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Lying in the Grass

Conditions Treated

Allergic rhinitis, also called hay fever, occurs when the immune system mistakenly identifies a harmless substance, called an allergen, as an intruder.  It presents as nasal congestion, runny nose, mucous drainage, sneezing, itchy and watery eyes.   


Environmental allergens include pollen, mold, dust mites, cockroach droppings and pet dander. Irritants like smoke, odors, humidity and weather changes cause similar symptoms.  Depending on the specific trigger, symptoms may be seasonal or year-round.

Allergic rhinitis is diagnosed by history, physical examination and allergy skin or blood testing.  Treatment includes allergen avoidance, medications and/or immunotherapy (allergy shots or drops) based on patient preference.

Sinus headache

Sinusitis is inflammation of the air-filled cavities within the face and skull bones.  Sinusitis can present with headache, tooth pain, facial pressure, thick drainage and reduced sense of smell.  It often coincides with nasal symptoms as the two spaces connect.  Chronic sinusitis may be associated with frequent ear infections, which over time can impair hearing and language development in children.

Sinusitis may be caused by allergies, infections, air pollution or structural problems in the nose.  Some cases are associated with nasal polyps, obstructive growths requiring special medications or even surgery.  Rarely, recurrent sinus infections indicate immune deficiency.  Allergic sinus disease is treated similarly to allergic rhinitis and utilizes allergen avoidance, medications or immunotherapy.  Dupixent is a new non-surgical injection available for nasal polyps. 

Asthma inhaler


Asthma is a chronic lung disease of airway inflammation and muscle constriction.  Symptoms include shortness of breath, chest tightness, wheezing and cough. This may cause trouble sleeping or waking at night.  Triggers include allergies, irritant odors, temperature changes, infections and exercise.  Asthma is diagnosed by a thorough history, physical examination and pulmonary function testing in our office.  Your doctor may recommend trigger avoidance, medications, and/or immunotherapy based on testing results.  Patients with severe disease may benefit from biologics, advanced injections offered at ETAA. Treatments offered include Xolair, Fasenra, Nucala, Dupixent and Tezpire

Asthma is not a reason to stop being active.  With proper treatment, many asthmatics enjoy and excel at their favorite sports and hobbies again.   If asthma is sidelining you or your loved ones, we are here to help!

Skin rash, eczema

Skin Allergy

Many skin conditions have allergic causes including urticaria (hives), angioedema (swelling), atopic dermatitis (eczema) and allergic contact dermatitis (from plants, metals, fragrances, personal care products, etc.)

Each disease has its own method of diagnosis and treatment.  Contact allergy from external triggers is diagnosed through patch testing.  Some skin diseases indicate an underlying condition such as cancer or autoimmune disorders.  

We proudly offer the advanced treatments Xolair for chronic hives and Dupixent for atopic dermatitis.  These non-steroid injections are very helpful for severe cases.  Our experts will determine if these are right for you.

Top food allergy triggers

Food Allergy

Food allergies now affect 1 in 13 children in the US.   Symptoms include itching, rash, hives, swelling, abdominal pain, vomiting, shortness of breath and even low blood pressure and death.  Common food allergens include peanuts, tree nuts, milk, egg, wheat, soy, fish and shellfish.   However allergies have been reported to hundred of foods.  

Food allergy should be diagnosed only by a board-certified allergy specialist.  This may involve skin testing, blood testing or sometimes an observed food challenge.  The only way to completely prevent a reaction is to avoid the culprit food.  Life-threatening allergies should be distinguished from intolerances, especially in children to prevent unnecessary diet restriction.  


Some companies offer tests purporting to diagnose "food sensitivities" and claim removal of such foods improves a variety of symptoms.  It is important to understand this test has never been scientifically proven to accomplish what it claims.  Results are often inaccurate and lead to overly restrictive dietary changes and worse, nutritional deficiencies.

An allergy test alone is not enough to diagnose food allergy.  A thorough history and physical exam by a trained allergist is important to distinguish what is and is not an allergy. 

Under an allergist's guidance, early introduction of high-risk foods may prevent the development of allergy in children.  There is currently one FDA-approved product (Palforzia) to reduce the risk of reaction in patients already allergic to peanut.  It is only available under an allergist's supervision.

Prescription Drugs

Medication Allergy

Medication allergies range from mild rashes to anaphylaxis.  Certain types of asthma may be triggered by medications. Common medication allergies include antibiotics, aspirin and other pain relievers, blood pressure medications, chemotherapy agents, anesthetics and contrast dye. 

Some medication allergies are outgrown with time while others are unpredictable.  Drug allergy testing determines whether a patient is truly allergic, and drug desensitization administers increasing doses of the drug in order to build temporary tolerance.   

Bees at Work

Insect Allergy

Allergic reactions to insects range from localized pain and swelling to life-threatening anaphylaxis.  Insects known for severe sting reactions include bees. wasps, hornets, yellow jackets and fire ants.    Patients at risk for severe reactions are advised carry injectable epinephrine.  Venom immunotherapy (allergy shots) protects against reactions and is advised in cases of systemic allergies.

Baby exam

Immune Deficiency

Immune deficiencies occur naturally or as a result of some other disease or medical treatment, leading to frequent or more severe infections.  These can occur in both children and adults.  Certain pediatric diseases are discovered on newborn screening conducted by the state of Texas.  Dr. Chen previously served as a registered Pediatric Immunology Consultant by the Texas Department of State Health Services. 

The most common immune deficiencies present with persistent ear, sinus and lung infections despite appropriate antibiotics.  Specialized tests and medications, such as intravenous immune globulin (IVIG) may be needed to prevent life-threatening illness. 

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