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updated September 24, 2010

Mold allergy

Filed under: Children's Health
If you have a mold allergy, your immune system overreacts when you breathe in mold spores. This reaction triggers a cascade of reactions that lead to allergy symptoms. Like other allergies, a mold allergy can make you cough, make your eyes itch and cause other symptoms that make you miserable. In some people, mold allergy is linked to asthma and exposure causes restricted breathing and other airway symptoms.

If you have a mold allergy, the best defense is to reduce your exposure to the types of mold that cause your reaction. While it isn't always possible to avoid mold allergy triggers, medications can help keep mold allergy reactions under control.

©1998-2013 Mayo Foundation for Medical Education and Research (MFMER). Terms of use.
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Mold allergy causes the same signs and symptoms that occur in other types of upper respiratory allergies. Mold allergy symptoms can include:

  • Sneezing
  • Runny or stuffy nose
  • Cough and postnasal drip
  • Itchy eyes, nose and throat
  • Watery eyes

Mold allergy symptoms vary from person to person, and range from mild to severe. You may have year-round symptoms or symptoms that flare up only during certain times of the year. You may notice symptoms when the weather is damp, or you're in indoor or outdoor spaces that have high concentrations of mold.

If you have a mold allergy and asthma, your asthma symptoms may be triggered by exposure to mold spores. In some people, exposure to certain molds can cause a severe asthma attack. Signs and symptoms of asthma include:

  • Coughing
  • Wheezing
  • Shortness of breath
  • Chest tightness

When to see a doctor
If you have a stuffy nose, sneezing, watery eyes or other bothersome symptoms that don't seem to go away, see your doctor.

©1998-2013 Mayo Foundation for Medical Education and Research (MFMER). Terms of use.
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Like any allergy, mold allergy symptoms are triggered by an overly sensitive immune system response. When you inhale tiny, airborne mold spores, your body recognizes them as foreign invaders and develops allergy-causing antibodies to fight them.

After the exposure has passed, you still produce antibodies that "remember" this invader, so that any later contact with the mold causes your immune system to react. This reaction triggers the release of substances such as histamine, which cause itchy, watery eyes, runny nose, sneezing and other mold allergy symptoms.

Molds are very common both inside and outside. There are many different types, but only certain kinds of mold cause allergies. Being allergic to one type of mold doesn't necessarily mean you'll be allergic to another. Some of the most common molds that cause allergies include alternaria, aspergillus, cladosporium and penicillium.

When it's not an allergy
Although a mold allergy is the most common problem caused by exposure to mold, mold can cause illness without causing an allergic reaction. Mold can also cause infections, or irritant and toxic reactions. Infections caused by mold can cause a variety of problems from flu-like symptoms, to skin infections and even pneumonia.

An irritant reaction is caused when substances from molds called volatile organic compounds irritate the mucous membranes in the body. Symptoms of an irritant reaction are similar to an allergy and include eye irritation, runny nose, cough, voice hoarseness, headache and skin irritation. With a mold allergy, your symptoms will generally get progressively worse with each exposure to mold, while an irritant reaction doesn't get worse.

A toxic reaction to mold is caused by eating, drinking or inhaling substances called mycotoxins. As with an irritant reaction, the symptoms of a toxic reaction may also include flu-like symptoms, eye and skin irritation, and breathing troubles. You may also experience headaches, nervousness, dizziness, difficulty concentrating and extreme fatigue if you're having a toxic reaction to mold.

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A number of factors can make you more likely to develop a mold allergy, or worsen your existing mold allergy symptoms, including:

  • Having a family history of allergies. If allergies and asthma run in your family, you're more likely to develop a mold allergy.
  • Working in an occupation that exposes you to mold. Occupations where mold exposure may be high include farming, dairy work, logging, baking, millwork, carpentry, greenhouse work, winemaking and furniture repair.
  • Living in a house with high humidity. If your indoor humidity is higher than 60 percent, you may have increased exposure to mold in your home. Mold can grow virtually anywhere if the conditions are right — in basements, behind walls in framing, on soap-coated grout and other damp surfaces, in carpet pads and in the carpet itself. Exposure to high levels of household mold may trigger mold allergy symptoms.
  • Work or live in a building that's been exposed to excess moisture. Leaky pipes, water seepage during rainstorms, flood damage: At some point, nearly every building has some kind of excessive moisture. This moisture can allow mold to flourish.
  • Living in a house with poor ventilation. Tight window and door seals may trap moisture indoors and prevent proper ventilation, creating ideal conditions for mold growth. Damp areas, such as bathrooms, kitchens and basements, are most vulnerable.

