Plagued by Pollen

Preventive tips, treatments, and more: Your survival guide for the spring allergy season.

From the WebMD Archives

Warmer weather may feel good after a long, cold winter, but spring can be rough on the nose and eyes. That's because hay fever, a seasonal allergy to pollen, kicks in just as the sunnier days arrive. Never been near a bale of hay, you say? You may still have hay fever, caused by the pollen from a variety of trees, grasses, and weeds. The allergy's hallmarks-stuffy nose, watery eyes, and fatigue-are a minor annoyance for some and bring full-blown misery to others.

Hay fever is not the only kind of spring allergy, but it is the most common. As many as 50 million people in the United States have allergies -- and nearly 36 million of them have hay fever, says the American Academy of Allergy, Asthma & Immunology (AAAAI).

Don't settle for all that sniffling, sneezing, and teariness. Work with a doctor to find out what's causing your allergies. Hay fever treatments are plentiful, including over-the-counter products, prescription drugs, and allergy shots. With proper care, "most everybody can get through the season without a whole lot of distress," agrees Larry Williams, MD, of the pediatric allergy and immunology division of Duke University Medical Center.

Your first step: Decide to take control. Use this guide to learn more about the kind of seasonal allergy you may have, house hold tips to help keep allergens away, and treatment options in and beyond your medicine cabinet.

The ABCs of Allergens

Allergies are classified by their source (such as food allergies) or the part of the body they affect (such as skin allergies). Some allergies last all year, including those to food, medicines, latex, dust mites, insect stings, and animal dander. Other allergies, like hay fever, are seasonal. That's because from spring through fall, plants reproduce by spreading pollen through the air. In people with hay fever, pollen irritates the immune system, triggering a host of allergy symptoms.

Nasal allergies, including hay fever, can irritate the eyes, nose, roof of the mouth, and throat. Top culprits include:

  • Animal dander. Dead skin cells from animals.
  • Dust mites . Microscopic insects that live in household dust, even in tidy homes. "Dust mites have to have conditions of warmth and humidity" to thrive, says Williams.
  • Mold spores from fungi. Spores that thrive indoors in damp areas, such as basements and bathrooms. They also gather outside in warm climates and in leaf piles.
  • Pollen. A fine, powdery substance released by trees and plants, including ragweed, grasses, and, of course, hay. Flowering plants, such as roses, usually don't cause allergy symptoms. Their pollen is too large to be carried by wind.
  • False irritants. Tobacco smoke and perfumes can irritate the eyes, nose, and throat, but they're not allergens.

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The Hay Fever/Sinusitis Connection

Seasonal nasal allergies, such as hay fever (or rhinitis, its medical term) and sinusitis, often go hand in hand. Why? Hay fever can cause swelling of the opening to the sinuses. If the sinuses inside the skull don't drain adequately, an infection can develop that leads to worse symptoms.

People with hay fever are more likely to develop sinusitis than those without hay fever. Of course, not everyone with hay fever gets sinusitis. But "definitely, the data suggest that people who have allergies and sinus disease have worse sinus problems," says Michael Schatz, MD, MA, chief of Kaiser Permanente's allergy department in San Diego.

That's one more reason to seek treatment if you have an allergy, says Williams. Anything you do to cut down on congestion-such as treating your hay fever as early as possible should help your head feel clearer and might help you avoid sinusitis.

Home in on Solutions

Hands down, your No. 1 defense is to avoid the allergens that make you so miserable. You can't get rid of pollen outside, but you can tweak your daily routine to limit it indoors. Some tips:

  • Shut it. Close the windows at home and in your car.
  • Air it. If you need to cool down, run the air conditioning instead of opening the windows. Also, put the air on "recirculate" so you're not bringing in outside air filled with pollen.
  • Case it. Put pillows, box springs, and mattresses in cases that keep dust mites out.
  • Wash it. Throw sheets, comforters, blankets, curtains, and washable stuffed animals regularly into the washing machine, set to the hottest water temperature the material can handle.
  • Dry it. Use the clothes dryer. Dust mites can't take the heat.
  • Clean it. Keep kitchens and bathrooms clean and dry. If you use a humidifier, clean it regularly so it doesn't become a breeding ground for bacteria and mold.
  • Freeze it. If your kids have dust mite allergies and their toys can't be washed, put the toys in the freezer for 48 hours every two weeks. Freezing temperatures will kill the dust mites, Duke University's Williams says.
  • Expose it. To further reduce dust mites, consider replacing your carpeting with hard flooring and getting rid of upholstered furniture.
  • Ask about it. Ask your doctor if your allergies are linked to your pet, and what to do about it.
  • Store it. In the basement or attic, put away collectibles and clothes in plastic storage bags and run a dehumidifier to prevent mold growth.

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Treatments range from OTC to alternative

Here's how to get the right treatment for your symptoms. If you have:

  • Mild hay fever: An over-the-counter product may be all you need. The key ingredient-antihistamine-targets histamines, which are chemicals your body makes in response to allergens. Histamines cause runny noses and eyes, itching, and sneezing. Check product labels about a risk of drowsiness with some products. Non-drowsy antihistamines are also available.
  • Severe or long-lasting hay fever: If over-the-counter medicines aren't working, see a physician. "These days, with the medications that are available, seasonal allergies are usually very well controlled," says Michael Schatz, MD. Prescription medications come in three forms: antihistamines, nasal steroid sprays, and medicines targeting allergy-related chemicals called leukotrienes. Any doctor can prescribe those drugs, not just allergists, says Williams.

Alternative Approaches

Acupuncture, part of traditional Chinese medicine, has shown promise in some allergy studies. In acupuncture, very fine needles are inserted into specific points on the body to rebalance what practitioners call chi, or vital energy.

Although there is little research on the use of supplements for hay fever, one herb has undergone clinical testing. One study showed that an extract called butterbur Ze330 worked as well as a prescription antihistamine. It also did not cause sleepiness, which may make it a better option than some over-the-counter allergy remedies.

Researchers have also looked at vitamin C and other supplements, such as urtica dioica, bromelain, quercetin, and N-acetylcysteine, for fighting allergies. At this point, there is little evidence that they work.

Tell your doctors about any other treatments or products you're taking so they can watch for interactions with medicines.

A Shot of Hope

Allergy shots can be very effective, Schatz says. But they're not an instant fix or the first option most people try (nor are they a good idea for people with heart disease or uncontrolled asthma). They also take time. Allergy shots can take a year to help.

Typically, patients try allergy shots if other allergy drugs haven't helped or if they need allergy medicines for more than half of the year.

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Allergy shots require repeated doctor visits. First, doctors pinpoint the allergy's source. They prick the skin with tiny allergen doses, checking for allergic reactions.

Next, patients get allergy shots in their upper arm once or twice weekly for several months. Over time, patients are given increasingly higher doses of the allergy trigger to slowly help their body become more used to it. If the shots work, patients get maintenance doses every two to four weeks for up to five more years.

Allergic reactions to allergy shots are rare, but possible. After all, the shots do contain allergens. Reactions can include itchy eyes, runny nose, shortness of breath, or throat tightness. Take an antihistamine and seek emergency medical care for those symptoms.

WebMD Magazine - Feature Reviewed by Matthew Hoffman, MD on March 20, 2008
© 2006 WebMD, Inc. All rights reserved.

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