Spring is in the air. Literally. From weeds to spores to grass and tree pollens, the warm weather
drives airborne allergen levels through the roof. That means your allergy symptoms - the sniffling,
sneezing, and itchy eyes - are in overdrive and apt to stay that way for months.
What can you do? WebMD asked some of the country's leading allergy experts to weigh in with answers
to your top questions about spring allergies. Here are suggestions for helping you find some
much-needed relief this season.
How do I know what I'm allergic to?
There is a world of spring allergens out there. How can
you possibly figure out which one is playing havoc with your eyes, nose, and throat?
"The allergy skin test is the quickest, most inexpensive, and most accurate way to find out
what you are allergic to, whether it's mold, grass pollen, or a type of weed," says Neil Kao,
M.D., an internal medicine physician specializing in allergy and immunology at the Allergic
Disease and Asthma Center in Greenville, S.C.
Talk with your primary care doctor or an allergist. Both can give you an allergy test. The skin
is pricked slightly to allow an allergen, such as grass or mold, to enter the outer layer; after
about 15 to 20 minutes, the physician will check for a reaction, such as hives or redness and
swelling, which will identify the specific allergen causing your symptoms.
Once you know your trigger, keep an eye on allergen levels in the air using online pollen
counters during the spring season, and avoid your triggers as much as possible - the first
steps in keeping your allergies under control.
How can I manage my allergies using over-the-counter medication?
Spring allergy relief is within your reach - on your local drugstore's shelves. "Start by taking
an over-the-counter, non-sedating antihistamine, such as generic Claritin or Zyrtec, every morning.
If your nose remains congested, add a saline nasal rinse or oral decongestant pill
(if you don't have high blood pressure). You can also take a
long-acting decongestant nose spray for a few days, if
necessary. If these treatments don't clear your nasal
congestion, ask your doctor about adding a corticosteroid nose spray," says Paul Enright, M.D.,
WebMD's allergy expert and research professor of medicine and public health at the University of
Arizona.
Other over-the-counter tools for managing your allergies are lozenges to soothe a sore throat,
which can be irritated by postnasal drip from your runny nose, and antihistamine eyedrops to
relieve itchy, watery eyes.
Look for antihistamine on the label when shopping for eyedrops; these treat the root of your
allergy symptoms, instead of eyedrops that just relieve the redness (also known as decongestant
eyedrops). If you do buy the latter, be sure you don't use them for more than two to three days
- over time you will need more and more to relieve the redness.
Are nasal sprays really addictive?
The rumors are true. Some over-the-counter nasal
decongestant sprays can be addicting if not used as a short-term solution. You want to find a
nonaddicting nasal spray if you decide to use this product.
"Over-the-counter nasal sprays are extremely effective,
but they are also extremely addictive," says Jeffrey M.
Factor, M.D., an allergist and immunologist at the
Connecticut Asthma and Allergy Center in West Hartford.
Your nose becomes dependent on the nasal spray and stops working the way it should when the spray
is
overused, he explains. This causes rebound congestion - meaning the medication loses power the
more you use it. When the spray stops working, the congestion comes back with a vengeance. If
you're hooked, prescription nasal
steroids can help you kick the habit and improve your congestion during the spring allergy season.
How can you tell if an over-the-counter nasal spray might be long-term trouble? Check the label
for a warning - if it says "don't use the spray for more than three days at a time," pay attention.
Beyond medication, what can I do to manage my allergies?
First, think practically: Try to avoid your triggers altogether by keeping your windows closed,
even on an inviting spring day. That's when allergen levels are at their peak. Next, take a shower
after you've spent time outdoors.
"After you come inside on a nice spring day, you are literally covered in allergens," says Kao.
"You track it through your house, and worse, you get in bed covered with the pollen or grass spores
that make you congested. Guess what? Now you are going to lie in it for eight hours and wake up
feeling miserable."
Allergens such as pollen tend to stick to fabrics, which means you can deposit allergens from
your clothes on your furniture, on your pillow, and on the people around you.
All of a sudden the safe haven of your home is as
allergy-ridden as the outdoors.
So wash your bedding, your pajamas, and your clothes as often as possible to rid them of
troublesome allergens
during the spring season.
What about the natural and alternative remedies I hear about: Do any work?
If you're looking for a home-remedy approach for your springtime allergies, start simple: A
saltwater nose spray can be a springtime allergy sufferer's all-natural ally.
"Mix eight ounces of water with half a teaspoon of table salt in a squirt bottle," says Enright.
