People who suffer from allergies know just how annoying they can be. But the symptoms can go far beyond a sniffle – and be mild to life-threatening depending on the severity.
Fortunately, allergy sufferers who become more educated about their allergies and use preventive measures can impact their outcome significantly.
This guide takes a comprehensive look at how to survive the spring allergy season. We’ve obtained input from three Medical Doctors for this topic, including a Chief of Staff, a Board Certified Allergist, and a specialist in the field of allergy and immunology.
We explore several sub-topics, including signs and symptoms of allergies, how long spring allergy season lasts, ways that allergies can have a negative impact on your life, natural and traditional treatments for allergies, and things you can do to help diminish the potential impact of allergies.
It’s important to keep in mind that this article is not intended as medical advice. Before you proceed with any treatment for allergies, talk to your primary physician, first.
Symptoms and Signs of Spring Allergies
Typical symptoms include runny nose, nasal stuffiness, post-nasal drip, watery eyes, sneezing, coughing, itchy eyes and nose, and dark circles under the eyes, said Dr. Johnny A. Negusse, Chief of Staff and Emergency Room Physician at Dignity Health Community Hospital of San Bernardino in Southern California.
During pharmacy school, Dr. Negusse studied and mastered the area of allergies in order to understand how the medications reverse the disease state at the molecular level. He further refined his training in this field during medical school and has been caring for patients with allergies in the emergency department.
“Some patients can have systemic symptoms including malaise, generalized weakness, irritability, fatigue, and decreased appetite,” Dr. Negusse said. “Some of the signs that the doctor may notice include edematous, inflamed nasal mucosa that are boggy and violaceous, nasal polyps, conjunctival erythema (red eyes) and allergic shiners (dark, puffy lower eyelids).”
Allergies can also cause an “allergic crease” across the bridge of the nose, ear fullness, facial pressure, and sore throat, said Dr. Marc Tamaroff, a Board Certified Allergist who’s in private practice at the Allergy and Asthma Care Center in Southern California, and who works as an associate clinical professor of medicine at the David Geffen School of Medicine at UCLA.
“Individuals with these symptoms can also have nasal polyps, sinusitis, ear infections, asthma, and rashes,” Dr. Tamaroff said.
How Spring Allergies Can Have a Negative Impact on Your Life
Allergies can affect every aspect of the patient’s life, Dr. Negusse said.
First, the patient often is up all night dealing with symptoms, which results in poor sleep and fatigue the next day, he said. In turn, the patient’s performance at work or school is significantly impacted.
“Individuals with prolonged symptoms and severe symptoms are especially affected and they can lose their jobs and be held back in school,” Dr. Negusse said. “Partners of the patients are often affected as well due to snoring that is caused by the allergies.”
Patients often struggle in making the decision to go outside or not, as a severe allergy attack can occur, which impacts daily outdoor activity, leaving many patients unable to enjoy what the outdoors has to offer, he noted.
“Many patients are unable to play in the park, jog in the neighborhood, go for a walk outside and participate in recreational activities,” Dr. Negusse said.
Some patients are also embarrassed by daily appearance as they have red eyes, constant tearing, a runny nose, and bags under the eyes.
“These symptoms also give the impression that the patient has a contagious cold or disease and affects the patient’s social environment,” he said.
Additionally, some of the medications cause sedation and can prevent the patient from driving or from performing activities that require concentration.
“Some symptoms become severe enough to require hospitalization and can threaten the patient’s life altogether,” said Dr. Negusse.
Some types of allergies may bring more stress and anxiety, such as those with severe food allergies, especially if it is associated with anaphylaxis, a life-threatening allergic reaction, added Dr. Tamaroff.
“These effects can extend to family members of allergic sufferers,” he said. “Research has found high levels of anxiety and stress in mothers of children with food allergy.”
When Is Spring Allergy Season?
According to Dr. Negusse, this can vary from based on regions of the country.
“Spring allergy symptoms can start as early as February and usually taper by the end of May,” he said. “It typically lasts 3 to 4 months, but this varies depending on the region. Symptoms can also be year-round – the cause of the allergies is the result of indoor allergens.”
