Allergy to house dust mites
Allergy to house dust mites is one of the most common forms of respiratory allergy: it is estimated to affect up to 20 per cent of the general population in industrialised countries, with a significant impact on the quality of daily life. It is a chronic but manageable condition that can be addressed through an integrated approach comprising environmental measures, drug therapy and, where indicated, allergen-specific immunotherapy. (Ref. Bergmann Allergo J Int 2022; Bousquet ARIA JACI 2020)
What is house dust mite allergy?
A dust mite allergy is an IgE-mediated hypersensitivity respiratory allergy caused by the inhalation of allergens derived from dust mites present in indoor environments. It is not the mites themselves that trigger the allergic reaction, but rather the proteins contained in their faeces and body fragments, which are easily airborne and inhalable.
Dust mites are microscopic arthropods found in all homes. The clinically most significant species in such environments are Dermatophagoides pteronyssinus and Dermatophagoides farinae, which are responsible for the majority of respiratory allergic sensitisation in industrialised countries.
According to the international scientific consensus documents ARIA and GINA on the management of allergic rhinitis and asthma, dust mites are the main indoor allergens involved in persistent allergic rhinitis and allergic asthma.
(Ref. WAO White Book 2010;
Bousquet J, et al; ARIA Workshop Group; World Health Organisation. Allergic rhinitis and its effect on asthma. J Allergy Clin Immunol 2001; 108: S147–S334.
Global Initiative for Asthma. Global Strategy for Asthma Management and Prevention, 2025. Updated 15 November 2025. Available from:
www.ginasthma.org)
How an allergic reaction develops
In susceptible individuals, repeated exposure to house dust mite allergens triggers the production of specific IgE antibodies. Upon subsequent contact with the allergen, mast cells are activated and release chemical mediators, leading to inflammation of the airways (Ref. Bousquet ARIA JACI 2001).
This mechanism explains the frequent co-occurrence of allergic rhinitis and bronchial asthma, a correlation well documented in the ARIA (Allergic Rhinitis and its Impact on Asthma) report, which emphasises that the two conditions are often manifestations of the same inflammatory process, with corresponding localised effects affecting the upper airways (nose, nasopharynx, paranasal sinuses) and lower airways (larynx, trachea, bronchi and bronchioles).
Symptoms of dust mite allergy
A dust mite allergy is considered perennial — present all year round, unlike seasonal allergies — and symptoms tend to worsen at night and in the morning. Clinical manifestations involve the upper and lower respiratory tracts and can vary in severity.
Nasal symptoms
- Persistent nasal obstruction
- Watery nasal discharge
- Repeated sneezing
- Nasal itching
Eye symptoms
- Redness and itching of the eyes
- Excessive watering of the eyes
Bronchial symptoms
- Dry cough
- Wheezing
- Paroxysmal dyspnoea (shortness of breath)
- Tightness in the chest
Why do the symptoms get worse at night?
Mattresses, pillows and soft furnishings are the main source of dust mite allergens. During sleep, prolonged contact with contaminated surfaces, combined with body heat and moisture, encourages the proliferation of dust mites and increases inhalation exposure to their allergens.
The result is the frequent onset or worsening of symptoms during the night and upon waking, with a negative impact on sleep quality, daytime concentration and general well-being.
Impact on quality of life
Dust mite allergy is a chronic condition which, if not properly managed, can significantly impair quality of life (Ref: WAO WHITE BOOK 2010). The most significant consequences include:
- Sleep disturbances and daytime fatigue
- Reduced concentration and performance at work or school
- Restriction of physical and daily activities
- Increased risk of asthma exacerbations in patients with asthma
In patients with asthma, limiting ongoing exposure to indoor allergens is considered a key factor in controlling the condition and reducing the risk of exacerbations (ref: GINA 2025).
Where dust mites are found in the home
Dust mites are present in almost all homes. They thrive in environments with mild temperatures (18–25°C), high relative humidity (above 50 per cent) and the presence of organic material on which to feed, such as human skin flakes.
The highest concentrations are found in:
- Mattresses and pillows
- Sofas, armchairs and other upholstered furniture
- Rugs and carpets
- Textiles, curtains and soft toys
These environments are the main source of chronic exposure to indoor allergens.
Reducing exposure to allergens: environmental measures
A large body of scientific literature agrees that certain interventions can reduce the environmental allergen load, representing a potentially useful strategy in the management of dust mite allergy, to be integrated with the treatment plan prescribed by the doctor (Ref: GINA 2025; Bousquet ARIA JACI 2001; Hogaard Respiratory Medicine 2025).
Measures capable of reducing exposure include:
- Use of tightly woven anti-mite mattress and pillow covers
- Regular washing of textiles at high temperatures (≥60°C)
- Maintaining relative humidity below 50%
- Cleaning with vacuum cleaners fitted with HEPA filters and damp cloths
- Reducing the number of rugs, carpets and items that accumulate dust
The environmental measures described are for information purposes only and are considered part of an integrated approach to managing exposure to indoor allergens. The clinical management of allergies must be determined by a doctor based on the patient’s individual characteristics.
Frequently asked questions
No. Dust mites measure between 0.2 and 0.5 mm and cannot be seen individually without optical instruments. Their presence in the home can only be detected through specific tests.
Yes. Unlike seasonal allergies (caused by pollen), a dust mite allergy is year-round: symptoms often occur throughout the year, with possible seasonal variations linked to ambient humidity and the use of heating.
There is no definitive cure for a dust mite allergy in the traditional sense, but it can be effectively managed through a combination of environmental measures, drug therapy and, in cases selected by a doctor, allergen-specific immunotherapy (ASI), a treatment capable of altering the natural course of the disease. (ref. Roberts. EAACI guidelines. Allergy 2018).
People with a family history of atopic diseases (asthma, eczema, allergic rhinitis) are at greater risk. Children exposed at an early age to environments with high concentrations of allergens may also develop sensitisation over time.
You should see a doctor if you have persistent respiratory symptoms (blocked nose, sneezing, coughing) or symptoms that recur regularly, particularly in the morning or after a night’s sleep, and if you are exposed to indoor allergen sources. An allergy assessment will confirm the diagnosis and enable the most appropriate treatment to be prescribed.
Practical guide: how to reduce dust mites in the home
Information note
The information on this page is for information purposes only and is not a substitute for the advice of a doctor or other qualified healthcare professionals. For a clinical assessment and any treatment decisions, including the choice and management of drug therapies and allergen-specific immunotherapy, you should consult your doctor. The environmental measures described are considered part of an integrated approach to managing exposure to indoor allergens and must be assessed within the context of an individualised treatment plan.