Sunday, May 28, 2023

This winter has been long and snowy. Most of us are ready to trade in our snow shovels for lawn mowers and gardening tools. However, as the weather warms up and people venture outside, spring also brings on misery for many allergy sufferers.

A seasonal allergy is a reaction to a specific trigger that presents only at certain times of the year. These triggers are found outdoors that present typically from March through the Fall months. In our part of the country, tree pollen is the main springtime allergen that typically appears in March and lasts until about June. Trees such as oak, maple, and birch release a powdery like substance called pollen into the air. When it is inhaled by an allergy sufferer, it will trigger seasonal allergic rhinitis symptoms or “hay fever.” Such symptoms may include sneezing, runny nose and nasal congestion. Other symptoms may include red itchy eyes, cough, wheezing, and sometimes skin findings such as eczema. Once the trees die down, grass pollen tends to be the main culprit during the mid-summer months. From August until about October hay fever is mostly triggered by ragweed. Molds can also trigger symptoms for some sensitive individuals during the wet spring and fall months, but also during the humid summer months.

The first thing to do is limit your exposure to pollen. One can monitor the pollen counts by tuning into their local weather channel or checking out local pollen counts online through the National Allergy Bureau. I recommend that on high pollen days sensitive individuals stay indoors with the windows closed and air conditioning on. I recommend bathing in the evening so that pollen isn’t transferred from one’s skin and hair to their bed. Also, do not hang your laundry outside to dry because it will get covered in pollen.

If such measures are not enough there are very good medications available. There are three main categories of allergy medications: antihistamines, intranasal steroids, and leukotriene antagonists. Some of these medications are available over the counter but most require a prescription. For some individuals one category of medication may be sufficient, but for many others a combination of medications from different categories is required to control symptoms. Despite various medications, some individuals may still suffer, and at that point one may consider immunotherapy, or allergy shots. Immunotherapy is a method to desensitize patients to problematic allergens so that over time symptoms improve. Typically patients will start out receiving weekly allergy injections which then may spread out to monthly injections, lasting about three to five years. Most recently a new form of immunotherapy, sublingual immunotherapy, has become available and FDA approved. With this treatment, patients place a tablet daily under their tongue several months before the problematic season. Unfortunately, we do not have a tablet for tree pollen which is the main springtime trigger.

The important thing to remember is that the majority of allergy cases can be treated quite successfully so there is no need to suffer and say “oh it’s just my allergies.”

By Debora K. Geller, MD

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