Spring brings with it sunshine, warmer temperatures, flowers, and allergies. Although seasonal allergies, may make you want to hide inside, some important steps can be taken to help prevent and treat seasonal allergies, so you can enjoy Mother Nature at its finest.
Spring allergies are most often attributed to one major offender, pollen, which is given off by countless numbers of flowers, plants, and trees for fertilization. When the pollen is inhaled or settles on the skin, the body recognizes it as a foreign invader similar to bacteria and an immune response is initiated leading to release of histamine which accounts for the side effects of allergies including: itchy runny nose, itchy watery eyes, sneezing, and coughing.
During the spring and throughout the summer, it is important to monitor the daily pollen count which describes the concentration of pollen in the air.
During the spring and throughout the summer, it is important to monitor the daily pollen count which describes the concentration of pollen in the air. This can be found either by watching the local weather forecast or by going online to the Pollen & Mold Counts page on the American Academy of Allergy, Asthma and Immunology’s web site. Days when the pollen levels are particularly high especially dry, breezy days may be days you may want to try and avoid prolonged times outside or take allergy medicine prophylactically. Pollen levels do tend to be lower following rain, so that may be a better time to be outside.
If you have never been officially diagnosed with seasonal allergies, allergy specialists can use an allergen skin test to determine specifically what substances you are allergic to. Knowing specifically what you are allergic to can help you in your avoidance strategy. In addition to avoidance, another nonpharmacological option is using saline solution to help rinse out the nose. Neti pots have been shown to be quite useful in helping to relieve nasal inflammation caused by allergies. For best results, irrigation should be done as close as possible to exposure to help rinse out the allergens from the nose before they cause symptoms. Another nonpharmaceutical option is acupuncture which works by a mechanism not fully understood.
The first line option for itchy runny nose, sneezing, and itchy watery eyes caused by seasonal allergies is 2nd generation antihistamines such as loratadine (Claritin®), fexofenadine (Allegra®), and cetirizine (Zyrtec®). These work just as well as the 1st generation antihistamines diphenhydramine (Benadryl®) and chlorpheniramine at treating these symptoms, but do not have as high rates of sedation. All five of these agents are available over-the-counter.
If your symptoms seem to be primarily red, itchy, watery eyes, then you may want to consider antihistamine eye drops which are also available over-the-counter such Zaditor®, Alaway®, Naphcon A®, Opcon A®, or Visine A®.
Antihistamines do not treat nasal congestion well. If you have nasal congestion with your other allergy symptoms, you may want to try an oral nasal decongestant such as pseudoephedrine or phenylephrine which relieves congestion by constricting blood vessels around the nose. Note pseudoephedrine is restricted in how much you can purchase. Nasal decongestants should also be avoided if you have high blood pressure that is not stable. Another option is a nasal spray decongestant like oxymetalozine HCl (Afrin®) which acts locally to relieve congestion by vasoconstriction. These sprays however cannot be used for longer than 3 days as they cause rebound congestion.
Knowing specifically what you are allergic to can help you in your avoidance strategy.
If the agents listed above which are all available OTC do not seem to be working, then the prescription route may be pursued. Nasal corticosteroids (with the exception of triamcinolone (Nasacort®) which was recently approved as OTC) are prescription only. Nasal corticosteroids are very effective in relieving nasal allergies and inflammation, but do carry some of the risks of systemic corticosteroids including bone weakening and should not be given in children <12 without physician approval. Nasal spray antihistamines are also prescription only and include azelastine (Astelin®) and olopatadine (Patanase®). They should be used only when oral 2nd generation antihistamines are ineffective. Another prescription only option is to use a leukotriene receptor blocker such as montelukast (Singulair®). These medications help to prevent reactions to allergies by blocking another pathway which leads to inflammation.
Spring is a wonderful time of the year which everyone should be able to enjoy despite the challenges of seasonal allergies. We hope this article has given you a thorough overview of the options you have, so you can get outside and enjoy the nice weather.
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