Philip A. Gilly, MD, FAAFP
Family
Practice Board Certified
You have an allergy when your body overreacts to something that that you come into contact with. These things are called allergens. The term hay fever originally referred to symptoms experienced by the people living downwind from a farmer harvesting his hayfield. It is now a more general term used to describe an allergic reaction to allergens in the air. Your body’s overreaction to the allergen(s) is what causes symptoms (see below).
Things that may make allergies feel worse
Common allergens in the air are pollen, mold, dust and animal dander. Many other things that bother a person’s respiratory tract, such as those listed above, can make your allergy symptoms worse.
Pollen comes from trees, grass and weeds. Allergies that occur in the spring (late April and May) are often due to tree pollen. Allergies that occur in the summer (late May to mid-July) are often due to grass and weed pollen. Allergies that occur in the fall (late August to the first frost) are often due to weed pollen.
Pollen from flowering plants usually doesn’t cause problems in people with allergies because the pollen is too heavy to float in the air. These plants rely on insects to carry their pollen.
Mold is common where water tends to collect, such as shower curtains, window moldings and damp basements. It can also be found in rotting logs, hay, mulches, commercial peat moss, compost piles and leaf litter. This allergy is usually worse during humid and rainy weather.
Pet dander is made up of bits of skin and hair from animals. Both are allergens. You can be exposed to dander when handling and animal or from house dust that contains dander.
Dust contains many allergens, including dust mites. Dust mites are tiny living creatures found in bedding, mattresses, carpeting and upholstered furniture. They like places where it’s warm and humid. They live off of dead skin cells and other things found in house dust.
Pollens. Shower or bathe before bedtime to wash off the pollen and other allergens that may have collected in your hair and on your skin. Avoid going outside, especially on dry, windy days. Keeping the windows and doors shut can be useful, as can using an air conditioner both at home and in your car.
Mold. You can reduce the amount of mold in your home by removing houseplants, and by frequently cleaning shower curtains, bathroom windows, damp walls, areas with dry rot and indoor trash cans. Use a mix of water and chlorine bleach to kill mold. Don’t carpet bathrooms or other damp rooms and use mold-proof paint instead of wallpaper. Throw away old books, shoes and bedding, which can be a source for mold. Reducing the humidity in your home to 50% or less can also help.
Pet dander. You may need to give your pets away or at least keep them outside because they bring pollen as well as animal dander in with them. Cat or dog dander is often in house dust and takes four weeks or more to settle down, so a short-term trial of removing your pet may not help you find out if this is a problem.
Dust. You can reduce dust mites by removing the places in which they like to live and breed, such as carpets, drapes and feather pillows, and by making your home less inviting by lowering the humidity and frequently dusting with a damp cloth. See below for specific tips. Pay special attention to keeping your bedroom clean. This is where you spend much of your time at home. Wear a mask when you clean. Even better, have someone else in your family clean for you or hire someone.
Antihistamines help reduce the sneezing, runny nose and itchiness of allergies. They’re more useful if you use them before you’re exposed to allergens. The drowsiness and dryness in your mouth you may notice from taking antihistamines may go away after a few days of taking them.
You can buy some antihistamines without a prescription. Ingredients include brompheniramine, chlorpheniramine and triprolidine. These work in relieving symptoms just as well as prescription medicines do, but they tend to have more side effects than prescription medicines. The tiredness they may cause often improves after one or two weeks of regular use.
The newer antihistamines, fexofenadine (Allegra), cetirizine (Zyrtec), loratadine (Claritin) and astemizole (Hismanal), are less likely to cause tiredness or dry mouth, but they cost more, require a prescription, and may cause drug interactions.
Decongestants help relieve the stopped-up feeling of allergies. They come as pills, nose sprays and nose drops. It’s best not to use the nose sprays and drops for more than three days because your nose can become dependent on them very easily. This causes you to feel even more stopped up when you try to stop using them than you did before you started. Salt water nose sprays without medications may help relieve stuffiness by their rinsing and lubricating action.
You can buy decongestants without a prescription. Ingredients include phenylephrine, phenylpropanolamine and pseudoephedrine. Decongestants can raise your blood pressure or keep you awake, so it’s a good idea to talk to your family doctor before using them.
Many medicines that are available over-the-counter combine both antihistamines and decongestants, so be sure to look at the list of ingredients.
Inhaled steroids help reduce the swelling and inflammation that develops in your nose in response to allergens. They come as nasal sprays that your doctor may prescribe. You may not notice their benefits for up to two weeks after starting them. Some names of inhaled steroids include beclomethasone (Beconase, Vancenase), flunisolide (Nasalide, Nasarel), triamcinolone (Nasacort), budesonide (Rhinocort), fluticasone (Flonase), and mometasone (Nasonex).
Inhaled steroids aren’t as likely to have side effects as steroid pills, but you shouldn’t use the sprays or drops more than you doctor suggests. Your doctor may prescribe steroid pills for you to use for a short time if your symptoms are severe or if other medicines aren’t working for you.
Cromolyn sodium (Nasalcrom) is a nasal spray that helps reduce the symptoms of allergies. It may not start to work for two to four weeks after you begin using it. Your doctor may prescribe cromolyn sodium for you if your allergies are severe or if other medicines aren’t working.
Allergy shots (also called immunotherapy) contain small amounts of allergens. They are given on a regular schedule in gradually increasing doses, so that your body gets used to the allergens and no longer overreacts to them. That’s why this treatment is also known as desensitization. Allergy shots are only used when the allergens you’re sensitive to can be identified and when you can’t avoid coming into contact with them. It takes months to years to complete a course of treatment. Some people need to have treatments throughout the rest of their life.
Things you can do to control your symptoms
Remember that all of these treatments are simply aimed at reducing the uncomfortable symptoms which are a result of your body’s natural defense mechanisms. So if you are still being exposed to allergens the symptoms will return as soon as the medical treatment wears off. The best long-term solution to allergies is still avoidance and elimination of the source.
Family physicians are medical specialists who take care of you and your family. They are trained to treat 9 out of 10 medical problems and can help you get the health care services you and your family need.
This information provides a general overview on this subject and may not apply to everyone. Talk to your family doctor to find out if this information applies to you and to learn how to get more information. More health-related information is available on this and many other topics on the World Wide Web from Dr. Gilly’s Health Resource Directory and from the American Academy of Family Physicians.