Seasonal Allergies Are At an All-Time High—End the Suffering with These Tricks
It's not just you—seasonal allergies are at an all-time high. But that doesn't mean your nose is doomed to run forever.
All over the country, at this very moment, people—maybe including you?—are starting to notice a little tickle in their noses or throats. Some have never had allergies before but are developing them out of nowhere; others thought they had their allergies under control, but they’re back with a vengeance. If allergies are taking you by surprise, you may need to revisit the basics and revamp your action plan.
In medical terms, seasonal allergies are known as rhinitis. You probably know it if you have it: itchy, watery eyes, a stuffy or runny nose, sneezing, itching, a postnasal drip, coughing, wheezing, and shortness of breath are all common symptoms of seasonal rhinitis. “Seasonal allergies are basically an overreaction of the immune system for people who are allergic to pollen and mold spores, which you should not be overreacting to,” says Giana Nicoara, MD, an allergist-immunologist at Allergy Associates of La Crosse in Onalaska, Wisconsin. What’s more, when you have seasonal allergies, you tend to be more sensitive to other irritants. “If you have any baseline inflammation, as you would from seasonal allergies, pretty much anything—think strong scents, such as those from perfume—can put you over the limit,” says Nicoara. The smell of gasoline can contribute, and strong household odors, like bleach, may bother allergy sufferers as well, she adds. And for eczema sufferers, allergens can trigger flare-ups. In other words, everything is the worst.
Unfortunately, experts say, seasonal allergies are on the rise. The main culprit: climate change. “Increased temperature, humidity, and outdoor carbon dioxide are lengthening the pollinating season, with pollen production up 90 percent,” says Kathleen Dass, MD, an allergist-immunologist with the Michigan Allergy, Asthma & Immunology Center in Oak Park, Michigan. Air pollution, which rose by 8 percent between 2008 and 2013, per World Health Organization data, plays a role too. Particulate matter, which can come from power plants, construction sites, busy roads, and fires, is a big trigger, notes Sara Axelrod, MD, an allergist-immunologist with ENT and Allergy Associates in East Brunswick, New Jersey. You’re (probably) not going to move to a different zip code to avoid allergies, but there are some steps you can take to find relief.
First Step: Minimize
Yes, if you’re dealing with allergies, you’re probably going to need some kind of actual treatment (we’ll get to that). But you can reduce the misery—and maybe even your need for meds—by making a few small changes around the house.
Double down on cleaning. Dusting and vacuuming regularly—the Dyson Ball Multi Floor 2 vacuum ($300; amazon.com) is equipped with an allergen-mitigating HEPA filter—can keep pollen at bay, though you might consider wearing a mask while you do so, since cleaning can stir up irritants. Washing sheets and blankets regularly helps too. When it comes to cleaning surfaces, Nicoara suggests avoiding the strong smells of many store-bought products by making a DIY cleaner with one part white vinegar, one part hydrogen peroxide, and a bit of water. “I use it for all hard surfaces,” she says, “and it does as good a job as a commercial bleach formula would.”
Keep your windows closed. If things get stuffy, your AC unit is a better choice than fresh air because it helps filter the air. Just try not to leave it on 24/7, and keep it clean and well maintained to help reduce its environmental impact. (It’s a vicious cycle!)
Don’t track pollen around. When you enter your home, remove your shoes and change your clothes, says Nicoara (if you have a dog, wipe his paws). Wearing pollen-covered shoes and clothing inside will just spread the allergenic particles to surfaces in your home, especially upholstered furniture (which Nicoara recommends getting rid of altogether, by the way, if you suffer from seasonal sniffles). “Showering before bedtime can also help prevent your bedding from being exposed,” adds Dass.
Check pollen counts. If you like to exercise outdoors, aim to do so in the morning or evening, since pollen counts tend to be highest in the middle of the day. Check your local level on Pollen.com.
Treatments to Try
When you need a pharmaceutical assist, these are your options.
Antihistamines. “These are oral or nasal medications that decrease histamine-related symptoms, like sneezing, runny nose, and itchy eyes,” says Nicoara. There are the old-school antihistamines, like Benadryl, which are very effective in the short term (especially if you’re having a severe reaction to something you’re acutely allergic to) but can make you sleepy. Newer antihistamines—think Claritin or Allegra—don’t usually have that drowsy effect and last longer. Allegra in particular is not known to cause drowsiness and can be used safely even by pilots. But efficacy varies from person to person, and some of these newer antihistamines can take a while to kick in.
