ABSTRACT
If at all possible, the first mainstay of treatment is prevention, first, with causative antigen avoidance. It should be remembered that skin tests identify possible, but not definite, causes of asthma. Specific advice should be given about the avoidance of allergens, at least for a trial period: the most common is the house dust mite (but it can be difficult to avoid contact with this altogether). With house dust allergy, the patient should vacuum their home with a low dust machine as much as possible to eliminate dust, including mattresses and bedding. They should use synthetic bedding and pillows. Wrapping the mattress in a plastic sheet is an effective way of reducing antigen exposure, but is rather uncomfortable. Replacing mattresses is rather useless, as it only takes six months for house dust mites to get up to full numbers in a new mattress.
