Keeping Seasonal Allergies Under Control
by Lisa Sullivan, MD
S
easonal allergy generally refers to a specific allergic immune response to any number of pollens and molds. It can manifest as a classic runny, itchy, sneezy and swollen nose (rhinitis), sinus congestion (sinusitis) and/or eye irritation (conjunctivitis); but it can also affect the lung (asthma), headaches (migraines), gut (esophagitis) and skin, in the form of hives (urticaria) or rashes (eczema). Watery nasal and eye discharge are typical, but if swelling interferes with proper sinus and ear (Eustachian tube) drainage, mucus will soon become discolored (yellow, green, white or bloodtinged), and usually signifies a secondary viral or bacterial infection.
For allergic individuals, there are many different allergy “seasons” which are best characterized by knowing their allergic profile by way of skin testing and where they reside. Pollen and mold allergens have regional variability and are prevalent at different times during the year, depending upon where people live—someone will experience symptoms only if they are sensitive to the allergen that is prevalent at the time. Allergies are additive, so a person will have increased symptoms if they have multiple sensitivities and their allergy seasons overlap. For example, season overlap is common in the Midwest. As snow
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melts, the wet mold season begins and lasts until the ground is frozen again, typically in December. In mid-March, tree pollen season starts and lasts until early June. Grass season then overlaps from May to June, along with summer weeds, which start in May and last through the frost. Dry mold season tends to occur from July to the frost, and is overlapped with the fall weed/ ragweed season. Knowing these timeframes, it is not surprising that many allergy sufferers find it particularly difficult to function in May (tree, grass, wet mold and summer weed seasons) or August (summer weed, fall weed, ragweed and wet and dry mold seasons). Effective treatments for allergy can range from moving away to another clime, keeping the windows closed or using allergy medicine and taking allergy shots. It is reasonable for a mildly allergic person to start with a low-potency, over-the-counter (OTC) antihistamine such as loratadine (Claritin or generic) or try an OTC nasal steroid (Rhinocort or generic). Add OTC ketotifen fumarate eye drops (Zaditor) if needed on itchy eye days. Steer clear of nasal decongestants (Afrin) and “red-eye” eye drops (Visine), as they make matters worse if relied upon for too long. Old-fashioned diphenhydramine (Benadryl) works well, but it has a shorter duration and may cause fatigue. If OTC allergy medications are not helpful, that may indicate multiple or severe allergies or some other problem. A board-certified allergist can help by conducting tests and prescribing a treatment plan based on an individual’s allergic profile. If conditions become unbearable, plan a trip to a saltwater beach, cruise ship or desert getaway, preferably during our high-allergy season. Allergen levels in these areas are typically low. Be advised that the beach effect diminishes too far inland, and ocean breezes can only do so much toward removing pollen and molds. Staying at seaside is also beneficial because the high salinity of the water and air has natural cleansing and healing properties. When traveling, check the destination’s local pollen and mold counts at websites such as Weather.com or Pollen.com to know what to expect, determine medications