When it comes to treating allergies, two of the most common options are Sublingual Immunotherapy (SLIT) and allergy shots (Subcutaneous Immunotherapy, SCIT). Both work by gradually desensitizing your immune system to allergens. Each has its own advantages and can offer long-term relief from allergic reactions, but there are key differences between the two treatments. Let’s break them down:
Sublingual Immunotherapy (SLIT) vs. Allergy Shots (SCIT)
1. Administration Method
- SLIT:
- This treatment involves placing small doses of allergen extracts under the tongue, typically in the form of tablets or drops.
- The patient can take it at home once prescribed by a doctor.
- Allergy Shots (SCIT):
- Allergy shots are injections that deliver allergens under the skin, usually in the upper arm.
- These shots are administered in a medical setting, requiring a visit to a healthcare provider. The patient typically receives these shots once or twice a week during the initial build-up phase and then less often once they reach the maintenance phase.
2. Treatment Schedule & Duration
- SLIT:
- Patients usually start SLIT at least 12 weeks before the allergy season begins (if treating for seasonal allergies) and continue treatment year-round for 3–5 years.
- After the initial period, the dosage may decrease, but the treatment continues at home.
- Allergy Shots (SCIT):
- The build-up phase typically lasts 3–6 months, with shots administered once or twice a week.
- After reaching the maintenance dose (a stronger level of allergen exposure), the frequency is reduced to once a month. Treatment usually lasts 3–5 years.
3. Convenience & Home Use
- SLIT:
- One of the biggest advantages of SLIT is the convenience of taking the treatment at home. Once you have your prescription, you can manage it yourself.
- There are no needles involved, which makes it a less intimidating option, especially for children or needle-averse individuals.
- Allergy Shots (SCIT):
- Since allergy shots require a visit to the doctor's office, they’re less convenient. A patient must make time for appointments regularly (especially during the build-up phase).
- Some people also find needles uncomfortable, which can be a barrier for some patients.
4. Effectiveness
- SLIT:
- Studies suggest that SLIT is effective in treating allergic rhinitis (hay fever), allergic asthma, and other common allergies like those to dust mites, pollen, and pet dander.
- Some patients report improvement within 6 months, but full results may take 2–3 years to become apparent.
- Allergy Shots (SCIT):
- Allergy shots have been studied extensively and are considered very effective for patients with moderate to severe allergies, including asthma. SCIT can be used for a wider range of allergies, including insect venom (bees, wasps).
- It may take 1–2 years for the full effects of allergy shots to take hold, but they have been shown to have a more rapid improvement compared to SLIT in certain cases.
5. Side Effects & Risks
- SLIT:
- SLIT generally has fewer and milder side effects compared to allergy shots.
- The most common reactions are local, such as itching, swelling, or mild irritation in the mouth or throat.
- Systemic reactions (like sneezing or asthma) are rare but possible.
- SLIT has a lower risk of severe allergic reactions (like anaphylaxis) than allergy shots, but there is still a negligible risk, especially if the treatment is not properly managed.
- Allergy Shots (SCIT):
- Allergy shots can cause both local reactions (redness, swelling, pain at the injection site) and systemic reactions (sneezing, itching, more severe symptoms).
- There is a higher risk of anaphylaxis with allergy shots, which is why patients are usually required to wait 20–30 minutes after each injection for monitoring.
- However, anaphylaxis is rare, especially if the patient is carefully monitored during treatment.
6. Cost and Insurance Coverage
- SLIT:
- The cost of SLIT may be higher in the beginning due to the need for initial consultations and prescriptions, but since it is self-administered, the overall cost can be lower in the long term.
- Insurance plans do not always cover SLIT, although this is changing in some places as the treatment becomes more popular and recognized.
- Allergy Shots (SCIT):
- Allergy shots often cost less per dose since they’re prepared in bulk, but the frequent doctor visits can drive up the overall expense.
- Most insurance plans cover allergy shots, but the costs can still add up due to copays and clinic visits.
7. Ideal Candidates
- SLIT:
- Ideal for patients who have mild to moderate allergies and are looking for a more convenient, non-invasive treatment.
- Particularly useful for seasonal allergies, but can also help with year-round allergens like dust mites and pet dander.
- Allergy Shots (SCIT):
- Better suited for patients with severe or multiple allergies that need more intensive treatment.
- Often recommended for individuals with allergic asthma or those who have not responded well to medications like antihistamines or nasal sprays.
Which Should You Choose?
Both treatments have their benefits, and the best choice depends on your specific situation.
- If you're looking for a convenient, non-invasive, and less time-consuming option, SLIT might be the right choice.
- If you have severe allergies, asthma, or need more intensive treatment, allergy shots might be more effective for you.
In either case, it’s essential to consult with an allergist who can assess your allergy profile and help guide you to the best treatment plan.
