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Ask a Drexel Physician - Seasonal Allergies

April 30, 2014

Woman blowing her nose

Seasonal allergies are one of the most common medical problems in America, with around 20 percent of people affected. That means that if you do not personally have allergies, chances are a close relative or friend of yours does have them. Allergens in the air trigger an immune response leading to inflammation along the mucous membranes that line your nose, eyes, throat and ears.

Is it allergies or a cold?

Telling the difference between seasonal allergies and a cold can be difficult. Longtime sufferers of allergies can usually tell the difference, but if it’s not clear, there are a few clues to help figure it out. First, since the inflammation caused by allergies is confined to the mucous lining of your eyes, ears, nose and throat, body-wide symptoms such as fever and body aches should never accompany allergies. Presence of these symptoms would be suggestive of a viral illness. Second, viruses can cause soreness of various body parts, but don’t usually cause an itch. Itchy eyes or throat are suggestive of allergies. Finally, colds usually run their course in about 14 days. Runny nose or watery eyes lasting longer than that are more likely due to allergies.

How are seasonal allergies treated?

Antihistamines (both oral and eyedrop formulations), decongestants and nasal steroid sprays can all be effective in relieving severe allergic symptoms. But not all medications are right for all people, so you should work with your doctor to figure out the most effective and safest medication for you.

What are the potential side effects of medications for seasonal allergies?

In people under 65, oral antihistamines are generally well tolerated but are notorious for causing drowsiness. However, those over 65 need to be very careful with antihistamines, as they can also cause constipation, low blood pressure, urinary retention and even confusion. If you are over 65, you should check with your doctor before using them, even if they are over-the-counter. Nasal steroids, when used correctly, are less likely to cause side effects because the medication acts topically in your sinuses and doesn’t absorb as much into your bloodstream.

How do I avoid triggers of allergic symptoms?

Awareness is the key to avoiding allergy symptoms. Be mindful of the things you know will cause symptoms (e.g., pets, pollen, grass, dust, mold). Reduce your exposure by keeping windows closed, using your air conditioner/HEPA air filter, drying your clothes indoors instead of outside on a clothesline and minimizing dust and dander buildup with frequent housecleaning.

What are the worst times of the year for different allergies?

• Winter: As the heater kicks on and dries out the air, dust allergies are in their prime.

• Early spring: Pollen starts flying, and so do pollen- and flower-related allergies.

• Late spring: As the grass starts to grow long, those with grass allergies have their toughest time of year.

• Summer: Heat combined with some summer showers is the perfect recipe for mold growth. Mold-related allergies are common this time of year.

• Fall: Ragweed blooms in the early fall and can linger for months. With a single ragweed plant capable of delivering a billion pollen grains into the fall breeze, this is one of the most common allergies and one of the most difficult to avoid.

B. Brent Simmons, MD, is an assistant professor in the Department of Family, Community and Preventive Medicine at Drexel University College of Medicine. He is board-certified in family medicine, geriatric medicine and hospital and palliative medicine. He sees patients at Drexel Family Medicine in Manayunk.