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By Dr. Estelle Lin, MD, published in SouthSound and 425 Magazine on April 26, 2016.
Spring has arrived in the Puget Sound region with blooming cherry blossoms, tulips, and daffodils. In other words, for those of us with seasonal allergies, springtime is literally in the air—causing sniffling, sneezing and itching. Seasonal allergies can sometimes put a damper on the season, but fortunately, with a basic understanding of what seasonal allergies are, how to mitigate allergens and the available over-the-counter medications, springtime can be an enjoyable time for all.
Seasonal allergies, also known as hay fever or allergic rhinitis, are a result of our bodies overreacting to pollen, dust mites, animal dander and molds. When these allergens make contact with the mucous membranes of our eyes, nose and throat, our immune system releases histamine. Histamine causes our symptoms of seasonal allergies.
Primary care physicians diagnose seasonal allergies based on common symptoms including runny nose, sneezing, and itchy throats and eyes. Some patients may also experience post-nasal drip, which is when mucus runs down the back of the throat, causing an annoying sensation and a chronic, tickling cough. Others may experience allergic sinusitis, with pressure and pain over parts of the face and cheeks. Those with asthma can experience a flare in their breathing symptoms when seasonal allergies are added to the mix.
For seasonal allergy sufferers, getting symptoms under control starts with avoiding and filtering the triggering allergens. Changing clothes when you come home, showering frequently, using an air filter, keeping windows closed at night and doing saline nasal rinses are useful measures to decrease allergen exposure. While several dust mite–proof, impermeable mattress and pillow covers are available on the market, evidence-based studies have not found any benefit to using these products. If you have a pet, pollen can get lodged in the pet’s hair, so bathing your pets frequently and avoiding sleeping with them can also be beneficial.
In addition to allergen avoidance, several over-the-counter medications can be used to treat allergies. Antihistamines, including Claritin (loratadine) and Allegra (fexofenadine), are generally well tolerated compared to other antihistamines such as Benadryl (diphenhydramine), which is more sedating and can cause a dry mouth. If sniffling persists, Flonase, Nasacort, and Rhinocort nasal sprays are all available over the counter and have fewer side effects when used for short duration.
Decongestants can help with the sniffles and stuffy nose but must be used with caution. Over-the-counter options include Sudafed (pseudoephedrine), Sudafed (phenylephrine) and Afrin (oxymetazoline). These drugs should not be used by people who have cardiovascular conditions, hyperthyroid disease, glaucoma or high blood pressure. These medications can elevate blood pressure and cause headaches, agitation, racing heartbeats, and insomnia. Use should be limited to 3-5 days. Phenylephrine is also used in many over-the-counter cough and cold remedies, so it is very important to review drug labels and know the active drug ingredients in the products you buy. For example, Claritin-D is not the same as Claritin (loratadine); the “D” indicates that the formulation includes pseudoephedrine.
If over-the-counter medications don’t provide enough allergy relief, I recommend making an appointment with your primary care physician. Several prescription medications are available in addition to allergy testing and allergy shots for treating seasonal allergies. Having a one-on-one discussion with your physician is the best way to tailor treatments to your symptoms and enhance your quality of life so you, too, can enjoy spring in the Pacific Northwest.
Dr. Estelle Lin, MD, practices internal medicine at Pacific Medical Centers in its Federal Way clinic.