We have, so far, had much more sunny and hot weather than the last few years, but pollens and molds have spoiled the experience for many allergy sufferers. Those with nasal allergy and asthma have often appropriately taken refuge indoors, in air-conditioned environments. In many places it has been so hot, not many have desired to spend a lot of time outdoors. Yet even on the days when the temperature comes down a little, to more comfortable levels, the allergens are waiting for those millions of vulnerable people who dare to sample a little outdoor fun. Autumn will surely bring cooler weather but will you be ready for the ragweed and mold surges that may accompany it?
I posted an article about survival tips for the fall two years ago. Preparing for ragweed season is made easier by understanding when it starts. For Midwest and Northeastern states ragweed begins to pollinate in the middle of August. That’s right, it has already started. Mold counts have soared in many regions of the U.S. but ragweed counts have been fluctuating.
If you have already experienced worsening of nasal and eye allergy symptoms now is the time to take action. Here are seven steps you can take:
Ask your doctor to recommend a long acting, non-drowsy antihistamine. Antihistamines target symptoms of runny nose, itching of the nose, eyes or mouth, and sneezing. Some examples are: Claritin, Zyrtec and Allegra. All of these medications have generic forms and the first two are available without prescription. You may already be on antihistamines but feel they have stopped working. In most cases the antihistamine is working at the same level it started,** but** the severity level has increased, requiring more to be done. So changing the antihistamine may not be as helpful as adding on another medication that may work in concert with it.
If you are not on a nasal steroid spray (NSS) it may be time to get one from your physician. NSS has become cornerstone to treating seasonal and perennial allergic rhinitis. Some NSSs are FDA approved down to 2 years of age. The most common combination of prescribed medication for treating allergic rhinitis includes antihistamine and nasal steroid spray.
Sometimes the prevailing complaint is nasal congestion. I covered this topic in greater detail in a recent posting. Decongestants have their drawbacks (possible insomnia, blood pressure elevation, palpitations) but when well tolerated, they can greatly relieve intranasal swelling which may be the reason for sinus pressure and headache.
Some newer nasal sprays have become available that may not only work like oral antihistamines but also moderately decongest the nasal passages. These nasal sprays are topically effective, non-steroidal and non-habit forming (in contrast to over the counter nasal decongestants). These include Astelin, Astepro and Patanase. Some of my patients are on NSS in addition to one of these agents. Many of the NSSs have minimal taste but the antihistamine nasal sprays have a distinct bitter taste, especially Astelin and Astepro.
Not enough can be said about nasal saline rinses. Whether you use the Neti pot, NeliMed rinse kit or another nasal rinsing kit, irrigating the nose may reduce many allergy symptoms. Some of my patients have found that their need for medications plummeted after doing daily nasal rinses for their seasonal allergies.
Allergy eye drops may be helpful where antihistamine pills and nasal sprays fall short. Ocular allergy may be the top concern in some people with seasonal allergy problems. Some prescription brands include Patanol, Pataday, Optivar and Bepreve.
Remember, seasonal allergy is rarely less than six to eight weeks in length. I think the most common reasons medicines don’t seem work are:
- Getting a late start (beginning medication after the season has begun)
- Missing doses of medications which should be taken regularly throughout the season
- Not giving enough time for medications to work (NSS may take two to three weeks to reach maximum effect)
- Improper use of nasal sprays (I’ve previously reviewed proper nasal spray technique).
- Not addressing indoor environmental controls throughout the year
If you have already considered many of the above steps but are still suffering you should think about getting allergy tested. Allergy shots may be the answer for future seasons. There is no cure for allergy problems but there is a lot that can be done to control them.
Board Certified Allergist and Asthma Specialist