Spring Ahead Of Seasonal Allergies
There are plenty of ways to enjoy a breath of fresh air without the worry.
A daily walk has become part of many routines these days—the exercise and fresh air is a welcome break for those following the stay-at-home mandate. But for more than 50 million Americans, the reprieve from the indoors can bring itchy eyes, runny noses, congestion and fatigue. These are the symptoms of seasonal allergic rhinitis (also known as hay fever, rose fever or pollinosis), caused by allergic reactions to airborne substances such as pollen that affect the upper respiratory tract and eyes. For some, it also means itchy skin or worsened asthma.
According to Debora Geller, M.D., a pediatric and adult asthma, allergy and immunology specialist at Vanguard Medical Group in Emerson, tree pollen and certain molds will affect allergy sufferers through June. Grass pollen booms during the summer, then ragweed hits its peak from August through October.
The tendency to have allergies is genetic, and symptoms typically show up during childhood, but that doesn’t mean individuals can’t develop them later in life. “I’ve seen people develop allergies in their 20s,” Dr. Geller says.
Adults who experience symptoms for the first time usually treat themselves with an over-the-counter medication. “If that first line of defense isn’t working, then it’s time to seek advice from a physician or allergist,” she says. “It’s a scary thing to do with all that’s going on in the world right now, but they don’t need to suffer and be miserable. Allergies can trigger asthma and sinus infections, so it’s best to have them treated. With telehealth, I can ‘meet’ with patients who might be nervous because of COVID-19.”
Under normal circumstances, a good time to make an appointment with your physician is February to begin preventive measures, if necessary. Your doctor can evaluate symptoms, the organs involved and whether ongoing treatment is needed.
It’s important to individualize treatment for each patient. An experienced specialist can get a good feel quickly for what combination of medications might work best, but the patient’s specific symptoms and medical history must also be considered.
For those with occasional symptoms, solutions can be as simple as changing clothes after spending time outdoors and washing your hands and face. “I know people might have cabin fever right now so I feel badly saying this, but staying indoors and minimizing exposure is ideal too,” Dr. Geller says.
Over-the-counter medications such as Claritin and Zyrtec work well for sufferers with moderate symptoms, she adds. These antihistamines will reduce overall allergic response and provide symptomatic relief. For those who need more relief from stuffiness and congestion, doctors might add an intranasal corticosteroid spray or an intranasal antihistamine spray. These can take a few days to start working, but are more effective than over-the-counter sprays.
Prescription eye drops with either antihistamines or mast cell stabilizers can be used for longer periods and are better for persistently itchy eyes.
For allergy-induced asthma, there are a variety of prescription inhalers, both quick-acting “rescue” inhalers and long-acting anti-inflammatory products that can reduce the frequency of attacks. While these medications can provide excellent symptom control, their use must be individualized.
If those don’t work, or if a patient is having adverse side effects, your doctor might suggest immunotherapy, or allergy shots. This treatment aims to reduce sensitivity to triggers.
“Allergy shots don’t work immediately and take a commitment of time,” Dr. Geller says, adding that shots are administered on a weekly basis. “Before going this route, I have a discussion with my patients about the severity of their symptoms and how they are affecting their lives.”
Because of social distancing and concerns over the coronavirus, many allergists are not taking new immunotherapy patients. “But as soon as the pandemic eases,” Dr. Geller says. “we will start it again.”
WHAT HAPPENS IF YOU CHOOSE ALLERGY SHOTS
To determine a patient’s allergies, doctors perform skin-scratch or prick tests, placing tiny quantities of suspected allergens on the skin to measure a reaction. From those tests and blood tests, a regimen of customized injections is developed.
The therapy has two phases: buildup, which involves shots once or twice a week over a period of several months, and maintenance, after an effective therapeutic dose has been reached. From there, intervals between shots usually range from two to four weeks for a course of three to five years.
Immunotherapy can be a good option for treating persistent allergy symptoms in people who have reactions that persist for more than several months, and who haven’t responded to other forms of treatment.
Immunotherapy has been reported to have approximately an 85 percent success rate, but it does involve a significant time commitment on the part of the patient.
6 TIPS FOR INDIVIDUALS WITH ALLERGIES
• Avoid exposure to tobacco smoke. It not only triggers symptoms, but can also increase allergic sensitivity.
• When traveling in a car, keep the windows closed and the air-conditioning on.
• Do not hang laundry out to dry (pollenwill collect on linens or clothing).
• Do not let an allergic individual mow the lawn or rake the leaves without a filter mask.
• Wash bedding weekly in hot water.
• Shower and shampoo hair after spending time outdoors.