With spring upon us, many children and adults suffering from seasonal allergies and asthma are starting to feel their symptoms worsen. While seasonal allergies are very common, certain strategies can help reduce discomfort or prevent symptoms even before they start. It's important for allergy sufferers to know what causes their allergies, how to control their environments, which medications to take and when to consider allergen immunotherapy.
Spring Allergies: How to Prevent Them Before They Start
By Sunit P. Jariwala, M.D., Contributor |April 4, 2017, at 9:55 a.m.
Allergies are very common and can be debilitating.
Recent data from the Centers for Disease Control and Prevention suggest 50 million Americans suffer from allergies every year. Allergies affect 30 percent of adults and 40 percent of children in the United States. An estimated 10 percent of school-aged children in the U.S. have asthma, which is closely tied to allergic rhinoconjunctivitis. Allergies also have considerable economic consequences, exceeding $18 billion a year and nearly 4 million lost work and school days among Americans.
Allergies may be under-diagnosed.
Recent studies indicate that allergic rhinitis (nasal allergies) may be under-diagnosed and undertreated, especially in school-aged children. Allergic symptoms are sometimes confused with the common cold. Patients and health care providers should keep an eye out for allergy symptoms including: postnasal drip, nasal itching, nasal congestion, sneezing, rhinorrhea (runny nose), watery or itchy eyes, and fatigue. Common asthma symptoms include chest tightness, coughing (especially at night), wheezing and/or shortness of breath. However, many of these symptoms are also seen in other conditions. If you suspect you might have allergies, contact your health care provider for further evaluation and treatment. You may be referred to an allergy/immunology specialist, who can help in several ways: 1) conduct a diagnostic evaluation (skin testing and/or laboratory analysis) to identify allergens; 2) evaluate for other conditions that may masquerade as allergies; 3) manage severe asthma; and 4) plan for and initiate allergen immunotherapy in selected individuals.
There are many environmental triggers linked to allergies.
Allergic rhinoconjunctivitis and asthma may be perennial or seasonal. Perennial allergy symptoms are typically triggered by dust mites, cockroaches, animal dander and/or mold spores. Seasonal symptoms are usually triggered by pollen (weeds, grass, trees) or airborne mold spores. Since the predominant pollen types vary by geographic region and pollen levels can change day-to-day, it is important to monitor daily pollen counts through the local weather channel, radio station, and/or websites. To reduce pollen exposure, we recommend the following measures: 1) close windows and doors when pollen counts are high; 2) remove clothes that have been worn outside, and shower to remove pollen from skin and hair; and 3) avoid outside activity in the morning when pollen counts are highest.
Medications are effective in the prevention and treatment of allergies and asthma.
In addition to environmental control measures, oral and topical (including nasal and eye) allergy medications can be effective in preventing or relieving symptoms. Commonly used oral medications include antihistamines, leukotriene receptor antagonists and short courses of corticosteroids. Oral antihistamines work quickly and should be started before the allergy season in order to prevent symptoms. Due to varying side effects depending on the antihistamine being used, ask your health care provider which medication may be right for you. Nasal allergy sprays for symptoms such as nasal congestion, sneezing and post-nasal drip include nasal steroids, nasal antihistamines and nasal mast cell stabilizers. Allergy eye drops for symptoms such as watery and itchy eyes include ocular antihistamines and combination ocular antihistamines and mast cell stabilizers. Inhaled corticosteroids are effective in preventing asthma symptoms and should be used on a daily basis before the allergy season starts. You must have your "rescue" (short-acting beta agonist) inhaler available, in case your asthma flares during the season. Again, ask your provider which medication is right for you.
Allergen immunotherapy can offer more definitive treatment.
Allergen immunotherapy can dramatically reduce the severity and frequency of allergy symptoms over the long term. Immunotherapy involves health care provider-administered injections of gradually increasing doses of allergen extracts. Immunotherapy consists of an initial build-up phase (weekly sessions over several months) and a subsequent maintenance phase (typically, monthly sessions over two to three years). Allergen immunotherapy may help to reduce the long-term use of allergy medications. Recent studies suggest that approximately 85 percent of patients experience a significant reduction in allergy symptoms due to immunotherapy. If you have allergy symptoms despite taking medications as prescribed by your health care provider, or hope to reduce your allergy medications over the long term, ask your health care provider if you might be considered for allergen immunotherapy.
Allergy symptoms can be successfully controlled.
Through a combination of environmental control measures, medications and/or allergen immunotherapy, most individuals suffering from allergies can experience symptomatic relief. To prepare for the upcoming spring season with high pollen counts, we recommend the following:
- Monitor daily pollen counts, and close windows and doors when pollen counts are high.
- Remove clothes that have been worn outside, and shower to remove pollen from skin and hair.
- Avoid outside activity in the morning when pollen counts are highest.
- Start taking allergy medications before the spring season starts, and continue to consistently use these medications throughout the season.
- If you have allergy symptoms despite environmental control and medications, consider being evaluated by an allergy/immunology specialist for allergen immunotherapy.