Although typical allergies are confined to certain seasons, especially during the present Spring, various pollens and other allergens may be hanging around almost all year. Here we describe steps that can keep you comfortable throughout.
Think your allergies are getting worse? If it seems like your itchy eyes, runny nose, and congestion are more severe and last for more days, it’s probably not your imagination. Thanks to climate change, there’s a lot more pollen in the air these days, and it’s hanging around for a longer time. That’s a problem for a lot of people: About 26 percent of adults and 19 percent of children have seasonal allergies, according to the Centers for Disease Control and Prevention. Research has found that 80 percent of those with seasonal allergies report moderate-to-severe symptoms that significantly impair their quality of life.
But thanks to newer treatments and ongoing research, we have a variety of effective ways to help subdue symptoms. Today’s medications are worlds apart from what we had 40 years ago. There’s no reason anyone now needs to suffer unnecessarily—we can usually find some sort of treatment that works for everyone.
Here’s what to know about the latest treatment recommendations and what you can do to keep your allergy symptoms to a minimum.
Pollen-Proof Your Environment
One of the most effective strategies is also one of the most straightforward: reducing your exposure to allergens. So, monitor local pollen counts and try to stay indoors between 5 a.m. and 10 a.m. on days when counts are highest, recommends the National Institute of Environmental Health Sciences. Other effective steps follow:
- Take a bedtime shower. This helps wash off pollen that’s collected on your skin and hair during the day so that you’re not literally sleeping with allergens.
- Use an over-the-counter (OTC) saline nasal spray. This helps clear a clogged-up nose and wash out pollen and other allergens that may have accumulated there. You can use these products as often as you want, but it’s a particularly good idea after you’ve been outdoors and before bed. Skip nasal decongestant sprays, or use them only for a couple of days, because they can cause rebound congestion.
- Banish Pets from the bedroom. Even if you’re not allergic to your cat or dog, keep them off your bed, and if they spend any time outdoors, keep them out of the room entirely. Their fur can harbor pollen.
- Run the air conditioner. You may be tempted to throw your windows open, but those lovely breezes can carry pollen into your home. You want to keep doors and windows closed, so no pollen can get in. An air purifier might help, too.
- Vacuum regularly. This can help pick up stray pollen particles that float into your home, as well as allergens such as pet dander and dust mites. Have someone else do your vacuuming, and avoid bagless vacuums, which can stir up dust when you empty them
- Keep your lawn tidy. Short grass is less likely to release pollen than taller grass, so mow regularly. If possible, have someone else mow it. If you do it yourself, wear a face mask (like an N-95 filter mask) and sunglasses to prevent pollen from blowing into your nose, mouth, and eyes. Regularly clean your gutters and downspouts, too.
TAKE THE RIGHT MEDS AT THE RIGHT TIME
Allergen avoidance techniques may not always be enough. Here’s the rundown on common medications and when it’s appropriate to consider them.
Oral antihistamines. If you have mild seasonal allergy symptoms when you’re outdoors—but feel better once you’re inside—try a once-a-day OTC antihistamine.
These drugs, available in chewable, liquid, and tablet form, can be taken daily until the end of allergy season. They work by blocking histamine, the symptom-causing substance released by your body when it comes in contact with an allergen.
Stick with what’s known as a “second-generation” antihistamine: cetirizine (Zyrtec and generic), fexofenadine (Allegra and generic), and loratadine (Claritin and generic). They’re less likely to cause sedation than older antihistamines, such as chlorpheniramine (Chlor-Trimeton Allergy and generic); clemastine (Tavist and generic); brompheniramine (Dimetapp and generic); and diphenhydramine (Benadryl Allergy and generic). I have found that this latter drug, Benadryl, can be used as a mild sleeping aid in the absence of allergies.
Though the newer antihistamines all appear to be equally safe and effective, some people may respond better to one than another. So if, for example, cetirizine doesn’t seem to help, try fexofenadine or loratadine. As an advantage in producing slightly less drowsiness, I prefer fexofenadine (Allegra and generic)
Steroid nasal sprays. If your symptoms persist even when you’re inside, include nasal stuffiness, and make you so uncomfortable that it’s hard to sleep and go about your day-to-day activities, the new guidelines now recommend opting for a daily prescription or OTC nasal steroid spray, such as fluticasone (Flonase, Flonase Allergy Relief, and generic) or triamcinolone acetonide (Nasacort, Nasacort Allergy 24HR, and generic). These drugs reduce swelling and mucus in your nasal passageways, and though some people report feeling better within a day, they usually take a couple weeks to reach maximum effectiveness. It’s fine to take an OTC oral antihistamine for a week or so while you wait for the spray to begin working. But after that, don’t bother. Research shows that it isn’t any more effective than using a steroid spray alone. Special note: Prominently featured in many TV ads are wild beasts of allergy threatening everyone’s very existence, while a serene woman sits on a park bench sniffing on a Flonase inhaler. Before you buy this product, however, make sure a steroid inhaler fits in this overall plan, and if so, I suggest you obtain a cheaper generic alternative.
Antihistamine nasal sprays. If you’ve been faithfully using a nasal steroid for a couple of weeks and you’re still uncomfortable, the guidelines recommend adding in a daily prescription nasal antihistamine spray, such as azelastine (Astelin, Astepro, and generic) or olopatadine (Patanase and generic). A nasal antihistamine seems more effective than taking a pill by mouth—possibly because it goes directly into the nasal passages that provides a much higher concentrated dose.
Reduce Your Reaction to Allergens
Still not finding sufficient relief from seasonal allergy symptoms, and/or have year-round allergies that are very bothersome? You might find immunotherapy useful. This prescription treatment involves exposing you to ever-larger amounts of allergens, gradually increasing your tolerance. Traditional immunotherapy is delivered via regular shots—often for three to five years—and can help with seasonal and year-round allergens. Over 80 percent of the time, people experience relief. The shots carry a small risk of a severe allergic reaction, so you’ll need to have them supervised in a doctor’s office.
If your seasonal allergies are to grasses and/or you’re allergic to dust mites, you might look into a newer prescription option: sublingual immunotherapy, or SLIT. Here, you typically place a dissolvable tablet containing purified extracts of allergens under your tongue. Currently, four treatments approved by the Food and Drug Administration are available: Odactra, for house dust mite allergies, Oralair, for five different grass pollens, Grastek, for Timothy grass allergies, and Ragwitek, for ragweed allergies. This is a really good option for people who are allergic to these types of pollen but aren’t seeing improvement on nasal and antihistamine sprays, or develop other complications from these allergies, such as sinus infections or asthma. For grass and ragweed, you’ll need to begin treatment about three months before these allergens pop up. If you’re using them to treat dust mite allergy, you’ll need them year-round. SLIT may cause mild side effects, such as itchy or irritated mouth and throat, and nausea or abdominal discomfort, but severe reactions appear to be quite rare..