House Dust Mite Allergy

Symptoms

How It's Diagnosed

• Skin prick test to HDM extract (Dermatophagoides pteronyssinus, D. farinae)
• Specific IgE to Der p 1, Der p 2 (main allergen components)
• Nasal provocation test in research/specialist settings

Avoidance Strategies

• Encase mattresses, pillows, and duvets in allergen-impermeable covers
• Wash bedding at 60°C (140°F) weekly — this kills mites; cold wash alone does not
• Reduce indoor humidity to below 50% with ventilation or a dehumidifier
• Remove bedroom carpets and replace with hard flooring where possible
• Vacuum with a HEPA-filtered machine; damp-mop hard floors
• Soft toys in children's rooms should be washable; freeze them weekly if not

Immunotherapy for HDM allergy

Allergen immunotherapy (AIT) — either subcutaneous injections (SCIT) or sublingual tablets/drops (SLIT) with HDM extract — is the only treatment that modifies the underlying allergy. It can reduce symptoms, medication use, and the risk of developing new allergies or asthma.

Sublingual HDM tablets (Acarizax, Odactra) are approved for allergic rhinitis and asthma and are taken daily at home after the first dose is administered in a clinic.

The UAE and Gulf context

Despite the hot, dry outdoor climate, Gulf homes are sealed and air-conditioned for most of the year, creating warm, humid indoor microclimates where dust mites thrive — particularly in bedrooms and upholstered furniture.

Indoor allergen sensitisation (dust mites, cockroach, mould) often plays a larger role than outdoor pollen in causing rhinitis and asthma in Gulf patients.