by Dr. Niveditha Hariharan
Spring may not be pleasant for people suffering from seasonal allergies. Seasonal allergies are hay fever and allergic rhinitis which happen when your immune system reacts to a specific allergen.
Seasonal allergies usually happen when airborne pollen from budding trees, grass, flowers, and weeds enters the eyes, nose, and throat and initiates an allergic reaction.
In response to an allergen, your body produces an array of chemical mediators including histamine that causes allergic symptoms.1,2
Allergic reactions cause runny nose, coughing, sneezing, itchy eyes, congestion, and a scratchy throat. In some instances, allergic reactions can also cause hives, rashes, breathing trouble, asthma attacks, and even death3.
It is estimated by the American Academy of Allergy, Asthma & Immunology (AAAAI) that allergies are the sixth leading cause of chronic illness in the United States and approximately 50 million Americans experience various forms of allergies every year4.
As there is no cure for allergies, the best thing you can do is manage the symptoms wisely. Here are the top 10 tips to beat seasonal allergies. The following simple strategies may help you cope with seasonal allergies.
Common Allergy Triggers
The symptoms of seasonal allergic rhinitis are most often seen in spring, summer, and/or early fall5. The following are considered to be the common allergy triggers:
1. Trees | Birch, cedar, cottonwood, and pine
Birch pollen is the most common airborne allergen that usually blooms during the spring and is seen throughout the continental US. It is estimated that a single birch tree produces 5 million pollen grains6.
The mountain Cedar trees in Arkansas, Missouri, Oklahoma, and Texas cause cedar allergies. Cedar pollen allergies season usually starts in January and may last till June7.
Cottonwood tree is native to North America and pine trees are seen throughout the United States but pine allergies are relatively uncommon7.
2. Grass | Timothy, Johnson, and Rye grasses
Grass pollination is usually seen later in the spring. Many regions of the United States have a predominance of one or more types of grasses5.
3. Weeds | Ragweeds
Ragweeds allergies are usually seen during the late spring and early fall and are the common allergy trigger in North America. Ragweed pollens are highest in early to mid-September5.
An Immunologist’s Top 10 Tips for Seasonal Allergies
1. Avoid Allergy Triggers
The best way to avoid an allergy is to get rid of the potential allergy triggers. This will help minimize the symptoms of your allergy. Avoid cutting grass, picnics, and camping during the season8. You should assign the gardening chores to others, if you can’t avoid them, wear a filter mask during gardening2.
2. Keep A Clean House
The dust and mold that stick on the bookshelves, window, and air conditioning vents can provoke symptoms of allergy. So do a thorough cleaning to ensure your home is spick and span2.
Wash the beddings in hot water (130-140ºF) every week. The hot water will remove any lingering mites1.
During the allergy season, try to dry the laundry indoor as pollen can stick to sheets and towels. This helps minimize the effect of blowing pollen2.
Use ammonia to remove mold from bathrooms and other wet spaces2.
3. Take a Note of the Pollen and Mold Count
It is a better idea to stay at home during windy days. If you wish to go outside, plan your visit after rain which will clear the pollen from the air5.
Always monitor pollen and mold counts in your area. Do check for pollen forecasts in newspapers, television, and radio, or visit the site National Allergy Bureau. 2,8
When you realize that the pollen count is high, shut the windows and doors in your house2.
Avoid using windows or fans that tend to draw pollen inside.2,8
When you travel in a car, keep the car windows closed. Installing a car pollen filter may help.2,8
You can take some protective measures when you go outside like wearing sunglasses to protect your eyes and applying a small amount of petroleum jelly inside of the nostrils to prevent allergens from reaching the lining of the nose8.
4. Personal Hygiene
As pollen can collect on hair and skin, make sure you wash your hair before bed. Also, change your apparels after working or playing outdoors.5,8
5. Pets off The Bedroom
If you are a pet lover, keep your pets off the bedroom as pollen can cling to the dog or cat1. The use of a zippered allergy-proof pillow case and mattress cover can help minimize the effect of dust mites1.
6. Floors
Try to go carpet-free. Instead of wall-to-wall carpeting, prefer hardwood floors, vinyl, or linoleum9. If you can’t avoid carpets, clean them with a vacuum using micro filter bags or a HEPA filter2.
7. Air-Conditioner and HEPA Filters
Other precautionary measures you can take to eliminate allergens from the house.
Use air-conditioner in the house and car. Ensure that you regularly clean the vents to stop allergens and dust blow around your home.1,2
Use a dehumidifier to keep the indoor air dry. Relative humidity of below 50% prevents the growth of molds1.
Use a portable HEPA filter in your bedroom.1,2
Also, try cleaning the floors with a vacuum cleaner that has a HEPA filter. A damp duster can help stop pollen from moving about the home and help clear up the existing allergens in the home.2,9
8. Home Remedies
A saline nasal rinse can help clear allergens from nasal membranes. Gargling with salt water can also help soothe a scratchy throat2.
Recent evidence suggests that stinging Nettle (Urtica dioica), a medicinal plant, has been shown to reduce the signs and symptoms of allergic rhinitis. It is considered a natural antihistamine10.
Quercetin is a naturally occurring polyphenol flavonoid and natural anti-histamine found in onions, apples, berries, and Brassica vegetables. Studies from animal models proved that quercetin reduced the respiratory side effects of allergies in rats by dampening the inflammatory response in the airways11.
