Seasonal alergies

Every year I find it difficult not to write about allergies in April.  When I see all the yellow stuff flying around outside, it’s hard to ignore. Many Virginians suffer from allergies to tree pollens which are produced mainly in the springtime.  It’s called allergic rhinitis, also referred to as “hay fever”, “sinus”, or seasonal allergies.  

So what causes allergies?  Essentially, it’s an overreaction of the body’s immune system to allergens (pollen, animal hair, dust and mold) in the air. The yellow stuff you see on your car everyday is normally too big to cause an allergic reaction.  It’s the tiny, microscopic stuff that can get up into your nose and cause problems.  

When these substances contact the nasal lining, the body reacts.  But in some people, the response is dramatic.  Chemical called histamine is released by the nasal cells. 

Histamine causes the symptoms of runny, itchy nose, sneezing, and watery eyes.  Nasal blood vessels dilate producing nasal stuffiness.  This can lead to pressure in the sinuses, fullness and popping in the ears, and dark circles under the eyes.  Some will experience red and itchy eyes, sore throat, and a cough due to drainage.

With severe symptoms, sufferers can experience fatigue, disturbed sleep due to nasal congestion at night and at times, hives.  Long-standing nasal congestion can also predispose some individuals to frequent sinus infections.  

So what can be done for allergy sufferers?  Some general avoidance measures can be helpful.  Avoid going outside on high-pollen or very dry, windy days.  Shower or bathe before going to bed to wash the pollen from the skin and hair.  Keep windows shut during the pollen season and use air conditioning to remove pollens from the home and car.  Wearing a filtering face mask may be helpful when working outdoors.

Many over-the-counter medications are available for the treatment of symptoms.  Most contain antihistamines (Claritin, Zyrtec, Allegra, Benadryl) which can block the body’s response to the pollens.  Some preparations contain a combination decongestant (like pseudoephedrine) for nasal stuffiness.  Cromolyn sodium is a nasal spray that can prevent the body’s response to allergens.  However, it must be used for at least two to four weeks to see results.  

Check with your doctor before trying any of these medications if you have a chronic medical condition or are on other medications which could interact with allergy medicines.  Older antihistamines and decongestants can cause drowsiness or jitteriness in some people.  Decongestants can elevate the blood pressure.

Prescription medicines are also available.  These include more potent antihistamines, nasal steroid sprays, nasal antihistamine sprays and eye drops.   Different individuals will respond differently to any medication, so talk with your doctor to see which medicine might work best for you.  

Finally, there are allergy shots.  These are prescribed only after specific testing is done to determine the precise allergen(s).  With this treatment, a small amount of the allergen is injected within the skin to get the body used to the allergen or “desensitized.” Several months or years of treatment may be required.

The content in this column is for informational purposes only.  Consult your physician for appropriate individual treatment.  Dr. Reynolds practices Family Medicine in Chesterfield.

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