Seasonal Allergies in Bloom

As spring arrives, so do the unwelcome symptoms of allergies—sniffles, sneezing, and itchy eyes—all triggered by the increased pollen in the air. The types of pollen that cause allergic reactions can vary from person to person and are often influenced by geographic location. While many first experience allergy symptoms in childhood or early adulthood, it’s possible for allergies to develop at any stage of life. Factors such as exposure to new allergens due to relocation, shifts in climate that lead to higher winds and pollen counts, and even hormonal changes can all play a role.

Common Symptoms

Research indicates that the spring allergy season is now starting 20 days earlier than it did between 1990 and 2018, leading to an earlier onset of common symptoms such as:

Hay Fever (Allergic Rhinitis)

• Sneezing
• Congestion
• Runny nose and postnasal drip
• Dry cough
• Sinus pressure and headaches

Allergic Conjunctivitis

• Red eyes
• Watery eyes
• Itchy eyes

How to Stay Ahead of Common Triggers

Pollen grains are tiny particles dispersed from flowering plants. For people with pollen allergies, the amount and type of pollen in the air matters. Making a habit of checking local pollen forecasts can help you plan when levels are high.

Tips to Limit Your Exposure to Pollen

1. Monitor local pollen forecasts and limit time outdoors during high levels
2. Keep windows closed
3. Use air purifiers and certified asthma/allergy HVAC filters
4. Wear a well-fitted mask outside
5. Wash your face, shower, shampoo your hair, and change your clothes when you get home
6. Keep outdoor pets out of your bedroom and bathe them regularly
7. Wash bedding in hot, soapy water once a week
8. Rinse out your nose with a saline spray or neti pot

Medications and Treatments

Various types of medications and treatments are available to address symptoms of seasonal allergies. Consult with your health care provider to understand which ones are the most appropriate for you.

Nasal Corticosteroid Sprays  

• For people with moderate or severe seasonal allergies, nasal corticosteroid sprays are most effective when used starting 1-2 weeks before pollen season to calm inflammation in airways and continue daily use through allergy season.
• Users should spray with the nozzle pointed toward their ears to maximize the benefit.
• Ongoing use of corticosteroid spray can lead to nosebleeds due to drying of the lining of the nose. People using corticosteroid sprays continuously should consider also using saline nasal sprays to help prevent nosebleeds.

Antihistamines

• Antihistamines are taken as needed as pills, nasal sprays, or eye drops. They work quickly to relieve itchiness and inflammation.
• “First-generation” oral antihistamines (e.g., diphenhydramine) are linked to negative side effects such as sedation, performance impairment, and increased risk of dementia.
• “Second-generation” oral antihistamines (e.g., loratadine, cetirizine) won’t make most people drowsy, but all antihistamines include side effects such as dry eyes, dry mouth, and constipation.

Decongestants

• Pseudoephedrine is a “behind-the-counter” medication that is sometimes combined with antihistamines. This decongestant is not recommended for children or adults for consecutive days because it can increase heart rate & blood pressure.
• Oxymetazoline is a nasal spray that should only be used for 3-4 days. A higher dose may be needed over time to get the same response.

Immunotherapy

• If your symptoms are getting worse, interfering with daily activities, or causing other health problems and medications are not helping, consult a board-certified allergist about immunotherapy.
• FDA-approved allergy shots (deliver progressively higher doses of protein to teach the immune system to tolerate it) OR sublingual immunotherapy (tablet containing an allergen placed under the tongue) may be helpful to certain patients with severe symptoms.