The Itch: Allergies, Asthma, Eczema & Immunology

Chronic hives that come and go without warning are exhausting physically and emotionally. But here is something many patients don't realize: feeling "okay" is not the same as being well controlled.

Kortney and Dr. Gupta are joined by Dr. Tom Chacko, a board-certified allergist and immunologist based in Atlanta, to discuss what good hives control actually looks like and what to do when you are not there yet. From "just living with" your condition to managing a bad flare, tracking your symptoms, and preparing for your follow-up appointment, this episode gives you the tools to stop just coping and start getting better care.

What we cover in our episode about what chronic hives control looks like:

Chronic spontaneous urticaria. The plain-language definition of CSU, including why hives appear without a clear trigger and what angioedema is.

The trap of normalizing symptoms. Why patients adjust their lives around hives without realizing it, and how to spot the signs that your condition is not actually controlled.

How to track your hives. Why symptom tracking helps with diagnosis and better care, and how to use tools like the UAS7 score.

What to bring to your follow-up appointment. The concrete information your doctor needs to work with you to find the best treatment plan. This includes information about sleep, daily activity, and medication side effects.

How to ask for more help. What to say when antihistamines are not enough, and what newer treatment options exist for CSU patients today.

More resources about chronic hives

UAS-7 Urticaria Activity Score worksheet

Allergy & Asthma Network chronic urticaria resources

More episodes about hives

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Made in partnership with The Allergy & Asthma Network.

Thanks to Novartis for sponsoring today’s episode. 

This podcast is for informational purposes only and does not substitute professional medical advice. Always consult with your healthcare provider for any medical concerns.

If you have chronic hives and antihistamines aren't helping, there's a new treatment option to know about. In this episode of The Itch Review, we spotlight "Remibrutinib in Chronic Spontaneous Urticaria" published in The New England Journal of Medicine, March 2025.

This article looks at the REMIX trials, which tested whether remibrutinib, a BTK inhibitor, can help adults whose chronic spontaneous urticaria (CSU) is not controlled by antihistamines alone. Remibrutinib works differently from antihistamines. Instead of blocking histamine after it's released, it stops mast cells from releasing those itch-causing chemicals in the first place.

The FDA approved remibrutinib in September 2025. 

What we cover in our episode about the REMIX trial:

Understanding CSU: Chronic spontaneous urticaria causes itchy hives and swelling for more than 6 weeks with no clear trigger, and antihistamines don't work for everyone.

How remibrutinib works: This BTK inhibitor stops mast cells from releasing chemicals like histamine, rather than blocking histamine after it's already released.

Why do two identical trials: Running the same study twice (REMIX-1 and REMIX-2) with different patients helps prove the results are real, not a fluke.

Key results: About half of patients reached well-controlled disease, and about 1 in 3 became completely clear of hives and itch.

Safety and side effects: Petechiae (tiny dots of bleeding under the skin) were the main thing to watch for, but most cases were mild and went away on their own.

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More resources about chronic hives

Chronic Spontaneous Urticaria - Allergy & Asthma Network

Chronic Urticaria Toolkit

What are hives?

All episodes on urticaria

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The Itch Review, hosted by Dr. Gupta, Kortney, and Dr. Blaiss, explores allergy and immunology studies, breaking down complex research in conversations accessible to clinicians, patients, and caregivers. Each episode provides key insights from journal articles and includes a one-page infographic in the show notes for easy reference.

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Made in partnership with The Allergy & Asthma Network.

Thanks to Novartis for sponsoring today’s episode. 

This podcast is for informational purposes only and does not substitute professional medical advice. Always consult with your healthcare provider for any medical concerns.

Chronic rhinosinusitis with nasal polyps, or CRSwNP, is a condition driven by ongoing inflammation. That is why treatment is not a one-time fix and why polyps can come back even after surgery. In this episode, Dr. Payel Gupta and Kortney are joined by Dr. Maeve O'Connor, a board-certified allergist and immunologist, to walk through CRSwNP treatment options.

This episode is released around World Anosmia Day because loss of smell is one of the most frustrating and most common symptoms of CRSwNP, and one that treatment can actually help with.

What we cover in this episode about nasal polyps treatment

Nasal therapies as your base management: Saline rinses and nasal steroid sprays are the foundation of CRSwNP treatment. They need to be used consistently as part of your daily routine, not just when symptoms flare.

Why nasal polyps keep coming back: CRSwNP is driven by ongoing inflammation, not just the polyps themselves, so removing them does not address the root cause.

When surgery is the right choice: Sinus surgery can open blocked passages and help nasal sprays reach deeper into the sinuses, but works best as part of a long-term plan, not a one-time fix.

