Hyposensitisation: Procedure, duration & costs

What is hyposensitisation?

Hyposensitisation is basically nothing more than an allergy vaccination. It is also called specific immunotherapy or allergy immunotherapy. This type of treatment not only relieves the symptoms, it also fights the cause of your allergy: an overreaction of your immune system. When you engage in this treatment, you get to the root of your allergy.

The principle is simple: with an allergy, the immune system reacts to substances that are actually harmless. Immune cells mistakenly classify these as substances to be fought. Hyposensitisation can reduce this overreaction. Through confrontation with controlled amounts of a certain allergen, the defence cells become accustomed to these allergens. In this sense, hyposensitisation is a kind of training – towards more tolerance.

Why should people choose hyposensitisation?

With nasal spray or eye drops, you only relieve the symptoms of your allergy. The medicines do not treat the cause. Hyposensitisation is the only treatment option that gets to the root of your allergy. If you want to improve your quality of life permanently, allergy immunotherapy is the only option.

How does hyposensitisation work and what does it involve?

The goal of allergy immunotherapy is to gradually get your body used to a certain allergen. Gradually, allergic symptoms will simply stop when you come into contact with this allergen.

To achieve this effect, the allergen in question is administered again and again over a longer period of time, either via:

• Tablets
• Drops
• Injections

Depending on the application, the allergen is administered daily or every four to six weeks.

Patient reports on hyposensitisation

Hyposensitisation has helped many people to finally enjoy their lives free of symptoms. See for yourself and read the testimonials from Dennis, Nina and Lisa!

Dennis, hobby gardener and beekeeper about his hyposensitisation – insect venom allergy

Why did you decide to undergo hyposensitisation?

Beekeeping and the bees, that really captured me emotionally. You put a lot of heart and soul into it. And then a situation like this allergy comes up and you are faced with it and don’t know what to do. There was really a bit of fear involved and also briefly the consideration of quitting the hobby. Family and friends advised me to do so and said, “Hey, that’s it for your bees”. But what happens if you get stung somewhere in the garden while mowing the lawn? Then you are in no way prepared. But if you are prepared now and you go to the bees, you have a complete protective suit on and you are also treated – then that is the best option. So that’s what I decided to do at that time. I thought, if there is any way to continue, I would like to do that.

Dennis advice to other sufferers:

I would recommend to other people: Keep going! Don’t stop with your hobby. If you really care about it, then do the therapy. You get so much freedom back when you get treatment, and I would advise everyone to do that. It gives you a lot of energy to live again. Hyposensitisation has given me back security. I don’t have to be afraid when I walk barefoot somewhere in the garden that I constantly have in the back of my mind: There might be bees flying around somewhere here now and if I step on them, I might have a severe allergic reaction again. I don’t let this allergy limit me!

Nina, nature lover and blogger about her hyposensitisation – pollen allergy

Why did you decide to undergo hyposensitisation?

Before I did hyposensitisation, nature was actually my enemy. It’s getting green, the trees are blossoming, then I actually got scared because I knew it was going to be bad for me. Being in nature for a longer period of time was not a joy for me, it was more of a nuisance because then I started to suffer and end up feeling really sick. I had eye drops, nose drops and that didn’t help very quickly and it got worse and worse. The nice thing is that after hyposensitisation I can enjoy nature for hours, which I couldn’t before.

Nina’s advice to other sufferers:

So I think a successful way to deal with the allergy is to go to an allergist first. You should know what’s going on in your body and what can happen if you don’t treat it and don’t dismiss it. I would advise everyone to try hyposensitisation.

Lisa, fashion and art lover about her hyposensitisation – house dust allergy

Why did you decide to have hyposensitisation?

I was pumping myself full of allergy medication for a long time. On many days I didn’t feel well. I had puffy, red eyes, my nose was completely closed. Often my allergy was mistaken for a cold. I was always worried about being underestimated professionally. I have now been in treatment for three quarters of a year. After only half a year, I noticed that my allergy symptoms had improved considerably. In the meantime, I only notice about ten percent of my allergy. For that, it is worth starting this treatment and sticking with it.

Lisa’s advice to other sufferers:

Hyposensitisation has changed a lot in my life – I feel so much better. An allergy is very limiting in everyday life, so I also recommend hyposensitisation therapy to other people. Many people don’t know about this treatment – nor that there are specially trained doctors for it. Therefore, I want other people with allergies to know: “You don’t have to suffer from this allergy. If it bothers you, you can do something about it.”

