Seasonal allergies: Nothing to sneeze at

If you or your kids have started sniffling, sneezing and rubbing your eyes over the past few months, you’re not alone — it’s seasonal allergy time, and the transition between seasons is kicking symptoms into overdrive.

Hay fever, also called seasonal allergic rhinitis, is diagnosed when a person has allergic reactions to such substances as tree pollen, grass pollen and certain kinds of mold. Mistaking the allergen as a threat, the body’s immune system releases histamines, which cause a host of symptoms to come on suddenly, like a runny nose, itchy and watery eyes, sneezing and post-nasal drip.

Symptoms of hay fever emerge around the same time each year for those affected, said Dr. Rosa Ten, a consultant in the Allergy and Immunology Division of the University of California, San Francisco.

“Hay fever is very seasonal,” she said. “During springtime, it may be an allergy to trees; during summer and fall, it may be an allergy to grass.”

And while Woody Allen may have us believe that Jews are disproportionately affected by allergies, in fact the American Academy of Allergy, Asthma & Immunology estimates that almost 55 percent of the entire U.S. population tests positive to one or more allergens. According to the American College of Allergy, Asthma & Immunology, between 10 and 30 percent of adults and up to 40 percent of children have seasonal allergies.

Dr. Taylor Doherty, an assistant professor of medicine in the Department of Allergy and Immunology at the University of California, San Diego, said hay fever usually shows up in kids by the time they’re 10 years old. It occasionally resolves on its own, but more often than not, those affected retain their allergies into adulthood.

Many don’t get the medical care they need, he said. Untreated allergies can cause more than just annoyance — nasal congestion can prevent good sleep, and common over-the-counter medications can cause drowsiness.

“People just sort of live with their allergies and don’t realize what kind of problems they cause,” Taylor added.

Rather than ignoring symptoms or hoping they’ll go away on their own, both Ten and Doherty suggest visiting an allergist if signs like watery eyes or congestion occur around the same time each year or if they persist for longer than a week.

“Hay fever lasts for a few months,” Ten said, “so if a person is congested, has a runny nose or is sneezing for several weeks or months, that’s probably allergies.”

For parents, Doherty suggests bringing a child to the doctor if he or she isn’t sleeping well, is breathing excessively through the mouth or has developed a wheeze or cough.

Once a patient has met with a doctor, determining the best course of action to treat allergies hinges directly on an accurate diagnosis, Doherty said. There are a number of different kinds of plant pollens, as well as molds and other outdoor allergens, and most people suffering from hay fever are allergic to only a few.

“One of the misconceptions about allergies is that if someone is an allergic person, they are allergic to everything, but that’s really not true,” he said. “There is a lot of variability among patients — for instance, many have a specific outdoor trigger as well as a specific indoor trigger, and that’s why testing is so important.”

To find a patient’s triggers, allergists will perform one of a number of tests. According to the National Institutes of Health, the most common form of allergy testing is a skin test, which can be done by pricking the skin after an allergen has been applied to the area, wearing a patch containing an allergen, or injecting an allergen directly into the skin.

“If the patient is allergic to that particular allergen, within 15 minutes they will develop a hive,” Ten said. “If they are not allergic, they will have no reaction.”

Once an allergen has been identified, the first place to start in combating symptoms is avoiding it — or, Ten said, “find out what you can do in the environment to prevent exposure.”

That might mean dusting and cleaning up pet hair regularly, or keeping windows shut. But because exposure to the outdoors is inevitable, when it comes to hay fever, many patients turn to over-the-counter medications, prescription medications or allergy shots.

Of those treatment options, Doherty said, the best is available by prescription only.

“Far and away the best medications we have for people with hay fever are nasal steroids,” he said, which work to decrease the number of cells that become inflamed as a result of an allergen. Nasal steroids can be used preventively leading up to allergy season, and over the course of several months or years, can have a permanent effect on reducing sensitivity to allergens. 

For more immediate relief of symptoms, over-the-counter antihistamines, decongestants and nasal sprays can help, although the Department of Health and Human Services cautions that nasal decongestants should not be used for more than three days in a row because of the risk of rebound nasal congestion, a return — sometimes worse — of the original symptoms.

Certain allergies are severe enough that they won’t respond much, if at all, to attempts to control symptoms through medication. For those patients, Ten said, allergy shots — also called immunology — may be the best bet. Administered over the course of several years, allergy shots are designed to “desensitize a person, so they don’t have the allergy anymore,” she said.