What biologic medications actually do: Biologics target the underlying inflammation causing CRSwNP. Four are currently approved for CRSwNP: dupilumab, omalizumab, mepolizumab, and tezepelumab.

Why follow-up care matters even when you feel better: Inflammation can return before symptoms become noticeable, so regular check-ins with your allergist or ENT are key to catching early signs of polyp regrowth.

About our guest 
Dr. Maeve O'Connor, MD, FACAAI, FAAAAI, is a board-certified allergist and immunologist and founder of Allergy Asthma & Immunology Relief (AAIR) of Charlotte, North Carolina. She treats patients of all ages, practices integrative medicine, and has been named a Top Doctor by Charlotte Magazine since 2007.

More resources

What is Chronic Rhinosinusitis with Nasal Polyps (CRSwNP)?

What are nasal polyps?

What is AERD?

Biologics for Allergic Disease

What to know before starting a biologic 

Oral Corticosteroid Stewardship

 

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Made in partnership with The Allergy & Asthma Network.

Thanks to Sanofi-Regeneron for sponsoring today’s episode. 

This podcast is for informational purposes only and does not substitute professional medical advice. Always consult with your healthcare provider for any medical concerns.

We spend about 90% of our time indoors. But what's actually in that air we breathe, and why does it matter so much for people with asthma, allergies, and eczema?

This is part two of our series about indoor air quality. We discuss how you can improve your indoor air quality. Kortney shares her experience living in Germany, where ventilating your home isn't just a suggestion, it's practically a lifestyle. We also go room by room with practical tips you can actually use, from washing your sheets in hot water to why that scented candle might need to go.

Part one covered what causes bad indoor air quality and what causes health problems for people with asthma and allergic diseases.

What we cover in part two about indoor air quality

The art of Lüften, aka house burping: Fully opening your windows for 5 to 10 minutes is better than cracking them all day, but skip it during peak pollen season.

How to reduce dust mites in your bedroom: Hot water washes, dust mite covers, humidity control between 30 and 50 percent, and keeping stuffed animals off the bed.

What to know about air purifiers: HEPA filters catch particles, carbon filters catch chemicals, and size matters for your room.

Some cleaning products may make things worse: Choose fragrance-free products, avoid aerosols and scented candles, and wear a mask while cleaning.

Kitchen and bathroom tips: Run exhaust fans during and after cooking or showering, check for leaks, and watch your shower curtain for mold.

Advocating for better air at school and work: Ask about ventilation and MERV filters, and pay attention if your symptoms improve on weekends.

More resources

Allergy & Asthma Network: Healthy at Home

Allergy & Asthma Network: Healthy at Work

EPA Indoor Air Quality Tools for Schools

EPA Safer Choice Cleaning Products

EXHALE Resources

Listen: Ep. 144: What is Indoor Air Quality and Allergic Disease (Part 1 of 2)

This series is part of the EXHALE project, a set of six evidence-based strategies designed to help people with asthma achieve better health and improved quality of life. This series supports the last "E" in EXHALE by reducing asthma triggers in indoor environments.

This podcast is made in partnership with Allergy & Asthma Network

We spend about 90% of our time indoors. But what's actually in that air we breathe, and why does it matter so much for people with asthma, allergies, and eczema?

This is a two-part series about indoor air quality.

In the first part, we break down the three main categories of indoor air pollutants: particulate matter (PM2.5 and PM10), volatile organic compounds (VOCs), and biological allergens like dust mites and mold. Dr. G explains how each one affects the body differently and why people with allergic disease are especially vulnerable.

In part two, we discuss how you can improve your indoor air quality.

What we cover in part one about indoor air quality

What's actually in your indoor air: The three main categories are particulate matter (PM), VOCs, and biological allergens.

Why PM2.5 is more dangerous than PM10: PM2.5 is small enough to enter your lungs and bloodstream, while PM10 mostly irritates your nose and throat.

How we create particulate matter: PM2.5 comes from burning things like cooking, candles, and gas stoves. PM10 comes from dust, construction, and dirt tracked in on shoes.

The difference between particles and gases: PM2.5 is like tiny specks of dust or smoke. VOCs are invisible gases that cause smells, like that "new car" scent.

Indoor allergens: Dust mites, mold, pet dander, and cockroach allergens are biological triggers that can cause allergic reactions and worsen asthma.

More resources

Allergy & Asthma Network: Healthy at Home

Allergy & Asthma Network: Healthy at Work

EPA Indoor Air Quality Tools for Schools

EPA Safer Choice Cleaning Products

EXHALE Resources

This series is part of the EXHALE project, a set of six evidence-based strategies designed to help people with asthma achieve better health and improved quality of life. This series supports the last "E" in EXHALE by reducing asthma triggers in indoor environments.

This podcast is made in partnership with Allergy & Asthma Network