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Most allergic responses to mold involve hay fever-type symptoms that can make you miserable, but aren't serious. However, certain allergic conditions caused by mold are more severe. These include:

  • Mold-induced asthma. In people allergic to mold, breathing in spores can trigger an asthma flare-up. If you have a mold allergy and asthma, be sure you have an emergency plan in place in case of a severe asthma attack.
  • Allergic fungal sinusitis. This occurs when fungus lodges and grows in the sinuses. Surgery may be necessary to remove a tightly packed infection ("fungal ball").
  • Allergic bronchopulmonary aspergillosis. This fungal infection of the lungs can occur in people with asthma or cystic fibrosis.
  • Hypersensitivity pneumonitis. This rare condition occurs when exposure to airborne particles such as mold spores cause the lungs to become inflamed. It may be triggered by exposure to allergy-causing dust at work.

Other problems caused by mold
Some believe that certain molds (such as so-called "black mold") can cause a host of signs and symptoms such as fatigue, headache, nausea, fever, rashes and coughing — and even a condition that causes bleeding lungs in infants (acute idiopathic pulmonary hemorrhage). While some molds contain toxins that are poisonous when eaten, more research is needed to determine whether molds inside buildings release airborne toxins that cause problems in otherwise healthy people.

Living or working in a damp building can cause respiratory symptoms including nasal congestion, sneezing, runny nose, throat irritation and cough. But, it's not clear that mold is always the culprit behind these symptoms. Damp buildings are prime environments for other health hazards, including harmful bacteria, dust mites and rodents.

Exposure to high levels of mold can cause nonallergic complications in people who have weakened immune systems. If you're healthy, you can handle mold exposure, but if you're on chemotherapy or immune-suppressing drugs, you may be at risk of developing a mold infection.

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Many people are diagnosed and treated for allergies by their primary care physicians. However, depending on the severity of your allergies, and the impact allergies have on your life, your primary care doctor may refer you to a doctor who specializes in treating allergies.

You can take steps ahead of time to ensure that you cover everything that's important to you. Here's some information to help you get ready for your appointment, and what you can expect from your doctor.

What you can do

  • Ask if there are any pre-appointment restrictions, when making your appointment. For example, if you're going to have any allergy tests, your doctor will likely want you to stop taking any allergy medications for several days before the test.
  • Write down any symptoms you're experiencing, as well as what you were doing at the time you had the symptoms.
  • Make a list of all the medications, vitamins or supplements that you take, and take that list with you to your appointment.
  • Write down any questions you have for your doctor.

Preparing a list of questions helps you make the most of your time with your doctor. For a mold allergy, some questions you might want to ask include:

  • What do you think is causing these symptoms?
  • Are there tests available that can confirm a specific allergy? Do I need to prepare for these tests?
  • How can I treat a mold allergy?
  • What side effects can I expect from allergy medications?
  • What steps can I take to get mold out of my home?
  • Is there a generic alternative to the medicine you're prescribing?
  • I have another health condition. How can I best manage these conditions together?
  • Do you have any brochures or other printed material that I can take home with me? Are there any websites that you recommend I visit?

What to expect from your doctor
To determine whether allergies or other possible causes are responsible for your symptoms, your doctor will ask you a number of questions. Your doctor will want to know:

  • Exactly what symptoms you have
  • What seems to trigger symptoms or make them worse
  • Whether your symptoms are worse during certain times of the year or certain times of the day
  • Whether your symptoms flare up when you're in certain locations, such as outdoors or in your basement
  • What medications you take, including herbal remedies
  • Any health problems you have
  • Whether you have a family history of allergies
  • If you're exposed to mold, dust, fumes or chemicals at work
  • If you know of any areas with mold in your home

What you can do in the meantime
While you're waiting to see your doctor, there are numerous over-the-counter allergy medications available to ease your symptoms, such as loratadine (Claritin, Alavert), cetirizine (Zyrtec), diphenhydramine (Benadryl), clemastine (Tavist) and chlorpheniramine (Chlor-Trimeton).

If you have mold in your home, it will help your symptoms if you have someone who's not allergic to mold clean the area using a solution of 1 ounce of bleach to 1 quart of water, or a commercially available mold-cleaning product. If you have to clean up the mold yourself, be sure to wear long rubber gloves, safety goggles and a mask to limit your exposure to the mold.

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Your doctor will want to know your signs and symptoms and may want to conduct a physical examination to identify or exclude other medical problems. Your doctor may also recommend one or more skin or blood tests to see if you have an allergy that can be identified. These include:

  • Skin prick test. This test uses diluted amounts of common or suspected allergens, such as molds found in the local area. During the test, these substances are applied to the skin in your arm or back with tiny punctures. If you're allergic, you develop a raised bump (hive) at the test location on your skin.
  • Blood test. A blood test (sometimes called the radioallergosorbent test, or RAST) can measure your immune system's response to mold by measuring the amount of certain antibodies in your bloodstream, known as immunoglobulin E (IgE) antibodies. A blood sample is sent to a medical laboratory, where it can be tested for evidence of sensitivity to specific types of mold.