The answer depends somewhat on where you live, Dr. Tamaroff said. For instance, in areas where there is frost and snow, allergy seasons have a defined beginning and end.
“In more temperate climates like Southern California, exposure to pollen may cover most of the year,” Dr. Tamaroff said. “In the north and east United States, tree pollens are released in the air between March and May, grass pollens from mid-May through June, and ragweed pollen mid-August until early October. Indoor allergens, including dust mites and pet danders, can trigger symptoms throughout the year.”
There are several factors that determine the severity of allergy season year to year, which we discuss next.
Spring Allergy Season Severity: Determining Factors
Dr. Sonal R. Patel, a specialist in the field of allergy and immunology with Adventist Health Physicians Network in Los Angeles, noted that according to the American College of Allergy, Asthma and Immunology, 23.6 million Americans were diagnosed with hay fever during the course of last year.
The prevalence of allergies is rising, with up to 30% of adults and up to 40% of children having at least one allergy, said Dr. Patel, who is a member of the American College of Allergy, Asthma and Immunology – ACAAI.
The following factors, provided by ACAAI through Dr. Patel, may have an influence on how severe each allergy season is, ultimately determining the number of people being diagnosed for allergies.
Climate Change – Recent studies have shown pollen levels gradually increase every year. Part of the reason for this is due to the changing climate. The warmer temperatures and mild winters cause plants to begin producing and releasing pollen earlier, making the spring allergy season longer. Rain can promote plant and pollen growth, while wind accompanying rainfall can stir pollen and mold into the air, heightening symptoms. The climate is not only responsible for making the allergy season longer and symptoms more bothersome, but may also be partially to blame for the rise in allergy sufferers.
Priming Effect – A mild winter can trigger an early release of pollen from trees. Once allergy sufferers are exposed to this early pollen, their immune system is primed to react to the allergens, meaning there will be little relief even if temperatures cool down before spring is in full bloom. This “priming effect” can mean heightened symptoms and a longer sneezing season for sufferers.
Hygiene Hypothesis – This theory suggests that exposure to bacterial by-products from farm animals, and even dogs, in the first few months of life reduces or delays the onset of allergies and asthma. This may, in part, explain the increasing incidence of allergies worldwide in developed countries.
Allergy: The New Kleenex – Ever hear someone ask for a Kleenex instead of a tissue? Much like some relate all tissues to Kleenex, many also blame runny noses, sneezing and itchy eyes on allergies, even if they haven’t been accurately diagnosed. Increased awareness and public education can make it seem like nearly everyone has an allergy or is getting diagnosed with allergies, but it could be more public perception more than you think.
Additionally, Dr. Patel offered the following resources, including tracking allergy symptoms with the free online tool, MyNasalAllergyJournal.org. You can also Find an Allergist, or watch the video, Spring Sneezing Season. You can also download a Pollen App, and find more resources at Dr. Patel’s Facebook page, Allergy Busters.
Natural Treatments for Spring Allergies
Dr. Negusse offered the following six most common natural treatments for allergies:
Spray saline into each nostril twice daily. This washes away pollen and results in less congestion and need for medications.
Take a fish oil supplement. Decreases leukotrienes that contribute to the allergic reaction. This is especially helpful for allergic asthma.
Eat an anti-inflammatory alkaline diet. This helps by boosting the immune system and improving its ability to repair itself. Foods that typically help are green leafy vegetables, garlic, probiotic-rich foods (yogurt, raw cheese, miso, natto), almond butter/seeds, gluten-free grains, and lemons.
Take turmeric. Cooking with this spice may help as it has some decongestant effects that can help with reducing allergy symptoms.
Eat local raw honey. This can help by building a tolerance to local pollen. Raw honey contains bee pollen and is thought to boost the immune system and help will allergies by building tolerance.
Consume Quercetin, found in broccoli, cauliflower, onions, green tea, and citrus fruits. Can decrease allergy symptoms by stabilizing the release of histamines.
