Oops, forgot that you don't get snow there.
When allergies progress, a derm may be needed. I think it's fine to manage allergies with a general vet. If we went to an internist or dermatologist or board certified dentist as much as it is recommended on YT, we would not be in an okay place financially. They are needed sometimes and it's fine if you have the money to constantly pour into that type of thing. But a general vet is good for something and they are capable of treating most allergies.
About vets giving out steroids and covering the problem up...I don't know b/c that's not what Ellie's vet does. And if something has to be used long term and antihistamines aren't working, she is likely to grab the Atopica instead of steroids.
However, in our case, the majority of Ellie's problem is food allergies. May some some environmental, but not a huge issue as far as we know. We try to keep her diet allergen free, but that doesn't always work b/c elimination diets aren't always successful with her (i.e. she'll get something off the floor in the middle of it and throw everything off or she is still somewhat itchy at the end...probably environmental). So we do the best we can. She got into something last weekend that she shouldn't have (food) and the only way to control her itching until for the next few weeks is steroids. So back on Temaril-P she goes. Not something we wanted to do b/c of her pancreas, but we don't have a choice. That said, elimination diets aren't always accurate while pup is on steroids. So they may have to be stopped first.