Dust Mite Allergies: Common Does Not Mean Trivial

Inseparable Housemates

Dust mites live all around us - even directly on us. Those that burrow into human skin don’t make us sneeze. The term dust mite allergy refers to an allergy to the feces of those species that live in our homes and feed on flakes of our skin. Dust mites produce about 20 pellets of feces daily, each the size of a pollen grain, making them easily inhaled. The exoskeleton of dust mites can also trigger an allergic reaction, as it is an airborne allergen found indoors that causes allergic rhinitis-conjunctivitis, allergic asthma, and atopic eczema.

Dust mites thrive in environments around 30°C with about 70% humidity, which is why they prefer used bedding, mattresses, upholstery, and carpets. About 90% of our home’s dust mites are Dermatophagoides pteronyssinus, Dermatophagoides farinae, and Euroglyphus maynei.

Dust mite allergies typically develop in childhood or adolescence, with the first symptoms appearing before the age of 20.

Culprits Under the Microscope

The allergens most commonly causing problems to human “housemates” of dust mites are:

• Der p1, allergens from the Dermatophagoides pteronyssinus dust mite
• Der p2, allergens from the Dermatophagoides pteronyssinus dust mite
• Der p23, allergens from the Dermatophagoides pteronyssinus dust mite
• Der f1, allergens from the Dermatophagoides farinae dust mite
• Der f2, allergens from the Dermatophagoides farinae dust mite

Der p1 is the main cause of dust mite allergies and is responsible for elevated IgE levels. There is a quantitative relationship between exposure and the development of allergies, so household care aimed at reducing exposure is important. The less allergen we come into contact with, the lower the chance of developing an allergic reaction and allergic asthma.

A Range of Preventive Approaches

There are many ways to prevent dust mite allergies, varying in effectiveness, but they provide enough maneuvering space for use in specific conditions.

• Covering mattresses and pillows with sufficiently compact fabric or plastic foil. This prevents mites from penetrating and settling in them.
• Washing household textiles in hot water (60°C and above) at least once a week. This temperature should kill the mites.
• Removing carpets and throws.
• A home air purifier with a HEPA filter, which captures and removes volatile particles of dust mite feces.
• Freezing stuffed toys.
• Reducing humidity in the home below 45%.
• Frequent vacuuming.
• Eliminating activities that stir up dust in the home - pillow fights, moving furniture, beating throws, etc.
• Flow-through ventilation, which effectively exchanges the air in the home.
• Treating mattresses and bedding with a plant preparation containing substances similar to the pheromones of dust mites (ExAller) or applying them to cotton textiles, which can then be gathered in one place and washed to easily and quickly get rid of the mites.

Of course, there is also symptomatic treatment (antihistamines, corticosteroids, decongestants, etc.) or immunological treatment (immunotherapy).

Changing Oneself or the Home?

Changing the immune system’s setting is not easy; in contrast, choosing the right furniture is a breeze. But even this approach has its shortcomings. An ageal home for a severe dust mite allergy sufferer doesn’t exist, or it is likely very cold and uninviting. Textiles belong to the home, they are soft, pleasant to human senses, and create a cozy atmosphere. A home equipped with furniture made of leather, wood, glass, and metal is not conducive to a comfortable life, especially if the allergy sufferer is sharing it with someone who is healthy and views the ‘anti-mite’ regime as a concession to their environment. Therefore, it is advisable to arrange the apartment according to one’s preference and rather look for solutions that allow for regular mite removal.

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Source: Aggarwal P., Senthilkumaran S. Dust mite allergy. StatPearls Publishing, Treasure Island, 2020 Dec 8.