In further advice, Dr. Tamaroff said that nasal saline rinses are a very effective way to relieve congestion and flush out mucus. Other treatments that may help include extracts of the shrub butterbur and spirulina, a type of algae, by blocking the release of histamine.
“However, the benefits and safety of these extracts aren't clear,” Dr. Tamaroff said. “Some butterbur products contain an ingredient that can damage the liver and lungs. It may cross-react with ragweed, marigold or daisies and cause allergic reactions in sensitive individuals.”
Green tea is also a natural antihistamine, he noted, and adding cayenne pepper or hot ginger to meals may help with decongestion.
“Avoidance of certain foods may also reduce symptoms,” Dr. Tamaroff said. “People allergic to ragweed or other weed pollens should avoid eating melon, banana, cucumber, sunflower seeds, and chamomile, because these foods may make symptoms worse.”
He agreed with Dr. Negusse that Quercetin blocks the production and release of histamine.
“Please note that Quercetin may interfere with certain medications, including antibiotics, cyclosporine and other medicines metabolized by the liver,” Dr. Tamaroff said, adding that some people claim acupuncture can help with seasonal allergy symptoms. “There is some evidence that acupuncture works, and there is little evidence of harm.”
Traditional Treatments for Spring Allergies
Dr. Negusse offered the following five most common traditional treatments for allergies:
Antihistamines. These are available as over-the-counter and prescription. They work due to their anticholinergic effects. These include the over-the-counter diphenhydramine, chlorpheniramine, brompheniramine (sedating); and loratadine (non-sedating). Prescription non-sedating include fexofenadine, desloratadine, cetirizine. All of these are less effective than most of the nasal steroids and tend to have more side effects.
Topical nasal steroids. More effective than oral agents with fewer side effects, and usually takes two sprays once or twice daily. Can be used as prophylaxis. These include Beclomethasone, Fluticasone, Mometasone, budesonide, and Triamcinolone.
Oral decongestants. Pseudoephedrine is the main agent and decreases symptoms through its decongestant effect.
Ipratropium Bromide, an anticholinergic that helps with a runny nose only.
Immunotherapy. The administration of allergen vaccine can decrease sensitivity over long periods of time.
According to Dr. Tamaroff, the three main traditional treatment choices are allergen avoidance measures, medications, and allergen immunotherapy/allergy vaccination.
These allergen avoidance measures include washing bedding, removing all stuffed animals from the bedroom, and maintaining the relative humidity in the bedroom to between 35% and 50%. Frequent vacuuming and replacing carpeting with hard surface flooring can also help.
“As for medicines, there have never been more over-the-counter options than now,” said Dr. Tamaroff.
Oral antihistamines, like Claritin, Zyrtec, Allegra or Xyzal, work by binding to the histamine receptor, thus blocking the attachment of histamine to certain cells in the body.
“This prevents the activation of those cells leading to inflammation. Antihistamine medications are also available in nasal spray form or as eye drops,” Dr. Tamaroff explained.
Topical and oral decongestants reduce nasal swelling and runny nose by constricting blood vessels, he said, and intranasal corticosteroids are an extremely effective form of treatment for allergic rhinitis.
“These medicines reduce chemical release from allergic cells and prevent the influx of allergic cells into nasal tissue,” said Dr. Tamaroff, noting that this reduces inflammation in the lining of the nose.
Leukotriene receptor antagonists, including montelukast and zafirlukast, reduce nasal allergy symptoms by blocking the action of leukotrienes, which are fatty signaling molecules that the body produces when there is inflammation.
“After consultation with a trained allergy specialist, allergen immunotherapy/allergy vaccination is a longer-term solution where tiny amounts of the allergen are injected over time, provoking an antibody response,” Dr. Tamaroff said. “It has been documented to reduce cell mediator release, an influx of allergic cells, and circulating levels of the allergic antibody, Immunoglobulin E.”
Prevention Tips for Spring Allergy Season
Dr. Negusse offered the following 12 tips that can help prevent allergies:
Wearing sunglasses and brimmed hats will keep pollen away from the eyes.
