South Bay Allergy Center: Beware of Easter Allergy Triggers

Dear Friends,

Easter can be a fun time of eggs, candy and flowers, but it can also be dangerous for people who suffer with allergies. There are so many opportunities for danger if that bunny leaves something more than yummy treats. Riviera Allergy Medical Center (RAMC) provides advice year-round to help allergy sufferers cope with the potential allergy triggers that can hide in innocent packaging.

Dr. Ulrike Ziegner, allergy treatment specialist, recommends following these tips below to help keep Easter safe for people who suffer from allergies, asthma, and food sensitivities.

  • Safe Egg DecoratingKids With Food Allergies has some great egg decorating ideas so your kids won’t have to miss out on all the fun. Instead of using real eggs they suggest painting wooden, plastic, Styrofoam, ceramic or other types of non-allergy inducing eggs. Be sure to look at their ideas for safe Easter baskets and Easter activities, along with some yummy recipes.
  • Watch Out for Flowers and Pollen: The Easter lily is a beautiful flower, but it can also be an allergy trigger. In addition, this is the time when spring pollen starts appearing in various types of tree pollen, causing additional sneezing and wheezing.
  • Traveling Concerns: People like to visit each other around holidays. Make sure you take any allergy medications along in case they have a dog, cat, or even a bunny that might induce an allergic reaction. Ask what ingredients went into any baked good items, or take safe treats along for your child.
  • Easter Candy: It’s hard to resist a brightly-decorated basket of tempting treats. Make sure you inspect all candies for nuts, milk, wheat, eggs or other triggers that can affect your child. has a listing of Allergy-Friendly Easter Candy that is made in dedicated facilities. You can also consider a basket filled with plastic eggs that contain small toys, stickers, Legos, or other items your child will enjoy. Throw in some crayons and a rubber ducky, top it off with a brightly colored stuffed animal, and the basket will be a real treat.


Ask Riviera Allergy Medical Center about other safe practices you can follow, and learn about actions to take in case of an allergic reaction. We can show you how to recognize an allergic reaction and anaphylaxis. Dr. Ziegner can advise you on whether antihistamines or an epinephrine injector are appropriate for your allergic reactions, and will offer sound suggestions on how to manage and possibly even prevent them.

Dr. Ziegner and the entire staff at Riviera Allergy Medical Center want to wish you and your family a safe and allergy-free Easter!

Dr. Z and Staff

1711 Via El Prado, Suite 101
Redondo Beach, CA 90277
Phone: 310.792.9050
Fax: 310.792.9048



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To schedule an appointment, please call our office at 310.792.9050 or use our online Request an Appointment form. For additional information on any condition, treatment or procedure, please visit our Health Education Library.

Worst U.S. cities for spring allergies

If you’re cursing Mother Nature right now, we understand. The official start of spring was March 20, and yet signs of winter abound.

There’s snow on the ground in the North, and the South is being tossed between 40-degree and 70-degree weather like a pingpong ball.

Yet “even in the throes of what feels like a 2014 Ice Age, millions of Americans have begun showing up in doctors’ offices with the tell-tale signs of allergies,” the Asthma and Allergy Foundation of America says.


Polar vortex may mean miserable allergy season

It may be even worse for allergy sufferers in certain cities across the country. The foundation has released its annual list of the worst places for spring allergies. Topping the list this year are Louisville, Kentucky; Memphis, Tennessee; and Baton Rouge, Louisiana.

These so-called allergy capitals are ranked based on pollen levels, use of allergy medications and the number of board-certified allergists in the area.

Louisville has moved up the list from No. 5 last year because of higher-than-average pollen counts, high use of allergy medications and too few allergy specialists, according to the foundation.

New York; Columbia, South Carolina; and San Antonio are new to the top 20. Only Los Angeles residents can breathe a sigh of relief; the city fell 39 places from No. 38 last year to No. 77 this year.

Here are the worst cities for spring allergies in 2014:

1. Louisville, Kentucky

2. Memphis, Tennessee

3. Baton Rouge, Louisiana

4. Oklahoma City

5. Jackson, Mississippi

6. Chattanooga, Tennessee

7. Dallas

8. Richmond, Virginia

9. Birmingham, Alabama

10. McAllen, Texas

Why, you may ask, would lingering winter weather affect spring allergy season?