"You can use this every morning when you wake up and in the evening to clear the allergens out of
your nose." You can also buy a saline-solution nose spray at your local
drugstore if you don't
feel like whipping it up yourself.What about
other alternative
remedies for spring allergies? Acupuncture, homeopathy, and herbal treatments are possible
solutions to your spring allergy symptoms, but more research is
needed first for a solid
recommendation.
Some studies do show promise, especially with
acupuncture. In a study
of children with hay
fever published in the
November 2004 issue of Pediatrics, those who received acupuncture twice a week for eight weeks
showed fewer symptoms and more symptom-free days - both during treatment and for about 10 weeks
after - than the kids who did not receive acupuncture.
If you are considering an alternative therapy for your spring allergies, start by talking to your
doctor.
Are antihistamines addictive too?
Here's one rumor that is not true. "People may be worried about antihistamines being addictive,"
says Kao. "But we are concrete on this one - there is no way they are
addictive."
But while you won't get hooked on allergy medications such as antihistamines, either
over-the-counter or
prescription strength, you could build up a tolerance to them, he explains. The solution?
Rotate the types of
over-the-counter medications you take to ensure they
give you the most bang for your buck.
"If you build up a tolerance, it will happen after about three months or so," says Kao. "When
you notice your symptoms coming back, switch to a different brand or type of allergy medication
for a while until you either get through the season or lower your tolerance back to normal after
a few months."
I love the outdoors. How can I enjoy the warm weather with my allergies?
The trick to planting flowers or mowing the lawn on a pleasant spring day is not to treat your
allergy symptoms, but to prevent them before they kick in.
"Pre-treat your allergies with an antihistamine about a half-hour before your day begins to avoid
an allergy attack altogether and minimize your suffering," says Enright.
And don't be caught unprepared. Be sure to have "rescue" medications such as eyedrops and
decongestants on standby - just in case.
When do I need prescription allergy medication?
You've jumped through hoops to manage your springtime allergies. You started with an allergy test
to pinpoint your triggers, you've kept a watchful eye on pollen counts to avoid outdoor activities
when the numbers spike, you've been taking extra showers when needed and doing
laundry nonstop, and you've tried several over-the-counter allergy treatments. Your efforts,
however, are not producing results, and you're still suffering from all the classic spring
allergy symptoms. It's time to see your primary care doctor or an allergist.
When do I need prescription allergy medication? continued...
"The next step is to try prescription-strength medications," says Kao. "Once you get started, you
should have your
allergies under control in just a week or two." Does this mean you can put your laundry soap away?
"Not quite," explains Kao. You still need to be vigilant in managing
your allergies on your own, but now you can do it with prescription strength on your side.
Antihistamines block the release of histamine, a chemical that can cause redness, swelling, and
itching.
Nasal steroids reduce inflammation and prevent and treat nasal stuffiness, sneezing, and itchy,
runny nose brought on by seasonal or year-round allergies.
Any medications should be used as directed by your doctor, who will talk to you about how often,
for how long, and at what dose you should take your allergy meds.
Do I need allergy shots?
The same formula applies to prescription medications: If your allergy symptoms don't improve over
time, the next step may be to take it up a notch with allergy shots. When you start the shots,
generally given once or twice a week to begin, you'll probably stay on your prescription medicine
to manage your symptoms. If you're like most people, by the time the next allergy season rolls
around, you may have started to build up resistance and have milder symptoms. That's when allergy
medications are like spare tires, explains Kao - you use them only if you need them.
Is there hope on the horizon for those with spring allergies?
A new type of therapy could take the place of allergy shots in a few years; it's called sublingual
immunotherapy. As with today's allergy shots, you visit your allergist or primary care physician
for daily or weekly treatment, but instead of a needle, you get a few drops of an allergen solution
under your tongue (that's what "sublingual" means).
The drops are a slow-release immunotherapy, meaning they build up your resistance to allergens
over time. Better yet, they might be just as effective as shots, with a lower risk
of side effects such as severe allergic reactions.
That's the good news. The bad news is that although
sublingual immunotherapy is now in clinical trials, it's not yet available in the United States
and probably won't be for a couple of years, pending approval by the FDA. Stay tuned.
If I have allergies, will my kids have them too?
Unfortunately, the pollen doesn't fall far from the tree. In this case, family can be destiny.
"If one parent has allergies, then his child has a 33 percent chance of developing allergies,"
says Kao. "If both parents have allergies, then their child has a 67 percent chance."
His advice to avoid passing your allergies on to your kids? "Be careful whom you marry," says Kao,
half joking.
Originally published in the March/April 2008 issue of WebMD the Magazine.


