These recommendations are based on expert opinion included in guidelines for the management of allergic rhinitis provided by the British Society for Allergy and Clinical Immunology [Scadding et al, 2008].

• Recommendation on who to advise to try allergen avoidance:
• House dust mite avoidance measures are not routinely recommended for all people with house dust mite allergy because the measures are inconvenient, expensive and there is a lack of good quality evidence for their effectiveness.
• Avoidance of confirmed animal allergens is considered important to control symptoms of allergic rhinitis and reduce the risk of asthma developing.
• Recommendations on how to avoid allergens:
• There is a lack of good-quality trials examining the effect of house dust mite avoidance techniques in controlling the symptoms of allergic rhinitis.
• A Cochrane review of allergen avoidance techniques in the control of perennial allergic rhinitis found [Sheikh et al, 2007b]:
• Seven relevant randomized controlled trials, of which two trials were of good quality and five small trials were of poor quality.
• Of the interventions investigated, the authors found limited evidence that the use of acaricides and extensive bedroom-based environmental control programs may reduce symptoms of perennial allergic rhinitis caused by house dust mite.