Where do allergies come from?

“Allergy and asthma patients already have a chronic sensitivity to things like pollen, mold and other airborne allergens, but they can also be more susceptible to rapid changes in temperature and moisture,” Dr. Clifford Bassett, medical director of Allergy and Asthma Care of NY and an ambassador for the Asthma and Allergy Foundation of America, said in a statement. “A blending of the winter and spring means these patients are at risk of multiple symptoms simultaneously.”

And in case you were keeping a close eye on this type of thing, here is last year’s list of spring “allergy capitals”:

1. Jackson, Mississippi

2. Knoxville, Tennessee

3. Chattanooga, Tennessee

4. McAllen, Texas

5. Louisville, Kentucky

6. Wichita, Kansas

7. Dayton, Ohio

8. Memphis, Tennessee

9. Oklahoma City

10. Baton Rouge, Louisiana


RAMC on Salt Therapy: Why Salt Works for Respiratory and Skin Disorders

Salt as Therapy for Respiratory, Skin Disorders

Sodium chloride (NaCl), more commonly known as salt, is found in abundance in nature and is without a doubt the most frequently used condiment around the globe. Its use as a seasoning, as a preservative, and for medicinal purposes has been documented in almost every civilization.

Salt is an essential part of daily life, and this is reflected in several language derivations. In fact, the word “salary,” which comes from the Latin “salarium,” denotes money that was paid to Roman soldiers so they could buy salt rations. Likewise, the Austrian city of Salzburg literally translates as the “salt fortress” and derives its name from the barges carrying salt on the Salzach river.


Regular consumption of salt is necessary for proper functioning of the nervous system, as well as for the regulation of water balance in cells.   

Salt is found in a variety of forms. Sea salt is so abundant that there has been no scientific discussion of reserves. Other salt deposits are scattered around the world in areas thought to have once been ancient oceans that evaporated, leaving large salt deposits. The total world production of salt is estimated to be 290 million tons, with the United States being the largest producer at more than 44 million tons. In folk medicine, warm saltwater gargles for sore throats and salt poultices for soft-tissue infections are two of many commonly used salt therapies. 


The majority of clinical trials researching the efficacy of salt therapy target respiratory conditions. Therapeutic methods range from spending time in a natural salt cave­ to breathing aerosolized hypertonic salt water.

In the respiratory tract, salt’s mechanism of action is multifaceted. Because salt particles are smaller than most particulate matter in the air, they can be inhaled deeper into the airways. Once in the respiratory tract, salt triggers a cascade of therapeutic events.

Salt acts as a mucolytic, allowing natural ciliary action to improve: it decreases bronchial edema; it is an antimicrobial; and, due to these properties as well as an anti-inflammatory action, salt suppresses bronchial hyperreactivity. 

Aerosolized hypertonic saline has been studied as a treatment for cystic fibrosis. Researchers randomized 24 cystic fibrosis patients to receive either nebulized hypertonic saline (5 ml of 7% NaCl) four times a day with or without pretreatment with amiloride (Midamor), a mild diuretic. Treatments were continued for two weeks with pulmonary function and mucus clearance measured at baseline and periodically during therapy.

At the end of the trial, the study group that used only nebulized saline showed a twofold improvement in both immediate and sustained mucus clearance, and nearly a 7% improvement in pulmonary function (as measured by forced expiratory volume in one second [FEV1]). The hypothesis for the dramatic difference in the two groups was that by allowing the natural water-retaining action of the salt to function uninhibited by diuresis, the mucolytic action was much more effective.  

A study of the effect of dry salt aerosol on lung function focused on 393 patients with severe obstructive pulmonary disease. Participants were assigned to traditional therapy (aimed at bronchodilatation) alone or to traditional therapy coupled with aerosol salt therapy. After one hour, the patients receiving dual therapy showed an increase of 6.5% in oxygen saturation levels and a 26% reduction in respiratory rate compared with only 3% and 19%, respectively, in the standard-therapy group. 

Dermatology is another emerging area for salt therapy. About 2% to 3% of the world’s population is afflicted with psoriasis. In a phase 3 trial, researchers randomized 367 psoriaris patients to either traditional ultraviolet light therapy (UVT) alone or UVT and bathing in a Dead Sea hypertonic salt solution. After 35 treatments, the combination group showed a 46% greater symptom improvement than the UVT-only group.