9. Over-The-Counter Medicines
If you have a history of seasonal allergies, your immunologist/allergist may help you manage the symptoms. Some allergist recommends starting the medicines (topical nasal steroids) two weeks before the allergy season begin. This helps dampen your symptoms and manage the condition better5.
Some of the allergy medications are available as over-the-counter medicines and some medicines require a prescription.
1. Oral Antihistamines
Oral antihistamines help relieve symptoms like sneezing, itching, and runny noses. They are safe and can be taken for long periods. Some of the second-generation oral-antihistamines include:
- Reactin® (Cetrizine)
- Aerius® (Desloratadine)
- Allegra® (Fexofenadine)
- and Claritin® (Loratadine)
2. Decongestants
Decongestants are available in oral and nasal forms which help relieve nasal obstruction. Some decongestants contain a combination of both. These drugs should not be used for more than 5 to 10 days.1,2,3,8
Some of the oral decongestants include:
- Sudafed® and Afrinol® (pseudoephedrine)
- Nasal sprays include Afrin (oxymetazoline) and Neo-Synephrine® (phenylephrine) 1,2,3,8.
3. Intranasal Corticosteroids
These drugs help reduce inflammation of the nasal mucosa and improve mucosal pathology. In patients with concurrent asthma and allergic rhinitis, corticosteroids help reduce oral airway symptoms.1,3,8
Common intranasal corticosteroids include:
- Beconase® (beclomethasone)
- Rhinocort® (budesonide)
- Omnaris® (ciclesonide),
- Flonase® (fluticasone propionate)
- and Nasacort® (triamcinolone acetonide).1,3,8
10. Immunotherapy or Allergy Shots
Immunotherapy is considered to be an effective way of treating seasonal allergies. Before performing immunotherapy, allergy testing is performed to determine what a person is allergic to so that treatment can be initiated well1.
The idea behind immunotherapy is you are exposed to small standardized (diluted) subcutaneous doses of allergen gradually so that you don’t react to the allergen and instead try tolerating the allergen.
The process helps to create a form of resistance to the allergen and aids in decreasing the severity of allergy symptoms. This form is effective for treating allergic rhinitis caused by pollen and dust mites.1,5,8
If you have prolonged symptoms of rhinitis, asthma, recurrent sinusitis, symptoms that affect your quality of life, it is better to consult your doctor immediately.
Conclusion:
People with seasonal allergies have difficulties in managing their allergy symptoms and their quality of life is highly disrupted during the spring. Though none of the allergies can be cured, the best way to cope up with the allergy includes avoiding the allergy triggers as far as possible.
Also, it becomes highly important to maintain a tidy environment that is free from pollen. Outdoor visits need to be planned to take into consideration the counts of mold and pollen. After the outdoor visit, washing of hair and changing the apparel becomes necessary.
Other precautionary measures to eliminate allergens include keeping the pets off the bedroom, using air conditioners, dehumidifiers, and HEPA filters, and preferring hardwood floors instead of carpets.
Some of the home remedies for seasonal allergies include stinging nettle and quercetin which are considered to be natural antihistamines. Several over-the-counter medicines like antihistamines, decongestants, and intranasal corticosteroids are also available which will be prescribed by your physician based on your symptoms.
If the symptoms do not subside after pharmacotherapy, immunotherapy is done to make you tolerant to the allergen you are allergic to.
Dr. Hariharan completed her doctoral degree in Clinical Immunology from JIPMER, India. She worked on Pharmacogenetics in Rheumatoid Arthritis. Her areas of interest include immunology, genetics, and molecular biology.
References:
1. Small et al., Allergic Rhinitis. Allergy, Asthma & Clinical Immunology 2011, 7(Suppl 1):S3
2.https://www.mayoclinic.org/diseases-conditions/hay-fever/in-depth/seasonal-allergies/art-20048343, accessed on 25/3/2021
3. Emeryk et al., New guidelines for the treatment of seasonal allergic rhinitis. Adv Dermatol Allergol 2019; XXXVI (3): 255–260.
4.https://acaai.org/news/facts-statistics/allergies, accessed on 25/3/2021
3. Parikh et al., Seasonal allergic rhinitis. BMJ 1997;314:1392–5
4. https://acaai.org/news/facts-statistics/allergies, accessed on 1/4/2021
5. https://acaai.org/allergies/seasonal-allergies, accessed on 25/3/2021
6. https://www.healthline.com/health/allergies/pollen, accessed on 1/4/2021
7. https://www.webmd.com/allergies/ss/default.htm, accessed on 1/4/2021
8. Parikh et al., Seasonal allergic rhinitis. BMJ 1997;314:1392–5.
9.https://www.healthgrades.com/right-care/allergies/10-ways-to-allergy-proof-your-home?hid=nxtup, accessed on 26/3/2021
10. Bakhshaee et al., Efficacy of Supportive Therapy of Allergic Rhinitis by Stinging Nettle (Urtica dioica) root extract: a Randomized, Double-Blind, Placebo- Controlled, Clinical Trial. Iran J Pharm Res. 2017 Winter; 16(Suppl): 112–118.
11. Jafarinia et al., Quercetin with the potential effect on allergic rhinitis. Allergy, Asthma & Clinical Immunology 2020, 16:36
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