Nasal corticosteroids. These sprays are many docs’ favorite. They provide a more direct line of contact to the primary areas of inflammation: your nasal passages. “Nasal corticosteroids, like Flonase or Nasacort, are the most effective and potent drugs available to manage allergy symptoms. They are also most effective for stuffy and itchy noses and postnasal drip,” says Dass. Plus, side effects are rare and tend to be localized—as in a bit of irritation in the nasal passages. Some doctors like a combination: say, Zyrtec at night and Nasacort in the morning. Many allergy meds are safe to combine, but check with a doctor for the ideal and safest course of action.
Antihistamine eye drops. “These are great as an add-on therapy for itchy, red, and watery eyes,” says Axelrod. “Eye drops can be used as needed and can be very effective.” Look for drops labeled “antihistamine,” such as Visine-A.
Decongestants. While you may be tempted by the quick fix that decongestants—whether an oral one, like Sudafed, or a nasal spray, like Afrin—provide when you’re really stuffed up, they’re not a long-term solution and should be used carefully, if at all. Oral decongestants can be dangerous for those with high blood pressure, and nasal sprays can cause a rebound if used for more than three days in a row—the stuffiness comes back, often even worse. If you’re really stuffy and have to get on a flight, taking a nasal decongestant about 20 minutes before takeoff and landing (if it’s a longer flight) can help reduce your risk of a pressure headache and serious ear-popping, but don’t overdo it, and be sure to read the dosage directions.
Nasal irrigation. As far as “natural” options go, a neti pot— a small teapot-like container for rinsing out nasal passages with slightly saline water—may be worth trying. “Nasal irrigation can help move mucus out of your sinuses,” says Dass. Neti pots can clear things out and reduce swelling. Just make sure you’re using distilled water, or boil (then cool) it first. Rinsing with untreated tap water can introduce—wait for it—dangerous amoebas into your system, which can be fatal. While these invaders are extremely rare, it’s not a risk you should really be taking.
A healthy diet. Results aren’t guaranteed, but tweaks to your eating could reduce your allergy symptoms. “There have been very small studies that say a Mediterranean diet may decrease your chance of having asthma and allergies,” says Dass. “A diet high in antioxidants and omega-3 fatty acids may also help because it can reduce overall inflammation, a major trigger of allergy symptoms.” Same goes for eating to improve gut health. Focus on whole foods and don’t overdo it on anything inflammatory, like junk food and alcohol (not a bad idea anyway), says Purvi Parikh, MD, an allergist-immunologist with Allergy and Asthma Network. And for some people, dairy can make mucus feel thicker, so you could consider cutting back.
When to See a Doctor
Of course, if you’re really bothered by allergies—even after manically cleaning your home and trying over-the-counter meds—your best bet is to see a board-certified allergist-immunologist. If you’re not sure it’s worth seeing a specialist, the answer is a resounding yes if “your allergies are affecting your quality of life, causing fatigue, or causing irritability; if you’re having many sinus infections; or if you also have asthma or eczema,” says Dass. “As an allergist, I can help patients determine what exactly they are allergic to.” Those results point to a treatment plan.
What is immunotherapy? That plan may include a course of allergy shots or under-the-tongue tablets, both of which are forms of immunotherapy (some physicians are also fans of sublingual drops, but there aren’t yet any FDA-approved options for seasonal allergies). “Immunotherapy has been around for a long time, and it’s really useful to people who don’t respond well to medications,” says Nicoara. “What we’re trying to do with immunotherapy is teach their immune system to tolerate allergens—often permanently.”
Allergy shots. Shots consist of two phases. First, for three to six months, you visit your allergist once or twice a week to receive injections with increasing amounts of your allergens. Then you go into maintenance mode, in which you wait longer between injections—typically two to four weeks. At each visit, you’ll likely need to wait around for 20 to 30 minutes after your injections in case of an adverse reaction. And you may be in maintenance mode for up to a few years. But “over time, you will likely develop lasting tolerance to your allergens,” says Dass.
Tablets. If getting weekly shots for up to several years sounds less than appealing, consider sublingual immunotherapy (also known as SLIT), in which you take tiny doses of allergens via an under-the-tongue tablet. You can do this at home, and there’s no sitting around in a waiting room afterward. But the tablets are currently available for treating only ragweed, grass pollen, and dust mites, so if your allergies go beyond those three triggers, shots may be a better bet. The time commitment may be daunting, but focus on the blissful, sniffle-free life that could lie ahead.