Salt also may relieve atopic dermatitis in children with severe disease. Researchers compared topical therapies of traditional emollient cream with therapies utilizing cream enriched with Dead Sea salts. Eighty-six children were randomized, and at the end of 12 weeks, participants receiving the Dead Sea salt-enriched cream showed significant improvement in all symptom areas.


Although excessive salt consumption has been deemed potentially dangerous — especially for cardiovascular, renal or endocrine conditions — no warnings were found for topical applications.

Cost, How Supplied

Ionic salt generators, used in inhalation therapy, cost anywhere from $50 to several hundred dollars. Topical salt products are widely available and, depending on the concentration and purity, cost $30 to $100 for a one-month supply.


Data show that the various forms of salt therapy are safe and effective. However, many conditions require more than one type of therapy or medication. Consider salt therapy for patients with psoriasis in particular, as this treatment has shown significant efficacy in reducing sympto­matic lesions.   

This article originally appeared on Clinical Advisor June 21, 2013

About RAMC – Riviera Allergy Medical Center offers comprehensive treatment for the most common food allergiesskin allergy medicine, and asthma prevention. Located at 1711 Via El Prado, Suite 101 in Redondo Beach, the allergy and asthma center is headed by renowned seasonal allergy treatment specialist, Dr. Ulrike Ziegner. Visit the website and Facebook page or call 310-792-9050 for more information or to schedule an appointment for allergy treatment.

New treatment may offer hope for peanut allergy


(CNN) — When you live in fear of you or your child accidentally ingesting peanut crumbs, any hope of undoing severe food allergy is welcome.

A large clinical trial published this week in the Lancet confirms what smaller studies have shown in the past: Oral immunotherapy — swallowing tiny, increasing amounts of peanut over time — has the ability to desensitize allergic individuals to peanuts.

Peanuts are one of the leading causes of food allergy reaction, and 400,000 school-aged children in the United States have this allergy, according to the American College of Allergy, Asthma and Immunology. Symptoms may occur from any contact with the peanut protein, which is why cross-contamination of foods can be very dangerous.

The new results in the Lancet are a “very positive finding” because peanut-allergic people who become able to tolerate peanuts don’t have to worry about any accidental exposure or trace amounts of contamination, said Dr. Anna Nowak-Wegrzyn, associate professor of pediatrics at Mount Sinai Hospital in New York, who was not involved in the study.

Still, this is not a cure, she noted. The current thinking is that people who undergo oral immunotherapy need to continue eating peanuts every day in order to maintain tolerance.

Further research is needed to confirm the new results in more patients, and to see just how long the peanut allergy protection lasts, said Nowak-Wegrzyn.

How it works

Researchers at Duke University Medical Center and Arkansas Children’s Hospital found in 2009 that giving small doses of peanut protein over time could allow allergic children to tolerate eating peanuts.

A 2011 study from Duke University Medical Center found that 11 children who had peanut allergy could tolerate the equivalent of six to seven peanuts after a year of treatment.

Ninety-nine children ages 7 to 16 took part in the recent Lancet study.

Participants were divided as follows: 49 were randomly assigned to the peanut immunotherapy treatment and 50 were placed in the control group, which received no treatment.

Learn more about the study

In the first phase of the trial, lasting 26 weeks, researchers found that 84% of participants receiving the oral immunotherapy could tolerate a daily dose equivalent to about five peanuts. Rick Martin is a husband and father to two young girls. Researchers determined that 24 out of 39 participants who got the treatment — but none of the control group — had become desensitized. They measured “desensitization” as having no reaction during a peanut “challenge” of eating the equivalent of about 10 peanuts.

In the second phase, control group participants received the immunotherapy intervention, too, and 45 of them completed the treatment. The result here was that 54% of participants were able to eat the equivalent of 10 peanuts and 91% tolerated a daily intake equivalent to about five peanuts.

Most participants had only mild side effects. Some experienced gastrointestinal symptoms — 31 with nausea, 31 with vomiting and one with diarrhea.

