What is a seasonal allergy?It’s an inflammatory reaction to something in the environment that causes unpleasant symptoms, such as sniffles, sneezes, and swollen sinuses. If you’re predisposed to allergies, the first time your system deems a compound (such as pollen) to be potentially dangerous, your body mass-produces antibodies called immunoglobulin E, or IgE. IgE attaches to mast cells, which are concentrated in the nose, the eyes, and the lungs and which many experts believe help protect the body from invaders. When the allergen returns, IgE latches onto it, signaling the mast cells to release histamines, chemicals that make you sneeze or cause your eyes to tear and itch.
How do you develop allergies?There’s a genetic component to most allergies. If one of your parents has them, there’s an almost 50 percent chance that you will, too. It takes repeated exposure for allergies to develop fully, so several seasons might pass before a condition like hay fever sets in―which is why most kids don’t develop allergies until they’re 4 or 5. Seasonal allergies continue to develop throughout life. “New allergies can occur in any decade, but generally they tend to peak at around age 20,” says Linda Cox, an allergist and assistant clinical professor at the Nova Southeastern University College of Osteopathic Medicine, in Fort Lauderdale, Florida.
When do seasonal allergies strike?The season typically begins in early spring, when trees, including oak, cedar, elm, birch, ash, maple, and walnut, start to pollinate. Grasses, such as timothy, Bermuda, orchard, and some bluegrasses, germinate in late spring and early summer. Weeds, like sagebrush, tumbleweed, and ragweed―by far the most prevalent seasonal allergen, affecting 75 percent of sufferers―kick in during late summer and early fall. (Goldenrod, often confused with ragweed, is sometimes blamed for allergy symptoms, but it actually produces sticky, nonairborne pollen.) Many people think that if they can just make it to fall, they’re in the clear. Unfortunately for some, moldy leaves, an often overlooked allergen, can extend symptoms almost until winter.
There’s good news for flower lovers, though. “Regardless of what you see on TV, you’re never going to have a strong allergic reaction to a bunch of roses,” says New York City ear, nose, and throat physician Jordan S. Josephson. People don’t have allergies to actual flowers. If you find yourself sneezing after a flower delivery, it’s probably due to grasses, ferns, or molds in the soil or the bouquet.
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Diagnosis and Treatment
How do you find out whether you’re allergic and what you’re allergic to?A seasonal allergy can feel like a cold, with symptoms such as chronic congestion, a runny nose, and itchy, watery eyes. But allergies produce a thinner nasal discharge, won’t prompt a fever, are 14 times more likely than colds to trigger a migraine headache, and tend to last longer. If you’ve been sniffling for weeks on end, it’s probably time to get tested.
Luckily, that part is simple. The skin-prick test is the most common. A doctor introduces a number of allergens, sometimes as many as 60, by quickly pricking the patient’s arm or back. If redness, itching, or swelling occurs within 15 minutes, there’s an allergy match. “The process is so superficial, it’s quite painless,” says Cox. Alternatively, or if that test is inconclusive, a doctor might try a more sensitive intradermal shot, which injects allergens deeper below the skin.
What are the most effective treatments available?Don’t be stoic. It’s important to seek relief from your symptoms, because without treatment, allergies may worsen over time. Allergic reactions can spread deep into the lungs, putting you at an increased risk for asthma. In fact, up to 40 percent of long-term allergy sufferers also have asthma. Another 40 percent will develop sinusitis, an infection of the sinuses.
For mild to moderate allergies, drugs―some prescription, some over-the-counter―are usually enough. All work similarly, by trying to stop a reaction in its tracks. “The earlier you hit the medicine cabinet, the better your results,” says Daniel Ein, an allergist at George Washington University, in Washington, D.C. You might want to take something before going outside, or consistently treat yourself before the start of the season.
