The holidays are here! Holidays mean family centered fun, festive meals, and usually sweet treats to enjoy. For allergy suffers, however, holidays like Christmas, Hanukkah, and Kwanza can be challenging.  First, traditional holiday foods containing hidden allergies may be present. Also at risk is high dust mite exposure as more Americans are finding themselves gathering indoors together. Add in holiday décor from the attic, household pets, a freshly cut Christmas tree, and even scented candles and you’ve got a holiday wreck wreaking havoc on the nose and chest. Not to worry! Amanda Hofmann, PA, and VP of Clinical at United Allergy Services is here to share tips so that you and your family have a safe and happy holiday.

Food Allergy Aware

Traditional holiday meals are at the cornerstone of most holidays, especially winter holidays. Plan the meals in advance and be mindful of any guests that may have a food allergy. Flexibility is key! Try solutions such as switching ingredients or prepping allergy-friendly dishes separately from the other meals. Not sure whether guests have a food allergy? Consider printing recipes for each dish and display them next to it.

These winter holidays typically mean chocolate and sweet treats to younger members of the family, or those young at heart. Try to again consider those guest and family members that may have allergies to things like chocolate, so they are not left sitting on the sidelines. Allergy to chocolate itself, or the cacao bean, is incredibly rare, however more commonly the offenders are milk, peanuts, tree nuts, soy, and corn. A little research will provide an array of options of dairy free or peanut/tree nut free brands of treats. Always check labels to see if the offending food is contained in the ingredients list, or mentions it was produced in a facility that also processes other allergen containing foods putting your loved one at risk of cross contamination. Keep in mind most chocolate does contain soy in the form of soy lecithin to keep it solid at room temperature, and white chocolate commonly contains corn in the form of corn syrup. If the treats offered are of the homemade variety, it can be even more challenging for a food allergy sufferer due to lack of label to research ingredients. If you suffer from food allergies, a good rule to follow is “If you can’t read it, don’t eat it”. Plan to bring some of your own safe snack or goodies, unless you can make sure your host prepared foods allergen free, safely away from other allergen containing food, and on a separate and thoroughly cleaned surface. In lieu of store bought or homemade edible treats, consider offering nonfood items for younger guests such as books, sporting goods, stickers, novelty items, or toys.

If the above-mentioned allergies are life threatening for you or a loved one, always make sure to carry a minimum of two epinephrine auto injectors if it is prescribed. Make sure the epinephrine autoinjector is carried in a way it can be accessed and administered within 60 seconds of a need arising. If you or a loved one does have life threatening allergies, it is always a good idea to check with your health insurance and ensure you know where to seek medical care should the need arise if celebrating the winter holidays out of town.

Asthma Risks

Food allergens typically are the easiest to keep front of mind during the holidays, however equally as difficult for allergy suffers and arguably more difficult to avoid are the scents like pine, baking cookies, holly leaves and seasonal berries spreading plentifully from a scented candle. Unfortunately, scented candles can lead to asthma attacks. It’s even possible for a person with allergies to be agitated by the smell of candles. Candles, especially scented ones, can release toxic soot and petrochemicals that can aggravate the respiratory tract. Think about making the switch to unscented candles. These are a visually appealing alternative to create ambiance without any scents. If scented candles are used, always light them in well-ventilated areas. This way, the smell of the candle isn’t as prevalent. Try to avoid lighting scented candles in areas where guests are forced to gather or remain in close quarters like the meal table or bathroom. And finally, also try to avoid burning wood in the fireplace during gatherings where loved ones may have allergies or asthma. The smoke can irritate allergic and asthmatic airways. Hosting the fire outdoors if possible, or utilizing an electric fireplace, may allow the holiday cheer to stay without the difficult side effects.

Environmental Allergy Traps

If you celebrate Christmas this holiday season, then no decorating is complete without the home’s centerpiece: the Christmas tree. Many allergy sufferers tend to see an increase in symptoms around their beloved fresh cut pine tree, however you may be surprised to hear, pine isn’t the culprit. It is likely the dust mites and mold that is triggering the allergy attack. The strong evergreen smell can also be problematic. If getting an artificial alternative is out of the question to fulfill the holiday ritual (this goes for wreaths or garland as well), then consider allowing it to dry out on an enclosed porch or garage. If you are allergic to mold you can also spray with a fungicide (be aware of a chemical odor). Also, an air purifier in the same room as the tree is a welcome addition that can help reduce mold levels.

If a switch has been made to decorate an artificial tree, make sure to be diligent about cleaning the tree of all dust before setting it up year after year. The artificial tree, and any other holiday décor kept in the attic, garage or basement should be thoroughly cleaned as they can gather mold and dust while in storage. Consider wearing  a mask when getting it out every year if you are especially sensitive to those allergens and also have asthma. When considering your holiday décor, it helps to remember that plastic, metal, or glass decorations that cannot trap dust mites, and storing decorations in plastic boxes rather than cardboard can significantly reduce allergens like mold.

Pet Friendly Families

We cannot forget about the cherished furry family members that may be in attendance for the winter holiday celebration, as well as the propensity to give the gift of puppies or kitties this time of year. Dander, saliva, sweat, and urine from adorable dogs, cats, and even bunnies can trigger an allergic response in some people. If possible, try to keep pets confirmed to only a certain area of the celebration so that those that wish to enjoy them can, while those that are unable can find refuge elsewhere. Make sure to thoroughly wash your hands before returning to an animal free area of the celebration, before partaking in shared food items, or before touching your face, mouth, or eyes. Also, make sure the recipient of a new pet is not triggered by them. Although recent literature has shown us a true allergy to bird feathers is rare, there are substantial amounts of dust mites found in feathers that can trigger unwanted allergy symptoms as well. So given feathered friends careful consideration as well.

If you or a loved are unsure whether food allergens, mold spores, dust mites, or animal dander are potential allergy triggers and the cause of the nasal congestion, runny nose, postnasal drip, sneezing, and itchy watery eyes you have been suffering with, seeing your provider for an allergy test may provide the clarity you are looking for! And if you are already aware of true allergy triggers, but your current allergy medication and avoidance measures are just not cutting it, there is still time to see your provider and discuss starting allergen immunotherapy before the holidays!


Amanda Hofmann, MPAS, PA-C, is a graduate of Duquesne University, in Pittsburgh, PA. After spending 8 years in clinical practice, she joined United Allergy Services where she is currently the Vice President of Clinical. Amanda is also the past president of the Association of PAs in Allergy, Asthma, and Immunology. 

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