Simply having a wonderful Christmastime becomes a lot more difficult if you're allergic to Christmas trees, poinsettias or even the cold.

Dr. Samira Jeimy has some survival tips for the unlucky few who suffer through the holiday season. She spoke with the CBC's Conrad Collaco about allergies that arrive just in time for the holiday season and provided some advice on how to cope. You can read an abridged and edited version of the interview or listen to the full audio interview by hitting the play button above.

Dr. Samira Jeimy, immunologist and allergist at St. Joseph's Health Care

Can you tell us about some allergies that you've come across that flare up over the holidays?

So, first of all, I want to say we only get Christmas once a year so go out and enjoy and we can help. If you see that your nasal allergy or other such allergies are getting worse come and see us. If somebody has a mold allergy, they'll notice that they take the Christmas tree out of the basement and their nasal allergy might declare itself. The solution to most aero-allergens is avoiding the trigger and giving the tree a good wash with a solution of bleach and water and then dry barley can go a long way towards reducing the amount of mold that's on the tree. Some people if they handle a real Christmas tree they'll notice that the resin or the colophony on the Christmas tree can give them a contact allergic reaction. So, handling the tree with gloves is sufficient or letting somebody up who doesn't have the allergy and handle the tree is great.

If there's an issue of food allergy that's important to identify what your triggers are first and then having people be aware so that attending a party the host can make a dish that's safe for you. Sometimes we'll tell people to volunteer to bring their own dish or their own snack to a party so that they have more complete assurance that they're not going to be exposed to their food allergy trigger.

I've already this holiday season spoken with a couple people who've talked about a new allergy they have to shrimp. Why is that becoming so much more common now?

Excellent question. Adult onset shrimp allergy is a thing and we are seeing that, identifying it, a lot more than you think. So, believe it or not, shrimp and other crustacean members of the shellfish family are related to dust mites, which are microscopic little critters that live in warm wet environments. They feed on our dead skin cells. We are allergic to their feces. So, these bugs that a lot of people are allergic to are actually relatives of shrimp and we think there might be a link that maybe the dust mite allergy evolved into actually a shrimp allergy or a lobster, sadly, allergy. So, yeah it's important to be aware because as you mentioned we do pick it up in adulthood which is not common, as you probably are aware of, for food allergy but tend to manifest themselves mostly in childhood.

That's definitely going to change dinner menus during the holiday season.

Yeah. It tends to be a dose dependent phenomenon, too. If you suspect that there might be an allergy, in this case, some moderation would be key.

Some people are even allergic to the cold and that's a problem not just around Christmas but for the entire season. What suggestions do you have for people who suffer from contact with the cold?

This is a phenomenon called uticaria. Think of it more of an autoimmune phenomenon not an allergy where the immune system gets very hyper reactive for a little bit and tends to respond to the cold as if it's fighting a bug. The allergy cells are called mast cells in the skin and fire off with exposure to cold temperatures. And people generally give us a very good history that is suggestive of this phenomenon. When it happens the best thing to do is to actually avoid the trigger. I sometimes say in clinic 'do you want to go on a vacation to a warmer temperature? Do you want me to write you a prescription? And the other thing to do is manage the symptoms with the newer generation antihistamines. In some situations with cold uticaria the important thing to note is that it might require an EpiPen.

Some people have actually symptoms of swelling in the throat when they drink a cold beverage. And in these individuals we generally prescribe an EpiPen and to all people with uticaria we say don't go swimming alone because immersing yourself in the cold water may actually lead to anaphylaxis. So an EpiPen for cold uticaria, which is different from the other hives that we see.

That would be a terrible place to confront an allergy to the cold, while out swimming.

Exactly. Don't go swimming alone.

In the last little while we've seen some reports of people still taking Benadryl while there are better options out there for people who are trying to handle their allergies. So, as the holidays approach and people prepare for parties where there might be guests with all sorts of different types of allergies, what advice do you have for people trying to be good hosts who want to accommodate all these different allergies?

Excellent question about the Benadryl. Yes. So, as allergists we have been maybe preaching for a while about this Benadryl as one of the older generation antihistamines that can cross the blood brain barrier and have other than non-wanted side effects that we can avoid by using the second generation and second and third generation antihistamines. So, there are a lot of other options that don't have the side effect profile that Benadryl and its relatives like chlor tripolon, you might have heard of, or hydroxyzine. Long term it is best to avoid these options.

In terms of being a good host, I think it's important to know if a guest is allergic to something and give your guest options with allergen free foods. It's a little bit much to ask the host to stock the house with EpiPens. Our patients with food allergies are generally very educated and empowered. They're always advised to carry two EpiPens on their person at all times.

As I said, we encourage the patients with food allergies to bring their own snacks or bring their own dish to a party.