Ah, fall. The perfect time to get outside for long walks in the neighborhood, hikes in the hills, and autumn gardening.
But that "ah" can quickly become "ah-choo" if you're one of the 36 million Americans with seasonal allergy problems. The runny nose, itchy eyes, and congestion -- all typical fall allergy symptoms -- can slow you down and make you miserable.
While there have been no dramatic advances recently in allergy treatment, experts say if you are allergy-prone, you can take a number of steps to minimize the misery.
1. Know Your Allergy Triggers
Triggers, or allergens, can vary by region of the country, but two main culprits are to blame for many fall seasonal allergy problems, experts say.
- Ragweed and other weed pollens. Ragweed is a stubborn plant and grows easily in fields, along roadsides, and in vacant lots. A plant can produce a billion pollen grains in a season, and the grains can travel up to 400 miles because they are so lightweight.
- Molds. Outdoor molds grow in heavy vegetation, hay and straw, and are found in raked leaves. Outdoor molds increase after rain, too.
Predicting how bad an allergy season will be is an inexact science, but there are some general links with weather, says Gary Rachelefsky, MD, a staff allergist at Santa Monica-UCLA Medical Center and Orthopaedic Hospital. "Usually when there is more rain, there is more pollen," he says. Outdoor mold can increase, too, with more moisture. So if you live in an area struck by flooding or heavy rains in the spring or summer, you can probably expect a worse-than-usual allergy season.
2. Learn Do-It-Yourself Measures
It may sound obvious, but avoiding the allergens is the No.1 measure suggested by allergy experts. There are many steps you can take to eliminate or minimize your exposure to allergens and improve seasonal allergy symptoms. Among the often-cited measures:
- Wear a protective mask when gardening or doing yard work.
- Modify the indoor environment to keep out allergens, says Clifford W. Bassett, MD, vice chairman of the Public Education Committee of the American Academy of Allergy, Asthma & Immunology. For instance, use HEPA (high-efficiency particulate air) filters in air conditioners to better trap pollen spores. "Change air condition filters often," he says.
- Check pollen counts before you travel. "If you are traveling with allergies, consider vacations near the ocean or bays," Bassett says. "Pollen counts there are typically lower." To find pollen counts, contact the National Allergy Bureau (www.aaaai.org/nab), which offers reports to the public. Or check your local weather report; some provide pollen and mold spore counts.
- Protect your eyes. On vacation and at home, wear sunglasses when outdoors to reduce the amount of pollen coming into the eyes, Bassett suggests.
- "Wash your hair at the end of the day to wash out pollens," Bassett suggests. That will help avoid pollen transfer to the pillowcase.
- Exercise in the morning or late in the day, Bassett says, when pollen counts are typically lower than at other hours. Know that pollen counts typically are higher on a hot, windy, sunny day compared with a cool day without much wind.
- Check the dog. "Pets can bring in pollen," says Pamela Georgeson, DO, member of the AAAAI Public Education committee and an allergist in Chesterfield Township, Mich. You might consider rinsing off the dog if it were outside on a high-pollen day, she says.
3. Get Proper Treatment
An allergist or your primary care doctor can recommend a variety of medications, some over-the-counter and some needing a prescription, to improve your seasonal allergies. Many are approved for use in children. A home remedy, nasal lavage, may help, too.
Topical nasal sprays, available by prescription, work well, says Georgeson. "They actually reduce the inflammation in the lining of the nose," she says. Examples are Flonase and Nasonex. They contain medications called corticosteroids, which work by reducing inflammation and are "minimally if at all absorbed," she says. The sprays are typically used daily, before and during allergy season.
Oral antihistamines are another option. Some, such as Allegra and Claritin (and generic loratadine), are now over the counter, Georgeson says, while others, such as Zyrtec and Clarinex, are by prescription.
A newer option is Astelin, a nasal spray antihistamine.
Antihistamines are often recommended along with topical nasal corticosteroids, Georgeson says. Antihistamines work by preventing more histamine (a chemical released during an allergic reaction) from being released.
Prescription eye drops can help itchy eyes.
Another option is the medication Singulair, also used to treat asthma, which works by blocking leukotrienes, substances which help cause allergy symptoms.
Nasal irrigation or lavage may help, too.
Many over-the-counter allergy options contain a combination of drug ingredients that may include a decongestant. Decongestants may elevate blood pressure and heart rate, so check in with your doctor to make sure that it is OK for you to take these.
A longer-term solution is immunotherapy, or allergy shots. Tiny amounts of the allergen are injected over time, provoking an antibody response. "It actually changes a person's immune system," Georgeson says. But it takes time. "Generally most physicians will treat from three to five years," she says.
"Allergy injections are used more often in adults than kids," says Ronald Ferdman, MD, attending physician at Childrens Hospital Los Angeles. "Allergies change in kids. They could get worse or better, and they could get sensitive to different allergens. Most of the time they get worse."
Under development is "sublingual" allergy therapy, says Bassett. Tiny amounts of the allergen are placed under the tongue, using the same concept as the allergy shots but with a different and more convenient delivery system.
4. Beware of Foods That Trigger Your Symptoms
If you have seasonal allergies to ragweed, be aware that eating certain foods may trigger your symptoms. "This is the concept of oral allergy syndrome," Bassett says.
It's a double-whammy, he says. About one-third of people with fall seasonal allergies will have a cross-reaction to certain foods, he says. Foods that might provoke symptoms in those with ragweed allergies, according to AAAAI, include bananas, cucumbers, melons, zucchini, sunflower seeds, and chamomile tea.