Reserve outdoor activity for nighttime as there is less tree pollen and ragweed pollen during the evening.
Use a HEPA (high-efficiency particulate air) filter on vacuum cleaners, air conditioner or heating systems in the home. Doing so results in less pollen in the air. Vacuuming causes pollen that has settled on the floor to become airborne and this can results in more symptoms.
Changing your car’s air filter can decrease the amount of pollen that patients are exposed to.
During the spring season, keep your windows and doors closed to help keep pollen out.
Purchase an air purifier for the home.
Change your clothing when you get home and wash your hair if you’ve been outdoors. Allergens can collect there.
Vacuum at least twice a week; wear a mask when doing so.
Keep track of pollen count and stay indoors when the numbers are high.
Clean the home regularly, including vents and bookshelves.
Use Vaseline around nostrils to trap pollen.
Wear a mask when gardening.
Dr. Tamaroff said there are preventative things that one can do, “mostly common sense sorts of things.”
“For example, on high pollen count days, or days that are particularly dusty or windy, limit outdoor exposure,” Dr. Tamaroff said. “Wear a filtered mask if you cannot limit time outdoors.”
He also recommends showering before bed so that you don't carry pollen and dust left on your skin and in your hair into bed with you, and wash clothes and bedding to limit incidental exposure to allergens.
“Pets that spend time outdoors come into the home covered in pollen,” Dr. Tamaroff said. “Wipe them down with a damp washcloth to limit exposure to pollen and to dust.”
Carpet attracts and keeps dust and pollen that is difficult to remove with a vacuum.
“Replace carpeted areas with hard surface flooring,” Dr. Tamaroff advised. Additionally, “remove clutter, especially from the bedroom, to decrease house dust and allergens. Keep doors and windows closed to limit exposure, especially during high pollen counts or on dusty days.”
In further advice, Dr. Tamaroff said it’s important to remain well hydrated to keep mucus loose.
“Check the weather,” he said. “In general, pollen counts are highest on warm and breezy morning and low on cool and rainy days.”
On days with high pollution levels, stay indoors.
“If you can, exercise after mid-day when pollen counts tend to be lower,” Dr. Tamaroff said.
“Sometimes, opt for less intensive activities. The more stressful the exercise, the faster you breathe, the more allergens and irritants you inhale. If exercising outdoors on a cold day, cover your mouth and nose with a scarf to help warm the air before it gets into your lungs. On bad days, exercise indoors.”
Final Thoughts: Is There Hope for Spring Allergy Sufferers?
“Absolutely,” Dr. Negusse emphasized. “Patients that have allergies can have a significant impact on their outcome. Those who are aggressive with preventive measures, use both natural and when needed traditional treatment, actually do very well.”
Dr. Tamaroff believes the future is bright for sufferers of nasal allergy.
“In the years since I started in practice, I have seen an exponential leap in our knowledge of the workings of the immune system,” Dr. Tamaroff said.
This has led to incredible discoveries about disease processes and how to combat them in very novel ways.
“For example, a change from the traditional immunotherapy given by injection is sublingual allergy therapy,” Dr. Tamaroff said.
It is now available in the United States and its use is likely to become more widespread as experience with it grows and more allergens can be treated this way.
“It uses the same concept as the allergy shots but in a different delivery system,” Dr. Tamaroff explained.
Also, since the introduction of omalizumab (Xolair) 15 years ago, use of immunomodulatory treatment has shown particular promise.
“These include the use of targeted therapies towards specific segments of the immune system, like adhesion molecules or cytokines, that may refocus the immune system away from an allergic-type response,” Dr. Tamaroff said. “In the meantime, there is much that the doctor can do for the allergy sufferer right now. A consultation with an allergy specialist can be a good step in the right direction.”
Allergies are the leading cause of chronic illness in the United States and impact nearly 50 million Americans, Dr. Negusse added.
“The symptoms can be mild to life-threatening,” he said. “It can have a significant impact on the quality of life. Patients that actively visit with their doctor, become more educated about their allergies, use preventive measures tend to do well and can impact their outcome significantly.”
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