As the planet thaws and temperatures rise, seasonal allergy sufferers prepare for the worst. Having enjoyed a winter hiatus, those with environment-induced allergies (also called hay fever) wake each morning unsure of what they will experience when they walk out their door.
Runny nose; uncontrollable sneezing; congestion; itchy, watery eyes—the list of symptoms goes on and on, and that doesn’t even cover the sinus infections, poor sleep, headaches and decrease in productivity that are also associated with allergies.
Even though allergy conditions are on the rise and 1 in 5 Americans suffer from them, according to the American Academy of Allergy, Asthma and Immunology, only 1 in 8 people seek professional medical help. Instead, they opt for over-the-counter treatments, says Dr. Ahmed Butt, allergist at the Allergy and Asthma Centers of Fredericksburg, Fairfax and Manassas and clinical professor at the Medical College of Virginia.
“Some allergy conditions, such as a mild case of hay fever that occurs infrequently, may not need any treatment,” Butt says. “But millions of patients with allergic conditions, [like] asthma, seasonal allergies or eczema, suffer and live with uncontrolled symptoms even when taking over-the-counter medications.
“Non-allergic triggers—changes in temperature, humidity—may also be the culprit for some,” Butt adds. “Nobody wants to take unnecessary medications or spend money on treatment that does not work, so a thorough evaluation by an allergist can be helpful to obtain an accurate diagnosis and a personalized treatment plan.”
In the D.C. region, pollen allergies begin appearing in March. Tree pollen is typically at its peak during spring’s onset, whereas grass pollen shows up at the end of spring and gains momentum during the summer months.
“While identification and avoidance of allergens that worsen your symptoms is highly recommended, for many this may be a difficult task to accomplish,” Butt says.
Some preventative practices include closing car and home windows to limit allergen exposure and cutting back on time spent outdoors when pollen counts are high. If you do spend time outdoors, showering afterward can reduce symptoms experienced while asleep.
“For many, though, behavioral modification isn’t enough, and medications may be necessary,” Butt says. “While some medications work quickly, nasal sprays such as Flonase or Nasacort may take several weeks of daily use to reach their full potential.”
Antihistamines typically help with runny nose, itchy and watery eyes and sneezing, while nonsedative oral antihistamines like Zyrtec or Allegra are preferred over “first generation, sedating” medications like Benadryl. Nasal corticosteroid sprays are particularly helpful for nasal congestion.
“This class of medications is the mainstay of treatment for seasonal allergies as it helps to control nasal inflammation,” Butt says. “These types of nasal sprays are not addictive, but potential side effects include nosebleeds, stinging, burning and/or damage to the nasal tissue. Therefore, long-term use requires supervision by a health care professional.”
Nasal sprays can also treat allergic conjunctivitis (an eye allergy).
“Although over-the-counter antihistamine pills may be convenient, they are not as effective as antihistamine eye drops for treating an eye allergy,” Butt says. “Eye drops often have a faster onset of action and are more effective than any other form of therapy, but not all eye drops are equally effective.”
Some eye drops, which claim to reduce eye redness, include the ingredients tetrahydrozoline and naphazoline, which whiten the eyes but don’t treat the underlying issue.
Those who would rather not turn to medicine might consider allergen immunotherapy (allergy shots), which can help treat seasonal allergies, eczema, asthma or stinging insect allergy. The shots often are a preferred long-term, economical option, but an allergist will have to determine whether it will work best for a patient’s needs.