It appears that the treatment’s protection lasts if children eat peanuts daily for up to two years, Clark said. After that, researchers are increasing the time between peanut consumptions every week. Initial studies show that this regimen is well tolerated for another two to three years, he said.

“We expect children to have to take peanut for many years,” Clark said.

Despite shots, peanut allergy kills teen

Genetic change

But what if you forget to eat your peanuts?

To maintain desensitization after experiments that involve oral immunotherapy, patients are usually asked to continue eating peanuts on a daily basis for the rest of their lives. But researchers at Stanford University School of Medicine and Lucile Packard Children’s Hospital Stanford wanted to see if there was a way to figure out whether some patients could manage without doing that.

Their report, published Friday in the Journal of Allergy and Clinical Immunology, found that the DNA in patients’ immune cells gets altered with immunotherapy. This genetic change could be used in the future to create a blood test to assess whether peanut allergy immunotherapy has worked in a given person, researchers said.

Dr. Kari Nadeau and colleagues looked at 20 children and adults who were allergic to peanuts and underwent immunotherapy for two years. They were able to eat a serving of four grams of peanuts every day without major allergic symptoms.

Researchers instructed participants to stop eating peanuts for three months, after which they ate a small amount of peanut powder. Seven of the patients did not show allergic reaction, while 13 did.

Blood samples from all participants were analyzed, and compared with samples from peanut-allergic patients who had never had oral immunotherapy.

Researchers found differences in the DNA of regulatory T cells among the groups of people analyzed.

Study authors said this could be the basis of a blood test that evaluates just how desensitized patients who have received immunotherapy treatment have become to peanuts.

Monitoring DNA in allergic patients with this kind of blood test is not expensive and requires only common lab equipment. But the U.S. Food and Drug Administration would have to approve the test for this purpose outside of an experimental setting.

If you suspect that you or your children have food allergies, talk to an allergist.


Riviera Allergy Medical Center Highlights Three Children’s Book Authors

Redondo Beach, CA: Riviera Allergy Medical Center (RAMC), an allergy treatment center in Redondo Beach, CA is headed by renowned allergy specialist Ulrike Ziegner, MD, PhD. The Center treats children with many different types of allergies and respiratory conditions such as childhood allergies, asthma in children, or children with food allergies. Knowing that wellness is affected by many elements beyond just the physical symptoms, the allergy center understands that being sick is difficult for both the child and the rest of the family.

As a service to its patients, the skin allergy doctors often recommend children’s books to help parents entertain children with allergies. The child with allergies is sometimes unable to participate in childhood physical activities and needs other forms of entertainment. The family often has other obligations and activities, and appreciates any help the allergy center provides in keeping family life as normal as possible.

In an effort to ensure parents have an ongoing supply of entertainment ideas to help amuse children who are suffering with allergies, Dr. Ziegner reviewed several children’s books. She wanted to make sure that any children’s book she recommended was educational, interesting, fun and able to provide the sufficient distraction. After thorough consideration, Dr. Ziegner named Edelen Wille, Ned Mansour, and Suanne Margaret Hastings as her favorite children’s book authors.

“I have many great memories of reading from my youth and I wanted our patients to be able to experience the same joy I felt getting lost in a character, a story or brilliant illustrations,” commented Dr. Ziegner. “I made these selections based on the author’s creativity, design elements, and story line. These children’s books are interesting and fun and I believe they will prove capable of providing hours of entertainment for children with allergies.”


Riviera Allergy Medical Center works with parents in many ways to help children with allergies feel better. Since Dr. Ziegner knows that these children are sometimes less physically active due to their allergies or asthma, she wanted to provide information on children’s book authors she thought would be of interest to young readers. If you are looking for a great way of amusing your child with allergies, consider purchasing books from these children’s authors.


About RAMC – Riviera Allergy Medical Center offers comprehensive treatment for the most common food allergiesskin allergy medicine, and asthma prevention. Located at 1711 Via El Prado, Suite 101 in Redondo Beach, the allergy and asthma center is headed up by renowned seasonal allergy treatment specialist Dr. Ulrike Ziegner. Visit the website and Facebook page or call 310-792-9050 for more information or to schedule an appointment for allergy treatment

For Immediate Release: Riviera Allergy Highlights Three Children’s Book Authors