are the perfect breeding ground for dust mites.

Since dust mite allergy symptoms can appear at any time, people who have it used to rely on allergy shots – subcutaneous immunotherapy (SCIT) – to manage symptoms. These have been the go-to treatment for over a century but, despite their effectiveness, they’re not the most convenient or pleasant solution. According to a new study published in the Journal of Allergy and Clinical Immunology, there may be a better option: Sublingual immunotherapy (SLIT).

Sublingual Immunotherapy

The treatment itself isn’t new. The FDA approved the use of SLIT in 2017, which is basically a pill that you can take at home, sold in the US under the brand name Odactra. Like SCIT, SLIT can improve allergy symptoms by training the body not to view the dust mites as an allergen and even prevent new allergies from appearing. Its biggest benefit, however, is that it’s easy to administer, by placing it under the tongue.

The study published in the Journal of Allergy and Clinical Immunology found that participants with dust mite allergies who have taken SLIT for a year had fewer nose and eye reactions and didn’t have to use as many allergy medications compared to participants who had taken placebos. For the duration of the study, no participants in the SLIT group had an anaphylactic attack, and only four of them had to take epinephrine. The study was international and included 800 participants.

The only limitation of SLIT so far is that it only seems to manage the symptoms of dust mite allergy so, if you have several allergies that need treatment at the same time, SCIT might be your safest option. Also, if you are at risk of severe allergic reactions, you will still have to carry an EpiPen with you at all times.

Apart from dust mite allergy, patients with chronic sinus conditions, children with recurring ear infections, and highly sensitive patients with mold allergies, can also benefit from SLIT.

Why the lockdown made life worse for people with dust mite allergies

Before the lockdown, hotels were perhaps the biggest concern for people with dust mite allergies. The warm and humid environment in hotels, combined with an endless supply of dead skill cells from previous guests, made it almost impossible to have an overnight stay without getting an allergic reaction. According to legal platform howmuchcompensation.co.uk, dust mite allergies used to be the most common reasons why guests would seek compensation from hotels pre-lockdown. But we haven’t been able to travel in the past year, and COVID-19 protocols forced hotel owners to be extra careful with safety and hygiene. Ironically, the danger has now moved in our homes.

According to a study published in the journal Laryngoscope Investigative Otolaryngology in August found that spending several months indoors has worsened the symptoms of people with dust mite allergies. The reason for this is simple: spending more time indoors increased dust mite exposure, and the fact that more people started working from home increased dust mite numbers. Dust mites thrive in warm, poorly ventilated rooms, which is exactly how most people found themselves living in the first stage of the pandemic. A study conducted in the UAE reported similar results, but experts point out that the situation isn’t unique to specific countries or regions. Even cold countries are at risk because people keep the heaters inside turned on.

How to reduce the risk of dust mite exposure and manage allergy symptoms

Dust mites are notoriously hard to kill. If you reach the stage of a full-blown infestation, you probably need to call in the experts because dust mites are very small, and they can hide in nooks and crannies that you can’t reach by cleaning normally.

Realistically, you can’t prevent dust mites altogether, but you can take steps to reduce their numbers as much as possible and prevent severe allergic reactions:

• If you are working from home or just spending more time at home than usual, open the windows regularly to ventilate the room.
• Mites love humid environments and even something like leaving the bathroom door open after a hot shower can increase their numbers, so invest in a dehumidifier.
• Wash mattress coverings, bedding, and pillow covers at high temperatures (above 60 degrees C).
• Mites breed in hidden spaces with plenty of dead skin cells, such as behind sofa cushions, underneath quilts and mattresses, or between the fibers of fluffy carpets, so make sure you cover these surfaces with allergy-proof covers.
• Replace fluffy children’s toys with wooden or plastic toys, which carry a lower risk of contamination.
• Be more meticulous with your cleaning. That includes vacuuming once or twice a week in areas that you wouldn’t normally pay attention to, such as behind pet beds or inside the wardrobe. For even better results, do steam cleaning.
• Clean floors with a wet mop every day.
• Get rid of dust-collectors such as artificial flowers and stuffed decorations.
• Use an air conditioner, but make sure you clean the filters regularly.

The Takeaway

Most importantly, do not downplay symptoms if you know you are allergic to dust mites. In time, minor symptoms such as sneezing and an itchy nose can turn into severe allergic reactions, so talk to your doctor about possible treatment options.