There are a variety of different types of inhaler. Inhalers improve respiratory symptoms whilst supporting breathing capability and efficiency as well as relieving any symptoms, such as wheezing. Professor Lack will advise and prescribe the best type of inhaler suited to your specific needs. Training on the use and method of use is provided at the clinic by the Nurse Specialist. Additionally, expert videos are available on the Asthma UK website.

Eye drops

Eye drops are essential in relieving any symptoms of irritation, inflammation or infection to the eye(s). Professor Lack will prescribe eye drops at your appointment and training can be given by the Nurse Specialist. Additionally, expert videos are available on the Moorfields Specialist Eye Hospital website.

Nasal spray

Nasal sprays are essential in treating and relieving symptoms of inflammation and irritation within the nasal passageways and sinuses. Nevertheless, nasal sprays are commonly used incorrectly at home which leads to patients falsely believing they do not help or, in fact, make symptoms worse. Moreover, incorrect usage and technique can lead to trauma in the nose and nose bleeds.

Training is provided at the clinic by the Nurse Specialist. Additionally, expert videos for nasal spray techniques are available on the Asthma UK website.

Adrenaline Auto- Injectors (AAI’s)

Adrenaline Auto-Injectors are prescribed when the patient is at risk of having a severe allergic reaction to a food or drug. There are three different brands commonly prescribed within the UK: EpiPen, Jext and Emerade. Prescriptions are based on the weight of the patient.

It is imperative that the patient always carries two AAIs with them at all times to ensure correct dosage in times of emergency. For example, should the reaction require two doses of adrenaline or should one of the pens fail or be used incorrectly.

Training for usage and method is given in clinic by our Nurse Specialist. Additionally, expert videos are available on each of the manufacturers’ websites. Please note: patients’ GPs should be advised to add AAIs to repeat prescription lists as soon as possible after your consultation at the clinic.


Steroids come in a variety of preparations and are essential in the treatment of allergic inflammations on the airways and skin. Steroids are safe: regrettably, there are many false or misleading claims which contribute to poor compliance and, in turn, poor health and quality of life.

Short-term, strong steroid use in the management of severe eczema and airway inflammations is typically the most effective form of management for restoring health, comfort and minimising life threatening complications. Furthermore, all steroid prescriptions are closely monitored and accompanied by follow up appointments to ensure that treatment is effective.

Low dose steroid inhalers are prescribed for long-term management of chronic asthma; a potentially life-threatening condition if incorrectly managed or if the patient has poor compliance.

It is of the utmost importance that prescriptions and dosage for steroids must be taken exactly as directed to ensure patient safety and comfort. Furthermore, to control the risk of potential life-threatening symptoms or allergy prevention (in the case of severe topical eczema).

Topical creams

There is a direct link between eczema and the development of allergies. Therefore, monitoring of skin health and resolution of eczema flares is an essential part of on-going treatment. Common emollient creams must be used regularly although it is necessary to ensure that these creams do not contain food oils or proteins, particularly if the patient does not eat these specific foods regularly in ample amounts. For example, avoid creams with oat protein, coconut oil, avocado oil, almond oil as these ingredients may trigger an allergic reaction.

Advice and recommendations on emollient creams and the regular treatment of eczema patches are readily available in clinic. If the eczema becomes severe, particularly if the skin is bleeding, infected and extremely itchy, topical steroids and/ or antifungal creams may be prescribed. The foremost concern is healing the skin so that it can continue to act as a barrier.


Allergic reactions trigger the release of mast cells within the body which release histamine (‘soldiers’) to fight the allergen (‘the enemy’). This allergic response can cause a variety of reactions such as rashes, swelling, hives and anaphylaxis.

Antihistamine, therefore, subdues the histamine in the body to inhibit further worsening of the reactions in addition to treating developing symptoms. In the case of anaphylaxis and breathing difficulties, a prescribed adrenaline auto-injector will also be used. For children under the age of 1 year old, Chlorphenamine (common brand name Piriton) should be used. For any other person above the age of 1 year old, Cetirizine (common brand names include Pirtize and Zirtek) should be used.