Since allergy season is starting very early this year, we thought it would be a good time to remind everyone about allergies and how to treat them.
It is estimated that nearly half of all Americans suffer from some type of seasonal allergy. Of this group, nearly one third have missed work or school because of their allergy symptoms. Even more surprising is that many allergy sufferers have no idea that their symptoms are allergy related, so they go undiagnosed. Most simply think that they are suffering from a seasonal cold due to a change in the weather. This is commonly called “hay fever.” What they are really suffering from is known as allergic rhinitis.
Allergies can develop at practically any age. Most allergy sufferers will start to show signs in adolescence, but can start much earlier. Infants and toddlers under the age of two are more often exhibiting food hypersensitivity than a true pollen allergy. As the child ages and has more exposures, pollens become a factor and by age six allergies are considered to be present if the child remains symptomatic. Having said that, children under the age of six who are symptomatic and/or have a family history of allergies should be evaluated.
Is there a “best” time of the year for allergy sufferers? This answer is not so cut and dry as it might seem. To answer that question properly, you first have to know what is blooming and when. Typically, people with allergies to tree pollen will be most symptomatic in the spring. People with grass allergies will be most symptomatic mid-spring through late fall and people who have allergies to weeds will be most symptomatic late summer through late fall. Usually, by the time there have been two frosts, the majority of all pollen producing plants are either dead or dormant.
While the above holds true for many allergy sufferers, there are exceptions to this rule. Things like molds, dust mites, and pet dander are year round producers of allergy symptoms (especially dust mites and indoor pets). Then, there are the allergy sufferers that don’t have a single season that affects them, but are miserable from the time that they see the first spring foliage until the last leaf hits the ground in the fall. These types of allergy patients will typically have a period of the year when they are better, but they are never completely symptom free. With the past two winters being especially mild, many allergy sufferers have not truly gotten a break.
What types of symptoms does the typical allergy suffer have. Itchy eyes, watery eyes, and dark circles under the eyes are some of the ocular symptoms. Chronic cough, sore throat, and difficulty breathing are some of the respiratory symptoms. Runny or congested nasal passages, chronic sinus infections, post-nasal drip, and sneezing are some of the nasal symptoms. On the skin, we can have hives, itchy skin, and rashes. Many allergy sufferers will also list headaches or sinus pressure as one of their symptoms. For many of these multi-season allergy sufferers, medications alone are not going to get them the allergy relief that they desire.
Determining if a patient’s symptoms are allergy related or a simple sinus infection requires careful history taking, physical examination, and some detective work. Many allergy sufferers have all of the pieces of the puzzle, but have never put them all together. Physical examination of the allergy sufferer usually shows pale and swollen nasal passage tissue while the patient with a sinus infection will have very red and swollen nasal passage tissue. These are just two of the many differentiating symptoms between allergic rhinitis and a sinus infection.
While similar in symptoms, allergic rhinitis and a true sinus infection are treated differently. In most cases, a sinus infection has started out as a viral infection and will usually clear up on its own. However, if the symptoms have persisted over a period greater than a week, then antibiotics are usually needed as the infection has probably become bacterial in nature. If the patient is suffering from allergic rhinitis a combination of nasal steroid sprays, antihistamines, and in some cases, leukotriene modifiers will usually provide partial to complete relief from their allergy symptoms. For the allergy sufferer who does not get relief from medications or is not satisfied with their relief, immunotherapy, or allergy shots/drops, is the next option.
Doing things around your home can greatly reduce your allergy symptoms. Things like minimizing the amount of dust in the house will greatly reduce allergy symptoms such as sneezing. Vacuuming with a vacuum cleaner that has a HEPA filter will trap many indoor allergens and keep then from circulating in the air. Air filters for your heating and air system designed for the allergy suffer are also a quick and easy way to reduce indoor allergens and can be purchased at most home improvement stores. Other options to consider are air purifiers, dust mite covers, special detergents designed for allergy sufferers, and keeping pets out of the bedroom. When shopping for an air purifier, look for one that has a true HEPA filter and stay away from electro-static or ionic filters as this type can generate unhealthy amounts of ozone.
When trying to determine if your symptoms are allergy related or a common sinus infection there are several things you need to consider. Do your symptoms usually occur at the same time of the year? Is the season changing? Is there a family history of allergies or asthma? If the answers to the above questions are yes, then, most likely, you have seasonal allergies. If you symptoms are progressively getting worse, you are developing a fever or chills, you have facial pain or upper teeth pain, it is very possible that you have a sinus infection. In either situation, you should visit your health care provider so that a positive diagnosis can be made and the proper medications can be prescribed. With either diagnosis, proper treatment can quickly get you feeling better and enjoying the outdoors again.
Fred R. New, Jr, APRN, BC
Director of Allergy Services
Lake Norman Ears, Nose, and Throat, PHC