Don’t Like Needles? Why Sublingual Immunotherapy Is an Alternative to Allergy Shots

Imagine allergy relief with no needles required.

For millions of Americans, immunotherapy eliminates problems with year-round allergies. It’s sometimes referred to as “allergy shots.” But did you know that there is an allergy treatment that doesn't require shots? Whether you dislike needles yourself or are the parent of a child who is uncomfortable with needles, this treatment may be right for you!

How does immunotherapy work?

There are several different steps in immunotherapy treatment:

  1. An ENT physician determines the source of the allergy.

  2. A diluted form of the allergen is given to the patient.
    The ENT determines the correct, therapeutic dosage of the allergen. Eventually, the body will develop a natural resistance to the allergy.

  3. Then, the patient undergoes two phases: the escalation phase and the maintenance phase.
    During the escalation phase, the patient’s dosage is gradually increased until it reaches an effective level. Then, in the maintenance phase, the patient continues to receive the dosage at this effective level.

  4. Patients return to their ENT for regular maintenance doses, sometimes over the course of several months or years.


Types of Immunotherapy

There are two main types of immunotherapy. One is subcutaneous immunotherapy (also known as “allergy shots.”) The other is sublingual immunotherapy (SLIT), which doesn’t require any needles. While both share some common traits, SLIT does offer some significant advantages. See below:

No needles

Children with allergies may be afraid of needles—and they even make many adults uneasy! While allergy shots require needles to place a diluted form of the allergen under the skin, during SLIT treatment, patients are given daily drops under the tongue.


SLIT can be delivered from the comfort and convenience of your home, while allergy shots require office visits over the course of several months or even years. SLIT is also easier for those who travel a lot for business or who have children with allergies. Depending upon your child’s specific type of allergies, he or she may have to go to the ENT office once a week for several months to receive allergy shots. Needless to say, this can be challenging, particularly with younger children.

Keep In Mind

Those who are eligible for SLIT treatments should also keep a few things in mind. First, it is a long-term solution: some physicians recommend continuing treatment for three to five years to achieve the maximum benefit. Second, while SLIT is frequently used throughout Europe, in the U.S., it’s considered “investigational” by the Food and Drug Administration --- this is also sometimes referred to as “off-label” use. This means that your insurance will more than likely not pay for this treatment. While cost may vary from state to state, expect to pay around $2.66 per day for the first year. Third, the exact combination of a therapeutic dose must be decided by an ENT doctor who specializes in allergy treatment.

A word of warning: beware of any non-allergist or non-physician who claims to offer the same treatment. Often, these treatments are not effective at best and damaging at worst.

If you believe you’re a candidate for SLIT, speak to your ear, nose and throat doctor. You can have extensive allergy relief even if you're afraid of needles.


Johns Hopkins Medicine. “Sublingual Immunotherapy.”

The Mayo Clinic. “Allergy Shots.”

Raleigh Capitol ENT. “SLT”