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Seasonal Allergies

Posted 4/18/2018 by UHBlog

If April showers bring May flowers, what do May flowers bring? Seasonal allergies. We can help.

Dandelion blowing in the breeze

Seasonal allergies, also known as allergic rhinitis, affect millions of people each year. As the trees and grasses begin to return to life, so do the pollens that trigger the symptoms.

“Environmental allergies are broken up by seasons,” says family medicine specialist Lili Lustig, DO. “In the spring, it is mainly pollen as the trees start to bloom. In the summer, grasses are a contributor. Fall triggers are largely molds building up as the leaves fall. Winter allergies come about as you button up the house and turn on the furnace, blowing around dust and putting us in closer contact with dust mites.”

If your body’s immune system decides these harmless substances are bad for the body, it sends out a team of chemicals – called antibodies – to remove these raw materials (allergens). The allergen then triggers the antibodies to develop histamines. Histamines work by boosting blood flow to the problem area to rid your body of the irritant. In allergies, the antibodies go into overdrive making more histamine. This causes the visible symptoms of a localized allergic reaction, including runny nose, watery eyes and tissue swelling.

Allergies usually develop in these four steps:

  • Exposure to the allergen
  • Sensitization when the antibodies form
  • Re-exposure
  • Reaction (runny nose, etc.)

“To be an allergy, you have to have an indication that there are histamines at work,” says Dr. Lustig. “A person can be sensitive to eating a food, for instance, and have an upset stomach. Since there is no response from the immune system, they have sensitivity but do not have an allergy.”

According to Dr. Lustig, allergies are diagnosed through three steps:

  1. Personal and medical history. Your doctor will ask you questions about which symptoms are bothering you. For instance, is there any time when the symptoms get worse or go away? Is there any family history of seasonal allergies?
  2. Physical exam. A full physical exam may take place. Your doctor will pay close attention to your ears, eyes, nose, throat, chest and skin during the exam. This exam may include tests of your lungs to see if there are any breathing problems.
  3. Tests to determine your allergens. There are many options, including a skin test, patch test or blood test.

“As you age, it's unusual for you to develop new allergies,” says Dr. Lustig. “However, we may become more aware of those already in place. On the other hand, it is rare that a person with seasonal allergies ‘outgrows’ them as they get older.”

Since exposure is an important part of the process, allergies can develop later in life if new allergens are introduced in your environment. For example, if you move from Arizona to northeastern Ohio, you may be fine for awhile and then develop allergies to the grasses or trees in the area.

You can do some things to help lessen your symptoms, including:

  • Stay indoors on dry, windy days as these are more likely to stir up pollen
  • Avoid lawn mowing, weed pulling and other outside chores that add to pollen exposure. If you can't, wear a filter mask.
  • Remove outside clothes and shower to rinse off pollen
  • Keep track of pollen forecasts and current levels
  • Close doors and windows when pollen counts are high.
  • Use air conditioning in your house and car
  • Use high-efficiency filters in your home's air handling system

Most seasonal allergies are relatively harmless. Unless there is an underlying concern, such as asthma or lung disease, seasonal allergies are seldom life-threatening. This differs from food allergies, which can lead to anaphylaxis.

Speak to your family physician to assess your personal needs and to develop a treatment plan. Seasonal allergies can be treated with medications, such as:

  • Antihistamines that block the action of histamines. They are broken further into those that make you drowsy (alimemazine, hydroxyzine and diphenhidramine among others) and non-drowsy (acrivastine, loratadine, fexofenadine and others).
  • Steroid medications are often used to lessen the inflammation in the nose (mometasone furoate and fluticasone propionate).
  • Allergy shots (allergy immunotherapy), which are given as regular injections of the allergen(s) in increasing doses. This helps your immune system get more resistant and often lowers the need for medications.

“For seasonal allergies, it's best to start medication before you have symptoms,” Dr. Lustig says. “In the spring, begin treatment before the last snow fall. For summer allergies, mid-spring is a good time to start.”

Lili Lustig, DO is a family medicine specialist at University Hospitals Bedford Primary Care. You can request an appointment with Dr. Lustig or any other doctor online.

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