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The best treatment for any allergy is to take steps to avoid exposure to your triggers. However, molds are common and you can't completely avoid them. While there's no sure way to cure a mold allergy, a number of medications can ease your symptoms. These include:

  • Nasal corticosteroids. These nasal sprays help prevent and treat the inflammation caused by an upper respiratory mold allergy. For many people they're the most effective allergy medications, and they're often the first medication prescribed. Examples include ciclesonide (Omnaris), fluticasone (Flonase Veramyst), mometasone (Nasonex) and beclomethasone (Beconase). Nosebleeding is the most common side effect of these medications. These medications are generally safe for long-term use.
  • Antihistamines. These medications can help with itching, sneezing and runny nose. They work by blocking histamine, an inflammatory chemical released by your immune system during an allergic reaction. Over-the-counter (OTC) antihistamines include loratadine (Claritin, Alavert) and cetirizine (Zyrtec). Older antihistamines such as diphenhydramine (Benadryl) and clemastine (Tavist) work as well, but can make you drowsy. Fexofenadine (Allegra) and the nasal spray azelastine (Astelin) are available by prescription.
  • Decongestants. These medications are available in over-the-counter (OTC) and prescription liquids, tablets and nasal sprays. OTC oral decongestants include Sudafed, Actifed and Drixoral. Nasal sprays include phenylephrine (Neo-Synephrine) and oxymetazoline (Afrin). Because oral decongestants can raise blood pressure, avoid them if you have high blood pressure (hypertension). Don't use a decongestant nasal spray for more than two or three days at a time because it can cause rebound congestion when used over longer periods.
  • Cromolyn (NasalCrom). This medication is available as an over-the-counter nasal spray. It helps relieve mold allergy symptoms by preventing the release of histamine. Cromolyn is most effective when you start taking it before signs and symptoms develop.
  • Montelukast. Montelukast (Singulair) is a prescription tablet taken to block the action of leukotrienes — immune system chemicals that cause allergy symptoms such as excess mucus. It has proved effective in treating allergic asthma, and it's also effective in treating mold allergy. Like antihistamines, this medication is not as effective as inhaled corticosteroids. It's often used when nasal sprays cannot be tolerated, or when mild asthma is present.

Other treatments for mold allergy include:

  • Immunotherapy. This treatment — a series of allergy shots — virtually eliminates some allergies, such as hay fever. Unfortunately, however, allergy shots are only moderately effective against mold allergy.
  • Nasal lavage. To help with irritating nasal symptoms, your doctor may recommend that you rinse your nose with salt water. Use an over-the-counter nasal saline spray or prepare your own saltwater solution. To do this, mix 3 heaping teaspoons of salt that doesn't contain any iodine with 1 teaspoon of baking soda in a container you can seal. Take 1 teaspoon of this mixture and mix it with 8 ounces of water to make your saltwater solution. If you experience any burning or stinging, use less of the salt and baking soda mixture the next time.

Your doctor may recommend additional treatments if you also have mold-induced asthma, allergic fungal sinusitis, allergic bronchopulmonary aspergillosis and hypersensitivity pneumonitis.

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To keep mold allergy symptoms at bay, take these measures:

  • Sleep with your windows closed to keep out outdoor mold. The concentration of airborne mold spores tends to be greatest at night, when the weather is cool and damp.
  • Wear a dust mask over your nose and mouth to keep mold spores out if you have to rake leaves, mow your lawn or work around compost.
  • Avoid going outdoors at certain times, such as immediately after a rainstorm, in foggy or damp weather, or when the published mold count is high.

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You can take steps to reduce mold growth in your home. Consider these tips:

  • Eliminate sources of dampness in basements, such as pipe leaks or groundwater seepage.
  • Use a dehumidifier in any area of your home that smells musty or damp. Keep your humidity levels below 50 percent. Remember to clean the collection bucket and condensation coils regularly.
  • Use an air conditioner, and consider installing central air conditioning with a high-efficiency particulate air (HEPA) filter attachment. The HEPA filter can trap mold spores from outdoor air before they're circulated inside your home.
  • Change filters on your furnace and air conditioners regularly. Have forced air heating ducts inspected and if necessary, cleaned.
  • Be sure all bathrooms are properly ventilated, and run the ventilation fan during a shower or bath and immediately after to dry the air. If you don't have a ventilation fan, open a window or door while you're showering or bathing.
  • Clean bathroom and basement wall surfaces regularly with a bleach solution.
  • Promote groundwater drainage away from your house by removing leaves and vegetation from around the foundation and cleaning out rain gutters frequently.
  • Keep organic plant containers clean and dry, such as those made of straw, wicker or hemp.

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