Right now, we’re well into spring allergy season. In many parts of the country, this season begins in February and can last until early summer. But did you know that each allergy season varies slightly?
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Find out what makes the spring allergy season different from Frank J. Eidelman, MD, MBA, FAAAAI and learn how to manage the sneezing, wheezing, sniffling and more.
What happens during the spring allergy season?
“When we talk about spring allergies, we’re talking about tree pollen,” says Dr. Eidelman. “In a temperate climate, there are three basic pollen seasons. You have spring which is tree season, summer brings more grass pollen and in the fall, you have more weed pollen and a little bit of mold.”
He adds that in subtropical areas, there are still three main pollen seasons. However, the grass pollen season can be much longer and since these areas don’t get winter weather or true frost to stop trees and plants from producing pollen, allergy seasons don’t end.
If you feel like your spring allergies are worse year after year, you’re not imagining things. What you’ve experienced was most likely due to global warming.
Dr. Eidelman explains.
“With climate change, spring pollination has become worse during the last 10 to 20 years. As the seasons get hotter, we’re getting more pollen, longer pollination seasons and more intense pollination seasons. This seems to be a worldwide trend.”
How many people suffer from allergies?
According to Dr. Eidelman, one out of five people has some sort of allergy and the intensity can range from very mild to severe.
He says people with mild allergies tend to just grin and bear it. They may not have any particular need for medication. If their allergies are a little bit more intense, they may take over-the-counter (OTC) medications as needed.
“But as you get further along that spectrum, the severity of the illness can become disabling. People feel very sick, they can’t get out of bed, they can’t sleep — it can be intense. So, it all depends on where they are on that spectrum of intensity,” he says.
How bad can spring allergies get?
“People can be very miserable. Their eyes can become itchy and swollen, their noses get congested, they sneeze a lot and if they have asthma, their lungs can become irritated.”
Dr. Eidelman says if you have allergic rhinitis or nasal allergies, things can get really bad and may affect your quality of life quite significantly.
“People might have trouble working or going to school. They may have trouble sleeping and they often feel tired. Even if they try to get enough sleep, it’s not normal sleep. So, work presenteeism can be quite common. This is when people show up to work or school but they can’t function at 100% because they’re kind of out of it — like they feel when they have a cold or the flu.”
According to the American College of Allergy, Asthma and Immunology, allergies are the sixth leading cause of chronic illness in the United States. The annual cost from all of this is around $18 billion per year.
Is it OK to treat allergies with over-the-counter medicines?
Dr. Eidelman says that many of the best nasal medications are now available over-the-counter. He adds that the options fall under a few different categories.
“The first category would be antihistamines. Almost all of them are available over-the-counter now, but there are two basic groups. Older antihistamines, or first-generation antihistamines, are typically sedating and include medicines like Benadryl® (diphenhydramine). Second-generation antihistamines, which include medications like Claritin® (loratadine), Allegra® (fexofenadine) and Zyrtec® (cetirizine), are much less sedating or nonsedating. These antihistamines would be the preferred ones for basic symptoms like itching, sneezing or runny nose.”
Dr. Eidelman recommends being very careful with diphenhdyramine.
“A lot of people use it and it’s very sedating. Studies have shown that when people who think they’re not sedated are put in a driving simulator, their reaction times are slower. And when left in a quiet room, these people fall asleep quickly. It’s very deceiving. You might think the medication isn’t affecting you, but you’re compensating in some way and when you’re put to the test, you may not function well. Also, it depends on your age. As you get older, the effects are more profound.”
Decongestants and nasal sprays
Dr. Eidelman says when you start experiencing nasal congestion, postnasal drip and sinus pressure, antihistamines aren’t particularly effective. To help with these symptoms, one option is to add something like Sudafed® (pseudoephedrine), which is a decongestant. Decongestants are not recommended for people with hypertension or heart problems. A better option would be a topical nasal steroid like Flonase® (fluticasone), Rhinocort® (budesonide), Nasonex® (mometasone) or Nasacort® (triamcinolone).
“Topical nasal steroid sprays are the gold standard for moderate to severe nasal allergies. They work well, but the thing to keep in mind is that they don’t have an immediate effect. That’s the downside,” he says.
However, nasal steroid sprays do block a lot of allergy symptoms by preventing inflammation. Topical nasal steroids are nonsedating and they usually don’t have side effects, but you have to use them every day.
Since we have a pretty good idea of when spring allergy season starts, Dr. Eidelman recommends starting a topical nasal steroid spray one or two weeks before so it will be effective by the time the pollen starts to fly. He suggests using the spray daily until the season ends.
Possible side effects of decongestants
Pseudoephedrine can help with congestion and is found in combo medications like Allegra-D®, Claritin-D® and Zyrtec-D®. Dr. Eidelman says it’s a good medication, but it can cause side effects — and the side effects are more prominent in older people.
“It can raise blood pressure and it can also cause palpitations because it is a stimulant. Overall, I don’t recommend it for people with heart problems. I also wouldn’t recommend that people over 40 take it regularly.”
He adds that pseudoephedrine can also cause prostate problems. So if you’re older, you’re much better off with a topical nasal steroid.
When to consider allergy shots
If over-the-counter-medicines and nasal sprays don’t seem to be working, you might want to consider allergy shots. Dr. Eidelman says they can help lessen your sensitivity to pollen and more.
Allergy shots, also known as immunotherapy, can make you less sensitive to all the things that you’re allergic to. For example, if you’re allergic to tree pollen, you would get an allergy shot that’s made out of tree pollen protein.
So what does that mean?
“In a lab, they extract the protein from tree pollen and they make an extract with it. That extract is then used to desensitize or make the patient less sensitive to tree pollen. Allergy shots are very effective and many controlled studies have reflected this. Allergy immunotherapy is the only treatment that has the potential to cure allergic rhinitis,” Dr. Eidelman says.
Watch out for “natural” allergy remedies
Neti pots and nasal rinse squeeze bottles can provide relief if you’re looking for medicine-free ways to treat your allergies. However, Dr. Eidelman says it’s important to use distilled water with them to avoid getting infections and don’t use ice-cold water unless you enjoy brain freeze. Most of these methods just involve flushing out the nasal cavity with salt water and they’re fairly safe when used correctly.
If you have tree pollen or plant allergies, he recommends steering clear of herbal remedies.
“If you have pollen allergies, I don’t recommend anything herbal. For example, people who are allergic to ragweed sometimes have serious allergic reactions to echinacea. Echinacea is a commonly used immune stimulant. It’s an herbal product, derived from the purple coneflower, which is a close relative of ragweed. So, don’t take echinacea if you’re allergic to ragweed. With herbal products, keep in mind that just because something’s natural, it doesn’t mean that you’re not going to be allergic to it.”