Immunotherapy or “allergy shots” is the administration of gradually increasing amounts of an allergy extract over a period of time. Standard protocols increase the dose once or twice per week until a maintenance dose is reached. The maintenance dose is typically the dose at which clinical effect is seen. This process can take several months. Rapid desensitization is a process that helps patients reach their maintenance dose and therefore the clinical benefit more quickly. This procedure requires patients to spend 4 to 4.5 hours in our office. We increase the “allergy shot” dose every 30 minutes as tolerated, up to a maximum of 8 times. Most patients do well with this procedure, but some may have localized swelling, redness, and pain at the injection site. If the swelling is 2 cm or greater we will stop for the day. Rapid desensitization can be repeated once per week until the maximum rapid dose is reached. As with standard “allergy shot” protocols there is a risk of systemic reactions that may include diffuse rash with itching, hoarseness, difficulty breathing, dizziness or abdominal pain. This happens rarely, but is a risk of the procedure.