Mite allergy – and what next? Treatment and prevention

Mites, which are small arachnids that live in all environments and climates, include as many as 45,000-46,000 species [4]. However, from an allergist’s perspective, house dust mites are the most troublesome. They are among the culprits in the mechanism of allergy and asthma development [5]. Mites feed on exfoliated epidermis and other microorganisms such as moulds. In some respects, therefore, they are beneficial. The snag is that their proteins can be allergenic – to both humans and pets [9]. Mite allergens are found not only in their muscles, but also in their faeces [2]. Among other things, mite faeces contain the highly allergenic protein Der p 1 [11].

In our climatic zone, the main allergens are species of the genus Dermatophagoides (Dermatophagoides pteronyssinus, Dermatophagoides farinae), which account for up to 90% of all dust mites [2]. They are thermophilic organisms. They multiply most intensively at 17-32℃, i.e. in summer. However, their presence should not be underestimated in autumn or winter. The circulation of air heated by radiators encourages the mites to rise from occupied surfaces [10]. This is why autumn sees the greatest increase in complaints of mite allergy [11]. Under optimal conditions, mites accumulated during the summer season can survive for 1-5 months [6].

Mites accumulate in carpets, rugs, upholstered furniture, clothing and plush toys, among others [2], so their proteins are indoor allergens. The favourite habitat of mites is the bedroom, and within it, the bed. They are most abundant in mattresses, pillows and duvets [10]. There are up to 10 times more of them there than in carpets [11]. When allergenic proteins enter the allergic person’s respiratory tract, they irritate the mucous membrane, resulting in inflammation [5]. An allergic person may therefore have a chronic runny nose and a constantly blocked nose. Sometimes these symptoms are accompanied by persistent sneezing and headaches [5] and symptoms characteristic of asthma (shortness of breath and wheezing, especially at night and in the morning) [11]. These should prompt the diagnosis and subsequent treatment of mite allergy.

If an allergy to house dust mites is identified or suspected, it is important to act immediately. The first step to relieving symptoms is to limit exposure to the allergen. What will help combat the mite? First and foremost:

• removing domestic dust reservoirs (curtains, carpets, floor coverings, bedspreads, upholstered furniture) or cleaning them using heat, e.g. with a steam cleaner,
• daily ventilation of the rooms,
• frequent laundering of bed linen (weekly) and duvets and pillows (monthly) at min. 60℃,
• putting mattresses outside when the air temperature drops to -20℃,
• using so-called barrier bedding (anti-allergenic), which does not allow mites or other allergens to pass through,
• use of dust mite repellents, e.g. geraniol-based preparations,
• wet cleaning of furniture and floor surfaces and polishing with polishes,
• use of HEPA-type air filters and hoovers,
• freezing, i.e. placing material accessories and toys (especially teddy bears) in plastic bags in the freezer at least once every 1-2 weeks,
• reducing room humidity to 40-45%,
• hiding clothes in wardrobes and books and other everyday objects in locked cupboards [4, 10, 11].

The symptomatic treatment of house dust mite allergy to eliminate the accompanying complaints is based on pharmacology. For rhinitis, the following are used:

• antihistamines (topical and external),
• glucocorticosteroids (topical and general),
• intranasal antihistamines in combination with intranasal glucocorticosteroids,
• α-adrenergic drugs (sympathicomimetics),
• antileukotrienes,
• ipratropium bromide,
• cromones [10].

The treatment pathway should always be chosen by the doctor, depending on, among other things, the type and severity of symptoms and the age of the patient.

Currently, allergen specific immunotherapy (AIT) is considered the only causal treatment for mite (and non-mite) allergy [3, 7]. This is a variant of desensitisation involving the use of a vaccine (in subcutaneous, oral or intranasal form) [3]. This type of therapy results in the development of tolerance to the allergen, which takes place gradually (doses of allergen are systematically increased) [13]. Treatment of mite allergy, if it is to have a long-term effect, should be spread over 3-5 years [14].

Immunotherapy not only has a curative effect (relieves or completely abolishes symptoms), but also a preventive effect (prevents their appearance in the future) [7]. Vaccination can protect against allergic rhinitis and bronchial asthma caused by mite allergy. It can also protect against the development of sensitisation to further allergens. According to some studies, its effectiveness against mites is as high as 80 per cent [7]. However, in selected patient groups (e.g. those with AD), it is much lower [15].

Patients in Poland can benefit from refundable forms of mite allergy treatment with immunotherapy. These are:

• classical immunotherapy (injection, subcutaneous) for adults and children (over 5 years of age) with IgE-dependent allergy [12, 13, 16],
• oral (sublingual) immunotherapy for patients aged 12-17 years, which is suitable for use at home [7, 14].

Aleksandra Lipiec 

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translation: Julia Majsiak

Publication: 13.11.2023
Updated: 20.10.2025