Seasonal Allergies Are Back—What You Can Do About It
Seasonal Allergies Are Back—What You Can Do About It
by KATHY KATELLA
This post is an abridged version of the article published by Yalemedicine.org, March 23, 2023. To view the full article, follow the link below.
More than one-quarter of adults and almost 20% of children in the U.S. have seasonal allergies, according to the CDC.
Dr. Leeds and Florence Ida Hsu, MD, an adult allergist, answered our questions about how people get sick from allergies and what they can do about it.
Seasonal allergies: What you need to know
Pollen is an airborne substance that comes from grass, flowering plants, trees, and weeds. Every year, millions of people are diagnosed with hay fever, the name given to allergic rhinitis caused by pollen. When someone has hay fever, their immune system identifies pollen as a threat and releases signals that lead to congestion, itchy eyes, runny nose, and sneezing, as well as problems like sinus pressure and allergic conjunctivitis (itchy, watery, and red eyes).
The amount of pollen in the air depends on the season and the geographic area in which you live. The study reported in PNAS found the most pronounced effects in Texas and the Midwestern United States. However, the Northeast can have a significant spring allergy season as well, Dr. Leeds says. Tree allergies are especially common in New England—particularly due to birch and oak. Pollen allergies can also cause a cross-reaction with certain foods in some people; symptoms include an itchy or tingling mouth and throat after eating raw fruits and vegetables, seeds, and nuts.
People may also have allergic reactions to grass pollen in the late spring to early summer and weed pollen in the fall. “Many people are multi-sensitized, so they are allergic to more than one type of pollen, and they can be symptomatic through all of the warm weather seasons,” Dr. Leeds says. “Pollen can be carried by the wind, so windy days are the worst.”
Seasonal allergy symptoms are not life-threatening, but people do miss work over them, says Dr. Hsu. “There is a theory called ‘the unified airway’ in which the nose is connected to the lungs, so if you have a lot of inflammation in the nasal passages and the sinuses, that can then lead to ‘lower respiratory’ symptoms such as cough, shortness of breath, and wheezing as well,” she says. “You’ll find people with allergies getting recurrent sinus infections, and both can lead to respiratory symptoms, asthma, and bronchitis.”
What allergy treatments are available?
Treatments can help a great deal, says Dr. Hsu. “Allergy treatment has changed over the past 10 years, with a number of first-line medications now available over the counter,” she says. “So, while we have lots of consultations with patients, we don’t necessarily send a prescription to the pharmacy. We often advise people on what to buy—but we want to be very specific, because there are certainly a lot of over-the-counter medications that we would not recommend as first-line treatments.”
For instance, she might start with antihistamines for itching and runny nose, steroid nasal sprays for nasal passage congestion, and antihistamine eye drops for ocular symptoms. If a patient is still uncomfortable, she might recommend a decongestant, but not for daily use, since it’s a medication patients can become overly reliant on. Likewise, some patients should avoid antihistamines that are excessively sedating, she says.
“The problem is that some people… think they’ll just grin and bear it. But… you can take steps to minimize those weeks of misery.”
— Yale Medicine pediatric allergist Stephanie Leeds, MD
It’s helpful when patients have a skin or blood test to find out exactly what they are allergic to. “If you are really symptomatic, it’s helpful to get tested at least once. I don’t think you need to be re-tested year after year, but at some point, establishing the specific triggers can be helpful, because then you can take steps to avoid exposure,” Dr. Leeds says.
How can I manage my allergies without medication?
While some people may have allergies that will need medical treatment, the CDC and Yale Medicine doctors offer the following non-medication strategies to help both adults and children:
- Stay in the house if you can, particularly on windy days. Keep the windows closed (in the car, too). Run the air conditioner, which should have a clean filter on it.
- Wear a face mask when you go outside to prevent you from inhaling larger particles of pollen (note that smaller particles can still get through). Wash the mask after each use because it may have pollen on it.
- Wear a hat and sunglasses to avoid getting pollen in your hair and to protect your eyes.
- Avoid outdoor activities such as mowing lawns or raking leaves, as they stir up pollen.
- If you spend time outdoors, brush off any pollen once you go back inside. “If you are pollen-sensitive, it’s a good idea to take a bath, wash your hair, and change your clothes, especially if you’re going to bed,” says Dr. Hsu. “Try to minimize the amount of pollen that goes from your head to your pillow, because you will be breathing it in all night.”
- During the COVID-19 pandemic, the CDC suggested ways to create a cleaner air space at home that can also be helpful in protecting against outdoor air irritants. A portable air cleaner/purifier can help; it works best when run continuously with the doors and windows closed.
- If your home has a forced air system, consult a qualified heating, ventilation, and air conditioning (HVAC) professional about filters (HEPA or MERV-13 or higher) and settings (“Recirculate” and “On” rather than “Auto”) that can be used to reduce indoor air irritants.
Check the daily pollen count (the number of grains of pollen in a cubic meter of air based on a sample taken in a 24-hour period) before you decide to spend time outdoors. The measure is reported as low, moderate, high, or very high. You can sign up with the National Allergy Bureau for notifications with information for your area.
Both doctors also tell people who know they are prone to allergies to talk to their doctors before their worst season hits so they can be prepared. “I think the problem is that some people have a couple of weeks when they are miserable, and then the rest of the year they are fine, so they think they’ll just grin and bear it,” Dr. Leeds says. “But there is a better way. You can take steps to minimize those weeks of misery.”