How long does the treatment take?

Hyposensitisation is the only form of therapy that treats the cause of the allergy – if you have the patience for it. Hyposensitisation extends over a treatment period of three to five years. These positive effects speak for themselves:

• Relief and improvement of your allergy symptoms.
• Reduction of your allergy medication.
• Lasting improvement in your quality of life.

What are the different types of hyposensitisation?

There are different types of hyposensitisation – depending on how the allergen doses are administered.

A modern method is hyposensitisation with fast-dissolving tablets or drops. This treatment is also called sublingual immunotherapy (SLIT) because it is taken “under the tongue”. The affected person absorbs the allergens through the mucous membrane of the mouth. For children in particular, this is a far more pleasant treatment than hyposensitisation with injections: In subcutaneous immunotherapy (SCIT), the allergens are administered subcutaneously, i.e. under the skin. Allergy patients receive an injection from their specialist at regular intervals.

Are there any side effects?

Normally, the side effects of allergy immunotherapy subside quickly and without treatment. In rare cases, a general allergic reaction may occur. For some sublingual preparations, it is recommended to take the first dose at the doctor’s office and to wait in the waiting room for 30 minutes after the dose has been taken so that any side effects that may occur can then be discussed and treated immediately. After receiving an injection, you must remain in the doctor’s office for about half an hour for observation.

Other side effects are also possible. You can find out what these are in detail in the instructions for use of the respective preparation.

Am I eligible for hyposensitisation?

Do you suffer from hay fever, dust mite allergy or insect venom allergy? Or do you have mild to moderate allergic asthma? In these cases, allergy immunotherapy is an option for you. Especially in the case of allergies to bee or wasp venom, hyposensitisation can be life-saving, as an allergic reaction can easily lead to a life-threatening anaphylactic shock.

Can children use hyposensitisation?

Yes, the treatment can be carried out on adults as well as on children. Experts even assume that the chances of success are higher in children compared to adults. The professional societies recommend hyposensitisation from the age of 5.

When is hyposensitisation not possible?

Hyposensitisation is not possible for some diseases. However, for other health conditions, sublingual immunotherapy is possible. If you have any of the following conditions, it is best to ask your doctor about the possibility of hyposensitisation:

• severe asthma,
• tumour disease (cancer)
• autoimmune disease
• cardiovascular disease
• Weak immune system
• Kidney problems
• Hyposensitisation should also not be started during pregnancy

What does hyposensitisation cost and does my health insurance cover the costs?

The costs of hyposensitisation cannot be calculated in a general way. There are simply too many different factors, such as the preparations used, the choice of method and the duration of the therapy. As a rule, health insurance companies cover all costs incurred.

Preparing for your visit to the doctor

Do you want to know if you are allergic? Are you thinking about having your allergy treated with allergy immunotherapy? Then you can prepare for your visit to the doctor right now. If you want to know what you should ask your doctor, here are some suggestions:

• What is the normal course of an allergy? Can other problems develop? Can my allergy go away on its own?
• Can taking symptomatic medication for many years be harmful? What are the consequences for my allergy?
• How does causative allergy therapy work? Why does it take so long?
• When can I start therapy?
• How often do I need to see a doctor for this therapy?
• What side effects might occur? What can I do about them?
• Can I do hyposensitisation on holiday or abroad?
• What effect does hyposensitisation have on my athletic performance?
• Can I undergo hyposensitisation during pregnancy?

A little tip: Before you talk to your doctor, set yourself a goal and think about what you want to know when you leave the practice. It is best to tell your doctor in advance that you have prepared some questions. Then you can clarify when it is best to ask the questions.

Your doctor will also ask you some questions that you can prepare for:

• Are you taking any medication? If so, which ones?
• Do you have a chronic illness?
• Are you planning a holiday or a long business trip soon?
• Are you a competitive athlete or are you about to compete in a sporting event?
• Will you be receiving any necessary vaccinations in the foreseeable future?
• Are you pregnant or planning to become pregnant?
• Do you currently have any complaints in the oral cavity / teeth that might affect a sublingual treatment?

FAQs on hyposensitisation

Which treatment is best for me?

