Lenore Hirsch, a retired educator, is living the good life. Her home is in the impossibly beautiful Napa, CA, and she spends her days indulging her passions: photography, writing, and travel.
If only her allergies would let up.
Hirsch, who considers herself "a very young 69," has had hay fever since childhood and is no stranger to the stuffy nose and sinus pain that go with it. Sometimes it gets so bad she feels like her only option is to escape to the beach, where there are no trees or pollen.
Lucky for them -- and for you -- there are lots of meds that can bring relief.
Steroid Nasal Sprays
Nasal steroids are a type of nose spray and are often the first drugs recommended for allergies. They're a powerful way to fight stuffiness because they get to the root of the problem.
"Nasal steroids reduce the whole allergic inflammatory process," says Harold Nelson, MD, professor of medicine at National Jewish Health in Denver. Plus they target all your allergy symptoms, not just congestion.
Some options are:
- Beclomethasone (Beconase)
- Fluticasone (Flonase)
- Mometasone (Nasonex)
- Triamcinolone (Nasacort)
If you use one, be patient. "You don't get the full effect for several days or even a week," Nelson says. "But if you use it daily, it'll be incredibly effective."
Hirsch says she uses a steroid nasal spray year-round at bedtime. She's pretty sure it's been the key to opening the passages of her nose and keeping sinus stuffiness at bay. "I haven't had a sinus infection in many years, and I think this is why," she says.
They stop your body from releasing a chemical called histamine, which plays a role in allergic reactions.
The drugs come in pills, liquids, tablets, and nasal sprays. Some common ones are:
- Cetirizine (Zyrtec)
- Chlorpheniramine (Chlor-Trimeton)
- Clemastine (Tavist)
- Desloratadine (Clarinex)
- Diphenhydramine (Benadryl)
- Fexofenadine (Allegra)
- Loratadine (Claritin)
Like many people, Hirsch usually reaches for antihistamines first. They help with itching and sneezing, but they don't work as well for stuffiness and sinus pressure.
They shrink the blood vessels in your nose, which opens up your air passages. Better airflow means less pressure and discomfort.
Many pills combine a decongestant and an antihistamine. Some include a pain reliever, like acetaminophen.
Some pills with decongestants that you can check into are:
- Chlorpheniramine/phenylephrine (Actifed)
- Loratadine/pseudoephedrine (Claritin-D)
- Phenylephrine (Sudafed PE)
- Pseudoephedrine (Sudafed)
Decongestant Nasal Sprays
They shrink the swelling inside your nose to make you less stuffy. And they do it fast. Some sprays you might want to try are:
- Oxymetazoline (Afrin)
- Phenylephrine hydrochloride (Neo-Synephrine)
- Xylometazoline (Otrivin)
There's a catch, though. If you use them more than a few days in a row, your swelling and stuffiness may get worse. This is called a "rebound reaction." You get temporary relief, but your symptoms come back worse than before.
If you use nasal decongestant sprays, keep it to 3 days max.
You may want to consider them if you have allergy congestion all year and medication doesn't help much. The fancy name for this kind of treatment is "immunotherapy." It gets your body used to the things that trigger your hay fever so you won't have an allergic reaction.
"Allergy shots are far and away the most effective treatment," Nelson says. But it's a long-term process, not a quick fix. You get a series of injections over several years. Each one has a small dose of the stuff that causes your allergies.
Some allergists are turning to another form of immunotherapy that doesn't use injections. You may be able to take a pill that dissolves after you put it under your tongue. Examples are Grastek, Oralair, and Ragwitek. You need to take the first one at a doctor's office, but after that you can use them at home.
Eye drops can help your itchy eyes and even work for problems in your nose, too. You can try:
- Azelastine (Optivar)
- Ketotifen (Zaditor)
- Naphazoline (Opcon-A, Visine-A)
- Olopatadine (Patanol)
You can also use cromolyn sodium (NasalCrom), a nasal spray that blocks histamine and reduces swelling.
Leukotriene modifiers may help, too. They're prescription drugs that block chemicals that cause swelling. Some examples are montelukast (Singulair) and zafirlukast (Accolate).
Whatever your allergy trouble, there's no reason to say to yourself that it's just the way things are. Talk to your doctor about the best approach, and get the relief you need.