A mold allergy is an immune system reaction triggered when a person inhales microscopic fungal spores. This causes common symptoms like sneezing, nasal congestion, a runny nose, itchy throat, or watery eyes. Mold spores are present both indoors and outdoors, often leading to seasonal symptoms (late summer and fall) or chronic, year-round issues in damp indoor environments. Managing the condition involves a tiered approach, starting with immediate relief for acute symptoms before moving toward prescription options or long-term immune modification.
Immediate Relief: Over-the-Counter Symptom Management
Immediate relief for mild mold allergy symptoms involves readily available, non-prescription medications. Oral antihistamines block histamine, the chemical that causes itching, sneezing, and a runny nose. Non-drowsy options, such as cetirizine, loratadine, or fexofenadine, are preferred because they provide relief without the sedating effects of older antihistamines.
Decongestants shrink swollen blood vessels in the nasal passages, reducing stuffiness and pressure. They are available as oral tablets or topical nasal sprays like oxymetazoline. Nasal sprays offer rapid relief but should not be used for more than three consecutive days, as prolonged use can lead to rebound congestion.
Simple, non-pharmacological methods also help by physically removing mold spores and mucus. Saline nasal rinses or irrigation systems use a salt-water solution to flush out accumulated allergens and thick mucus. This process soothes irritated nasal linings and improves the efficiency of other medications.
Targeted Prescription Medications for Persistent Symptoms
When over-the-counter (OTC) options fail to control chronic or severe mold allergy symptoms, healthcare providers recommend prescription treatments that target underlying inflammation. Nasal corticosteroids are the most effective first-line medication for persistent allergic rhinitis, reducing inflammation and swelling directly on the nasal lining. These sprays contain anti-inflammatory agents that alleviate congestion, sneezing, and postnasal drip.
Consistency is important with nasal corticosteroids; they do not provide immediate relief and may require daily use for several days to achieve maximum effect. By addressing inflammation, they provide more comprehensive and lasting symptom control than quick-acting antihistamines or decongestants. They are safe for long-term use, though minor side effects like nasal dryness or occasional nosebleeds can occur.
Leukotriene modifiers may be used when mold allergies affect the lower respiratory tract or are linked to asthma. These oral medications, such as montelukast, block leukotrienes, inflammatory chemicals that contribute to airway swelling and mucus production. Stronger, prescription-only versions of antihistamines and decongestants are also available for severe cases, including prescription nasal antihistamine sprays like olopatadine.
Long-Term Desensitization: Allergy Immunotherapy
For individuals whose mold allergy symptoms are severe, year-round, and poorly controlled by avoidance and medications, allergy immunotherapy may be considered. Immunotherapy is a disease-modifying treatment that changes the body’s response to the mold allergen. The mechanism involves gradually introducing small, increasing doses of the specific mold extract to train the immune system to tolerate the substance.
This desensitization process shifts the immune response away from producing allergy-triggering IgE antibodies toward protective IgG antibodies. These protective antibodies block the allergen from binding to immune cells, suppressing the release of inflammatory chemicals like histamine.
Immunotherapy is delivered through two primary methods: subcutaneous immunotherapy (SCIT), or allergy shots, and sublingual immunotherapy (SLIT), which uses drops or tablets placed under the tongue. SCIT involves a build-up phase of weekly injections followed by a maintenance phase, typically lasting three to five years. Due to standardization difficulties, mold immunotherapy is currently limited primarily to the Alternaria alternata species. Candidates are those with confirmed mold sensitivity who have failed conventional prescription treatments.