There are different ways to treat an allergy: Antihistamines, decongestants, steroid sprays and drops, and hyposensitisation, also known as specific immunotherapy (SIT) in medical circles. Broadly speaking, these treatments can be divided into two types – symptomatic treatments and the causative treatment of hyposensitisation.

The main difference is that symptomatic treatment provides quick but only short-term symptom relief, whereas hyposensitisation addresses the cause of your allergy: it trains your immune system to stop reacting to the allergen that is causing your symptoms. However, it does not provide immediate symptom relief.

Could hyposensitisation work for me?

To find out, you would need to talk to your doctor or allergist. He or she can tell you if hyposensitisation is a good option for you. Hyposensitisation may be of interest to you if you:

– Have already tried several different medications to treat your allergy without getting satisfactory relief from your allergy symptoms.
– feel that your quality of life is limited by your allergic symptoms despite taking symptomatic medication.

What do the hyposensitisation preparations consist of?

Hyposensitisation contains natural ingredients, such as the natural allergens extracted directly from pollen of birch trees or grasses, or even animal hair and insect venoms. These are prepared in the laboratory and made available in the form of tablets, drops or as an injection solution. Hyposensitisation is a natural treatment that helps your body to no longer perceive the allergens you react to as a danger and to stop the allergic symptoms.

I don’t like injections – can I still start hyposensitisation?

Yes! Because hyposensitisation is available in different dosage forms. In addition to the injection solutions administered by the doctor, these include tablets or drops that you can take at home. Your doctor will discuss with you which of the available dosage forms suits you best.

Can I choose one of the different dosage forms?

Yep, not quite. Your doctor will discuss the available dosage forms for hyposensitisation with you. The doctor will decide together with you which one is best for you based on a number of factors. These include the nature of your allergy, your concomitant diseases, your lifestyle – and, in the best case, your preference. Hyposensitisation in the form of tablets is currently available for allergies to grass pollen, tree pollen, ragweed pollen and house dust mites, but not for animal dander or moulds, for example.

How do I receive hyposensitisation?

Hyposensitisation is prescribed by a doctor and is only available in pharmacies on prescription. If you have not already done so, you will need to make an appointment with your doctor or allergist to discuss whether hyposensitisation is a suitable option for you.

When should I start hyposensitisation?

This depends on the type of hyposensitisation. For seasonal allergies such as a tree or grass pollen allergy, it is usually recommended to start well before the pollen season begins. In order for you to get the most out of the treatment already in the coming spring, some advance notice is necessary. The reason for this is that the body needs time to develop a tolerance to the allergens that cause your symptoms. Therefore, it is best to talk to your doctor right away. This way you can make sure you have built up initial protection in time for next spring. Hyposensitisation for year-round allergies, such as to dust mites, can be started at any time.

Will I have to expect side effects?

Like all medicines, hyposensitisation can cause side effects, although not everybody gets them. There are some that occur more often than others: These include swelling and itching or tingling in the mouth, tongue or even in the ear when hyposensitising with tablets or drops. With hyposensitisation with injections, there may be redness or swelling at the injection site, for example. In addition, general allergic reactions of varying degrees of severity can occur. Most of the time, the side effects occur after the start and also in the first weeks or months of treatment. Your doctor or pharmacist will tell you about any drug risks. They will also explain to you how you can best deal with them.

How long does it take for hyposensitisation to show an initial effect?

As hyposensitisation is a continuous training of your immune system, you should not expect an immediate effect. If you start the treatment in time before the pollen season, the hyposensitisation can start working even before the first pollen is in the air again. Most people with an allergy to tree or grass pollen start their allergy therapy in autumn and notice an improvement in their symptoms and a reduced need for symptomatic medication already in the first season. In total, hyposensitisation lasts three years. After that, the treatment can usually be stopped.

Why do I have to do the hyposensitisation for three years?

The aim of hyposensitisation is to “train” your immune system to develop tolerance to the allergens that cause your allergy symptoms. The “training”, i.e. the “reprogramming” of your immune system brought about in this way, takes some time. It is important to continue the treatment for at least three years to get the best results.

Hyposensitisation and COVID-19 vaccination: What do I have to consider?

Experts from allergy societies recommend a one-week interval between the administration of subcutaneous hyposensitisation (with injection) and COVID-19 vaccination. The sublingual treatment (with tablet) should be paused one to two days after the COVID-19 vaccination.