Antihistamines They prevent cells in the body from releasing histamines, which trigger the coldlike symptoms. Oral over-the-counter options are often combined with a decongestant (generally tagged with a D) for more relief. Pros: Treat throat and nasal itching, watery eyes, a runny nose, and sneezing. Newer brands, like Claritin and Allegra, claim not to cause drowsiness. Cons: Alone, they won’t help congestion or inflammation. Some brands can cause drowsiness. Nasal Corticosteroids Stronger than antihistamines, these prescription sprays, like Flonase, block inflammation and have been shown in some clinical studies to be the most effective remedy for allergy symptoms. (An oral version is available for extreme cases.) Pros: Very effective at treating congestion. Cons: May take a week or so to bring noticeable improvement. There’s also a higher risk of mild side effects―including nosebleeds, irritation, and a burning sensation―than with other allergy medications. Decongestants Nonprescription and fast acting, decongestants are available orally or as a nasal spray. They work by constricting blood vessels, which in turn reduces the amount of fluid leaked from the nose. Pros: Instant relief from congestion. Cons: Duration is temporary. While the nasal sprays, such as Afrin, act faster than oral alternatives, like Sudafed, most doctors discourage their use for more than three or four days because of their strong “rebound effect.” Basically, once you start, you’ll need more and more to get the same relief. Long-term use can produce chemical burns inside the nose.
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When to Consider Allergy Shots
If allergies send you to bed or medications produce unpleasant side effects, immunotherapy might be for you. This treatment builds up long-term immunity to one or many allergens by continually exposing patients to greater doses of them. Covered by most insurance plans, immunotherapy typically reduces symptoms by 90 percent. That said, it’s also a lot of work. Over three to six months and well before allergy season, patients receive one or two injections a week of specific allergens in increasing concentrations. Then, once or twice a month over the next three years, patients get maintenance shots of the maximum concentration reached during the buildup phase. Some people maintain their improvement indefinitely, but others relapse. Most relapses occur within three years of stopping treatment.
If you’re needle-shy, ask your doctor about sublingual immunotherapy, a method that substitutes under-the-tongue pills or drops for the shots. The dose is higher, but the treatment appears to be safer, and experts say the results compare well with injections.
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Check the pollen count and try to stay inside when levels are high. For current levels, go to the American Academy of Allergy, Asthma & Immunology’s website. You can also sign up for an allergen report via e-mail. Close windows at night and delay morning jogs. Plants release pollen from 4 a.m. to 8 a.m., so the longer you stay inside during this period, the better. Run the air conditioner and invest in a HEPA (high-efficiency particulate air) filter, which is required to capture 99.97 percent of the particles passing through it. Because pollen from shoes, animal paws, and other things can get embedded in carpets, consider replacing permanent carpets with washable throw rugs. Be wary of nonairborne allergens, such as dander, mold, and dust, which can aggravate seasonal allergies. Keep your lawn mowed short to prevent it from sprouting pollen-producing buds. Consider substituting nonpollinating plants, like ivy and myrtle, for grass. Get rid of leaves and compost piles quickly, before molds form. Wear natural fibers. Synthetics, such as polyester and nylon, can create a pollen-attracting electric charge when rubbed. Shower and wash your hair before going to bed. Daytime pollen can collect on your body, meaning you’ll be breathing it in all night. Breathe through your nose. When it comes to keeping out foreign bodies, noses are much better designed than mouths. Avoid secondhand smoke. A study in the Journal of Allergy and Clinical Immunology found that exposure to secondhand smoke exacerbated allergic responses. Clean the house often. Reducing the levels of pollen, dust, and mold in your home will reduce your symptoms. Use vacuums, mops, and microfiber dust cloths, which collect particles, rather than brooms, which recirculate them into the air. Buy pillowcases and mattress covers made from fabrics labeled “dustproof,” and wash them frequently at hot temperatures to eradicate dust mites and pollen. Don’t air-dry bedding or clothes, since damp cloth attracts pollen. And wipe down windowsills with a damp cloth before going to bed so you can breathe and rest easy at night.
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Drug-Free Allergy Remedies
Change your diet. Some foods, particularly fruits, have the same allergens in them as tree pollens. Therefore some people who are allergic to tree pollens may have symptoms, such as tingling in the mouth, when they eat certain fruits. This is called oral allergy syndrome. Fruits this can occur with include apples, pears, and cantaloupes. Peeling or cooking the fruit usually prevents the reaction.
Use saline drops. Squirt a salt-water or saline solution up your nose once or twice a day using a bottle with an angled tip to rid nasal passages of residual pollen.
Try acupuncture. Results are preliminary, but a handful of studies have found that acupuncture can be effective at reducing seasonal allergy symptoms, according to a review published in the 2006 edition of Current Opinion in Allergy and Clinical Immunology.