Seasonal Allergies: Something to Sneeze at

If you’re taking the time to read this, chances are you or a family member suffers from seasonal allergies. And although our winter here in North Texas has been a mild one, spring is almost upon us, ushering in a whole new crop of things to make us sneeze, cough and itch all over.

Dania Wierzbicki, M.D., allergist/immunologist and physician on the medical staff at Texas Health Dallas, said that while most people across the country experience seasonal allergies in the spring and fall, we lucky Texans are subject to them three times a year.

“The mountain cedar gets us during the winter, but in the spring it starts with the yellow live oak pollen that coats the sidewalks and everybody’s cars,” she said. “Starting in about March we deal with tree pollen from live oak, elm and pecan trees, and then later in the spring the grass pollens come around and continue well into the summer. We might get a break when it reaches 100 degrees in August before we start it all over again in the fall.”

If you’re one of the millions of seasonal allergy sufferers, you know the common symptoms: sneezing, an alternately stuffy or a runny nose and itchiness in the nose, mouth, throat, eyes and ears. According to the American Academy of Allergy, Asthma & Immunology, allergic reactions are most commonly caused by pollen and mold spores which kick your immune system into overdrive. Your immune system reacts to the foreign substance (allergen) by making antibodies that release histamines to counteract the allergens, making you completely miserable.

Wierzbicki said keeping an eye on the calendar and starting preventative medication can help seasonal allergy sufferers get a jump on the sniffles before they start.

“I suggest people pick a day that’s easy to remember like Valentine’s Day and start early with a nasal steroid (Flonase, Nasacort, Rhinocort) because they are best at treating all of the symptoms of seasonal allergies,” she advised. “Starting this regimen two weeks before the start of allergy season is usually sufficient, but last year it hit early so I suggest people be on board by March 1. It’s much easier to prevent bad reactions than getting on top of them once they’re already out of control.

“I typically recommend one spray for kids and two sprays for adults in each nostril once a day. Most people take it in the morning but whichever time of day is easier to remember is fine.”

In addition to nasal steroids, Wierzbicki offered several other options as another layer of protection against pesky springtime pollen.

“Antihistamines can be taken orally or in a nasal spray and are especially helpful in controlling sneezing and itching in the nose and eyes,” she said. “They can also act more quickly for breakthrough symptoms on top of maintenance medication. If people are really congested, oral or nasal decongestants can be helpful but they should only be taken as a short-term measure.

“Another potential solution is leukotriene inhibitors (Singulair), which blocks chemical messengers that antihistamines don’t address and are FDA-approved for seasonal allergies and asthma. Also, nasal irrigation with a neti pot or Neilmed sinus rinse can be helpful in getting mucus out of the way and thinning secretions so when you do use nasal medication, it can do a better job.”

The American College of Allergy, Asthma & Immunology recommends the following strategies to avoid seasonal allergy triggers:

  • Check weather reports so you know when pollen counts are high.
  • Keep windows and doors closed at home and in vehicles during allergy season.
  • Know which time of day pollens are most “active.” In the warmer months, tree and grass pollen levels are highest in the evening, while ragweed pollen levels in the late summer/early fall are highest in the morning.
  • Shower, wash hair and change clothes after playing, exercising or working outdoors.
  • Wear a filter mask when mowing or doing other outdoor chores and take medication before you begin.

Wierzbicki said she sees several misconceptions among her patients with seasonal allergies.

“Lots of people think they get sinus infections a couple times a year and go to an urgent care clinic to get antibiotics when in reality, they have seasonal allergies,” she said. “Board-certified allergists can help patients find out what their triggers are and get their allergies under control before they get stopped up and end up with a bacterial infection.

“Another important thing to know is that you shouldn’t just give up on medication if it doesn’t solve things after 48 hours. Give it time. Many patients start a new medication like Flonase and give up after the weekend if it doesn’t work right away.”

Regardless of the season or which allergen gets your nose to twitching, Wierzbicki said working with an allergist can help patients determine which course of treatment is best.

“In addition to seasonal allergies, people struggle with year-round allergies from things like mold, pet dander and dust mites, which are a big problem in North Texas because of the humidity,” she explained. “Many times the same medications for seasonal allergies are effective for these year-round allergies as well.

“It comes down to the quality of life really, whether a patient needs over-the-counter medications, prescriptions or immunotherapy treatment. It’s very rewarding to see a patient who is miserable come in and get treated, and then be able to go back to enjoying life.”

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