What are seasonal allergies?
Seasonal allergies, also commonly called “hay fever” , are a group of conditions that can present with symptoms such as runny nose, sneezing and red eyes at certain times of the year depending on the allergy trigger. Seasonal allergies affect approximately 20% of people of all ages.
What causes seasonal allergies?
When a person has a seasonal allergy, their body’s immune system reacts as if that substance is a harmful invader to the body and causes an inflammatory response to it. The most common causes of seasonal allergies are:
- Pollen from trees, grasses or weeds
- Mold spores which grow when the weather is humid, damp or wet
For some people seasonal allergies may be life long, improve or worsen over time and for some there may be a genetic component to their allergies. The risk of developing these allergies is much greater in people with asthma, eczema, and in those with a family history of asthma or nasal inflammation.
Further, some people may have allergies that last year round (perinneal). These year round allergy symptoms are usually caused by:
- Mold spores
- Animals (i.e. dogs and cats)
- Insects ( i.e. cockroaches and dust mites)
What are the symptoms of seasonal allergies?
- stuffy or runny nose (allergic rhinitis)
- itchy or red eyes (allergic conjunctivitis)
- sore throat
- itching for the throat and ears
- Nighttime waking or difficulty sleeping leading to fatigue the next day
Is there a test for seasonal allergies?
Yes, your primary provider will ask you about your symptoms and may refer you to an Allergist (Immunologist) – a doctor with specialty training in the diagnosis and treatment of allergic diseases, asthma, and diseases of the immune system. This specialist may diagnose your allergy using either skin or blood tests.
Can seasonal allergies be prevented?
Yes, while the following recommendations may not eliminate allergy symptoms they may reduce the severity and frequency of symptoms.
Reduce exposure to Outdoor Allergens:
- Affected individuals should close the windows of the car and home
- Stay indoors when possible and use air conditioners to filter the air during times of peak symptoms.
- Use of a high quality mask may be helpful for activities, such as grass cutting or wood cutting. These are also helpful in avoiding nonspecific irritants, such as dust and fumes, which can trigger sneezing.
- Showering before bed removes allergens from hair and skin and can help reduce contamination of the bedding.
- Over-the-counter saline sprays and rinses can be used after being outdoors to wash away allergens from the nasal lining.
Reduce exposure to Indoor Allergens
|Indoor allergen||Recommendations for reducing exposure|
|Animal dander||Remove animal from house, or at minimum, keep animal out of patient’s bedroom. Keep pet in a room with a HEPA filter and replace the filter as recommended by the manufacturer.|
|Cover air ducts that lead to bedroom with filters. Replace filters as recommended by the manufacturer.|
|Use air filters and vacuums with HEPA filters. Replace the filter as recommended by the manufacturer.|
|Dust mites||Less costly|
|Encase mattress, pillows, and box spring in allergen-impermeable covers. Finely woven covers for pillows and duvets are preferable.|
|Wash bedding weekly in warm water with detergent or use electric dryer on hot setting.|
|Reduce indoor humidity to <50%.|
|Remove carpets from the bedroom.|
|Replace old upholstered furniture with leather, vinyl, or wood.|
|Cockroaches||Use poison bait or traps to control. Consult professional exterminator for severe infestation.|
|Periodically clean home thoroughly.|
|Encase all food fully and do not store garbage or papers inside the home.|
|Fix water leaks.|
|Indoor mold||Clean moldy surfaces with dilute bleach solution.|
|Fix water leaks.|
|Reduce indoor humidity to <50%. Avoid use of humidifiers.|
|Evaporative (or swamp) coolers should be avoided or cleaned regularly.|
|Rodents||Consult a professional exterminator.|
|Periodically clean home thoroughly.|
|All food should be stored in sealed containers. Do not store garbage inside.|
How are seasonal allergies treated?
Seasonal allergies may be treated one or a combination of the following types of medications:
- Nasal rinses– rinsing the nose with salt water (saline) helps to clean the inside of the nose and get rid of pollen in the nose. There are different over the counter devices for this (i.e. Neti pots)
- Steroid nose sprays (i.e. Nasonex) -available by prescription and used for congestion and post nasal drip but may take a few weeks before full effect seen. Taking a nasal decongestant for the first few days may help to reduce to swelling in your nose and help the spray get to the deeper parts. Parents of children using nasal sprays for more than 2 months out of the year should speak to their primary provider as use of these for extended periods of time may slow growth rate in some children.
- Antihistamines- (i.e. Claritin) these over the counter oral and nasal medications (i.e. Pantanase) help with itching, conjunctivitis, sneezing and runny nose symptoms. Newer versions of these medications may make you feel less tired (i.e. Claritin causes less sedation than Benadryl).
- Decongestants (i.e. Sudafed) – these over the counter medications help with stuffy nose symptoms. Both oral and topical nasal decongestants are contraindicated for patients with heart disease (they increase the workload of the heart), hypertension (they raise blood pressure), thyroid disease (they increase the risk of adverse reactions), diabetes, or, in men, difficulty in urination caused by an enlarged prostate. These problems are more common with oral pseudoephedrine than with topical sprays, since properly administered nasal sprays remain in the nasal mucosa. Use of nasal decongestants should be limited to no more than 3 days in a row as longer use may make symptoms worse. Can also be found in a combination nasal spray with an antihistamine (i.e. Dymista)
- Cromolyn (NasalCrom)- over the counter spray used reducing nasal inflammation
- Allergy Shots: given by an allergy doctor in the form of weekly or monthly injections containing tiny amounts of the offending allergen weekly to reduce sensitivity to allergens (not used to treat allergies to food, latex or medications). This treatment is often effective but may take months to work.
- Allergy pills (under the tongue)-these prescription medications are given under the tongue daily for several months a year. It is limited to only some types of allergies and may not always be effective.
- Other treatments:
- Nasal atropine(Atrovent)- prescription treatment used for severe runny nose. Should be avoided by people with glaucoma or men with an enlarged prostate.
- Leukotrine modifiers (i.e. Singulair)- prescription medication used for nasal inflammation when nasal sprays are not tolerated or for asthma patients.
- Allergic Eye symptom (Conjunctivitis) treatments:
- Basic eye care- see trigger avoidance section, cool compresses to reduce swelling, reduce to stop use of contact lenses when symptomatic as allergens often adhere to lens surfaces.
- Artificial tears- used to flush the eye out of allergen irritants and keep it lubricated. Best if used after refrigerated.
- Combination Antihistamine/vasoconstrictor eye drops (i.e.Visine-A) over the counter eye drops used short term up to 2 weeks for allergy eye symptoms. May cause eye redness for a few days after use of this med is stopped. Single agent topical products (ie, vasoconstrictors or antihistamines only are also available without a prescription, although the combination products usually work better.
- Combination antihistamine/mast cell-stabilizer eye drops- treatment of choice, prescribed for seasonal or year-round symptoms (i.e. Pataday). Zatador eye drops are a drug in this category available without prescription. May cause burning when instilled, use cold artificial tears beforehand or refrigerate the medication beforehand.
- NSAID eye drops (i.e. Acular) provide some benefit with inflammation and redness but not as effective as antihistamines.
- Topical Steroid Eye Drops (i.e. Lotamax)- used for short term therapy if the above therapies have failed. Best used with opthamologist guidance as may cause cataract formation, elevated intraocular pressure (IOP), glaucoma, and secondary infections.
Where can you get more information?
Talk with your doctor or nurse practitioner about your symptoms, if a referral is recommended and the benefits and downsides of the different treatments.
The Allergy Report. American Academy of Allergy, Asthma, and Immunology (www.aaaai.org).