adult-onset allergies – For many, allergies are a problem of childhood, something outgrown or managed with relative ease. Yet increasingly, adults with no prior history of allergic reactions are experiencing sudden episodes sneezing, nasal congestion, wheezing, skin rashes, and respiratory distress. Experts warn that adult-onset allergies are on the rise, particularly in urban settings.
Soumitra Sinha Roy, senior consultant, interventional pulmonology and lung transplant programme, MGM Healthcare, Chennai, recounts the case of a 42-year-old woman who had no previous allergy history but developed persistent sneezing, nasal congestion, and night-time wheezing shortly after moving into a newly-renovated apartment. “Her symptoms worsened indoors and improved outdoors.
Evaluation revealed a dust mite allergy and mild adult-onset asthma. With allergen-proof bedding, nasal corticosteroids, antihistamines, and inhaled therapy, her symptoms improved significantly within weeks,” he explains.
In another instance, a 37-year-old woman who adopted a cat and started working from home developed recurrent sneezing, itchy eyes, and night-time coughing. Testing revealed new sensitivities to dust mites and cat dander.
Dr. Roy notes that with targeted medications, home adjustments, and eventual allergen immunotherapy, her symptoms were effectively managed.
“These cases highlight how lifestyle and environmental changes, combined with genetic predisposition, can trigger adult-onset allergies suddenly,” he adds. Adult-onset allergies “Adult-onset allergies occur when the immune system mistakenly identifies harmless substances as threats, releasing histamine and other inflammatory chemicals,” explains Nanda Kumar R.
, senior consultant, general medicine, SRM Global Hospitals. Several factors predispose adults to such allergic reactions: age-related immune changes, prolonged indoor stays, poor ventilation, exposure to pollution, obesity, lifestyle associated issues, and exposure to new environments, workplaces, or pets. “Even substances that were tolerated for years can eventually trigger allergic responses due to cumulative exposure and immune system adaptation,” he says.
Over time, the immune system may begin to see the substance as a threat and produce IgE (Immunoglobulin E, an antibody produced by the immune system that plays a key role in allergic reactions and fighting parasitic infections) antibodies, leading to reactions that never occurred before. Common adult-onset allergies include food reactions, often to tree nuts or shellfish — drug allergies, dust mite-triggered asthma, and airborne allergies from pollen, mould, or pets. Occupational exposures — construction dust, chemicals, and textile fibers, can also precipitate allergic reactions, while contact dermatitis from cosmetics, perfumes, or metals like nickel remains common, adds Dr.
Roy. Late-onset asthma, in particular, is a growing concern.
Chronic exposure to indoor allergens, combined with air pollution, viral infections, or smoking, can induce airway hypersensitivity. Hormonal changes, obesity, menopause, pregnancy, and broader environmental shifts, including climate change may further alter airway responsiveness. R.
Nithiyanandan, consultant, interventional pulmonology, Apollo Hospitals, Chennai, observes that adults with a genetic predisposition may remain asymptomatic until prolonged exposure or significant life changes activate their sensitivity. Symptoms and red flags Adults should watch for repetitive sneezing, nasal blockage, itchy or red eyes, watery discharge, wheezing triggered by dust or cold air, and itchy skin rashes without fever.
Flare-ups that occur in specific environments or with particular exposures often indicate allergies. Red flags include persistent fever, purulent nasal discharge, unexplained breathlessness, weight loss, or chest pain, which may point to infections, lung disease, or cardiac conditions. Severe reactions such as swelling of the face, lips, tongue, or throat, or difficulty breathing, require immediate attention due to the risk of anaphylaxis.
Lifestyle, environmental influences Urbanisation and modern lifestyle changes appear to be major contributors to adult-onset allergies. Moving to new cities with different pollen profiles, home renovations that increase exposure to dust or mould, introduction of pets, prolonged air conditioning use, occupational shifts, and high stress levels can all trigger new sensitivities.
“The adult immune system remains responsive to environmental changes, and repeated or intense exposures can gradually reduce tolerance to allergens,” Dr. Kumar points out. Pollution, urbanisation, and climate change further exacerbate the problem.
Experts underline the importance of early evaluation. Adult-onset allergies, if left unmanaged, can progress to severe asthma, chronic skin conditions, or life-threatening reactions. Timely diagnosis, appropriate medication, environmental control, and, where indicated, allergen immunotherapy, can mitigate symptoms and prevent complications.
“Awareness of adult-onset allergies is essential, especially as urban lifestyles continue to evolve,” Dr. Roy says.
“Adults should not dismiss new allergic symptoms as minor or seasonal; early intervention is key to long-term health and quality of life. ” Management and treatment Treatment strategies are tailored to the severity and type of allergy. Avoiding known triggers and improving indoor air quality are foundational.
Under the guidance of a healthcare professional, mild allergic rhinitis can be managed with non-sedating antihistamines and nasal corticosteroid sprays, while inhaled corticosteroids and bronchodilators are essential for allergic asthma. Persistent or severe cases may benefit from allergen immunotherapy, either injections or sublingual tablets and, in selected patients, biologic therapies.
Dr. Nithiyanandan emphasises a multi-pronged approach, combining pharmacological therapy with lifestyle modifications to achieve optimal outcomes.