Sneezin' Season
If you suffer from springtime allergies, take heart: there are many ways to find relief.
After the brutality of this year’s winter, most of us are eager to trade our snow shovels in for garden spades. But while warm-weather outdoor activities are refreshing, the sun-splashed days of spring also spell misery for seasonal allergy sufferers.
“A seasonal allergy is a reaction to a specific trigger that is present only at a certain time of the year,” says Debora K. Geller, M.D., an allergist at ENT and Allergy Associates, with locations in Englewood, Hackensack and Oradell. While perennial allergies occur year-round and are sparked by indoor pests like pet dander, dust mites and mold, the culprits that cause pain from mid-March through the summer months are all found outdoors.
“In our part of the country, tree pollen is the springtime allergy trigger,” says Dr. Geller. As trees such as birch, maple, oak and poplar start to flower, they release into the air a powder we call pollen. When it’s inhaled by someone who is sensitive to that particular allergen, he or she will experience seasonal allergic rhinitis—more commonly known as hay fever. This inflammation of the nasal airways affects more than 35 million Americans, making it one of most common chronic diseases, according to the American Academy of Allergy, Asthma and Immunology (AAAAI).
Trees in the Northeast typically release pollen only from March to June. The bad news? Once they die down, the grasses kick into high gear, causing difficulty come mid-summer. “From late August to October, hay fever is sparked by ragweed,” says Dr. Geller. Then there are molds, which grow when it is warm and damp, such as in spring thaws and on humid summer afternoons.
Regardless of the trigger, seasonal allergic rhinitis symptoms are the same. “They can include sneezing, nasal congestion or a runny nose, a scratchy throat, red or runny eyes and itchiness of the ears, eyes and nose,” says Fuad Baroody, M.D., chair of the AAAAI’s Rhinitis, Rhinosinusitis and Ocular Allergy Committee. The amount of pollen in the air determines how severe one’s suffering will be. “Certain highly allergic individuals may even experience respiratory problems, like asthma or wheezing,” says Dr. Baroody.
The first thing to do is limit your exposure to pollen. “I always tell patients to monitor the pollen and mold counts by tuning into their local weather channel or checking out the website of the National Allergy Bureau [NAB],” says Dr. Geller. “On high-pollen days I advise them to remain inside with the windows shut and the air conditioning on.” Because trees, grasses and weeds generally emit pollen from 5 a.m. to 10 a.m., postponing outdoor activities until afternoon is a good idea. “I also recommend bathing in the evening so that pollen isn’t transferred from your skin and hair onto your bed,” adds Dr. Geller. “Change your clothes after coming inside, wash bedding in hot water and don’t hang laundry out to dry.”
Of course, none of us can exist in a bubble. If precautionary measures fail, it’s time for treatment. “There are three classes of medication seasonal-allergy sufferers can try,” says Dr. Baroody. Here’s how they break down:
Antihistamines
Available by prescription or over the counter, these pills and nasal sprays block the action of histamine, a body chemical responsible for producing the irksome symptoms associated with allergies. “Antihistamines can be very effective for relieving itching and sneezing, but they don’t offer full runny-nose control,” says Dr. Baroody. And while certain newer antihistamines such as Claritin and Zyrtec (both available over the counter) are non-sedating, many of the first-generation agents like Benadryl will cause drowsiness. “That’s problematic because it can affect job performance and driving ability,” says Dr. Baroody.
Leukotriene Receptor Antagonists (LTRs)
Instead of blocking histamines, these drugs block leukotrienes, another inflammatory chemical released by the body after it is exposed to an allergen. Besides relieving sneezing, itching and congestion to a similar degree as the antihistamines, LTRs such as Singulair (available by prescription) can also clear nasal congestion. Another bonus? “They’re non-sedating, and they’ve even been approved by the FDA for preventing asthma,” says Dr. Baroody. “Yet because they’re more expensive than the antihistamines, they wouldn’t be my first choice of medication to prescribe.”
Intranasal steroids
“By and large the most effective medications we have for controlling allergic rhinitis, nasal steroid sprays like Flonase have none of the side effects people typically worry about when taking steroids,” says Dr. Baroody. “There is no risk of becoming addicted to them, and they don’t make you fat or cause hair to grow where it doesn’t belong.” In fact, the worst result is typically an irritated nose. Five to 10 percent of users may experience dryness or bleeding, but even those problems often can be resolved by switching to a different preparation.
Immunotherapy
Immunotherapy (allergy shots) is often the last course of action a patient will pursue. Each shot contains enough of a specific allergen to stimulate the immune system, though not so much that it will cause a fullblown reaction. Though it’s extremely ef fective in treating seasonal allergies, immunotherapy does require a major time commitment. Injections must be administered once or twice a week for the first three to six months, so that the body can become accustomed to increasing allergen doses. Once an optimum level is achieved, two to four weeks can pass between doctor visits. Most patients receive immunotherapy for three to five years, af ter which time symptoms are generally mild enough to cease treatment or switch to medication. “The important thing to remember is that the majority of seasonal allergy cases can, in one way or another, be treated,” says Dr. Geller. “So there’s never any need to suffer and say, ‘Oh, it’s just my allergies.’”
