Recognising the early signs of allergy and understanding this progression, she added, is essential for timely intervention, especially in cities like Bengaluru, where environmental triggers are abundant.
Published Aug 04, 2025 | 4:47 PM ⚊ Updated Aug 04, 2025 | 4:47 PM
At the severe end is anaphylaxis, a potentially fatal reaction to certain foods, medicines, or even insect bites such as from honeybees.
Synopsis: Allergies are a progressive condition that can start with skin rashes in infancy and advance to respiratory issues or asthma, a sequence known as the “atopic march”. In India, about 80 percent of respiratory allergies are caused by dust mites. Early diagnosis, avoidance of common allergens, and simple preventive measures can help greatly reduce allergy progression and severity.
From itchy eyes and constant sneezing to breathlessness and a dry cough, what may start as an innocent sniffle could be your body raising a warning flag. And no, it is not always the common cold or pollution.
“Allergy is a progressive disease. What starts as a sneeze can end up as wheeze,” warns Dr Gayatri S Pandit, Consultant ENT and Allergy Specialist at Samarth ENT & Allergy Centre, and President of the Allergy Asthma Network of India.
Speaking to South First, Dr Pandit breaks down the most common allergens she sees in her clinic and some lesser-known but easily addressed reasons why symptoms persist.
“Allergy is a spectrum,” explains Dr Pandit. “It starts as atopic dermatitis in infants: dry, scaly skin on elbows or behind the knees. Then may come food allergies like milk, peanuts, or egg, which can sometimes improve as the child grows. Eventually, respiratory allergies develop, runny nose, sneezing, itchy eyes, and wheezing.”
At the severe end is anaphylaxis, a potentially fatal reaction to certain foods, medicines, or even insect bites such as from honeybees. But unlike infections, allergies do not simply go away.
“Allergy is not a trivial condition, it progresses. This is what we refer to as the ‘atopic march’, or now even the ‘atopic dance’,” she explains.
“A child may start with eczema or food allergies in infancy, then develop allergic rhinitis in early childhood, and later go on to have asthma. This sequential progression is what we call the atopic march.”
The key, she stressed, is that these are not isolated issues. “You can’t treat each one in a silo. If a child with eczema is not evaluated for allergies early on, we might miss the opportunity to prevent asthma later.”
This also explains why many adults with asthma or chronic nasal allergies may have had seemingly unrelated symptoms as children.
“Parents often say, ‘he had dry skin as a baby’, or ‘he couldn’t tolerate certain foods’, but they didn’t connect it to his breathing issues now. That’s the atopic march at play,” Dr Pandit said.
Recognising the early signs of allergy and understanding this progression, she added, is essential for timely intervention, especially in cities like Bengaluru, where environmental triggers are abundant.
The vast majority of people in India with allergies fall into the respiratory category. And the culprits, known as aeroallergens, are not always what people expect.
“About 80 percent of allergies are due to dust mites,” says Dr Pandit. “Not the dust you see on roads, but microscopic insects that live in beds, mattresses, carpets, and cushions. They feed on our skin flakes and release waste, which is highly allergenic.”
Other major aeroallergens include:
While allergens cause the condition, certain triggers make it worse.
“Perfumes, agarbattis, room fresheners, cold air, cleaning sprays, all these are irritants. They don’t cause allergies but worsen them, especially in someone who’s already sensitive,” she explains.
Think it is just a seasonal cold? Not if it lingers.
“If someone has a runny nose or sneezing for more than four weeks, especially on waking up, that’s a red flag,” Dr Pandit says. “Children who cough or get breathless after running could be showing early signs of asthma.”
Family history is another important factor.
“If one parent has allergies, the child’s chances are 40 percent. If both parents do, it goes up to 60 percent,” she says.
“But now, we’re seeing people with no family history developing allergies, thanks to pollution and lifestyle changes. Allergen molecules bind with diesel dust and particulate matter and become 16 times more allergenic.
This combination also increases the risk of gene mutations, leading to new allergies in people with no family history, what she calls neo-sensitisation.
Other contributors include:
Ironically, the effort to keep environments sterile may be making immune systems too sensitive.
“Earlier we suffered from infections due to low immunity. Now we suffer from allergies due to hyperimmunity. The immune system is hypersensitive to what it’s supposed to tolerate,” Dr Pandit points out.
Want to reduce your allergy load? It may be time to reconsider your bedding habits.
“Dust mites die above 50°C. Wash bedsheets weekly in hot water, dry them under the sun, and iron them. Also, use mite-proof encasements on mattresses and pillows,” Dr Pandit advises.
And do not follow popular trends blindly.
“A lot of parents use humidifiers, thinking it will help. But if your child is allergic, humidifiers create the perfect environment for dust mites. Use dehumidifiers instead.”
Other suggestions:
So, the next time you are sniffling for weeks or your child coughs every time they run, look beyond the cold. It might be your immune system working overtime.
(Edited by Dese Gowda)
