Help with Hay Fever

By Dr. Phil Jones
Board Certified Allergist with The Allergy, Asthma & Sinus Center

As spring approaches most of us look forward to more time outdoors, outdoor get-togethers and warmer temperatures, but for some people this may not be the case. Spring allergies can be very severe and can lead to red, itchy and watery eyes as well as sneezing, nasal stuffiness, fatigue, headaches, and post nasal drip. The fact is that spring isn’t a favorite time of year for everyone, but it doesn’t have to be a bad time—even for allergy sufferers.
Allergies contribute to decreased concentration and focus, limited activities, irritability, trouble sleeping, fatigue, missed days of work or school, decreased productivity, and more school or work injuries. In particular, allergic rhinitis, also known as hay fever, affects millions of adults and children each year.
What is Hay Fever?
Despite the name “hay fever,” allergic rhinitis can be caused by many things other than hay, and you don’t have to have a fever to have hay fever. Allergic rhinitis takes two different forms: seasonal and perennial. Symptoms of seasonal allergic rhinitis can occur in spring, summer and early fall. They are usually caused by allergies to airborne mold spores or to pollens from grass, trees and weeds. On the other hand, people with perennial allergic rhinitis experience symptoms year-round. It is generally caused by dust mites, pet hair or dander, cockroaches and/or mold. Some people may experience both types of rhinitis, with perennial symptoms getting worse during specific pollen seasons. It is important to remember that there are also other causes of rhinitis that are not due to allergies.
Symptoms of hay fever include runny nose, itchy eyes, mouth or skin, sneezing, stuffy nose due to blockage or congestion, and fatigue. Common allergic triggers include outdoor allergens such as pollens from grass, trees and weeds. Indoor allergic triggers include things such as pet hair or dander, dust mites and mold. Irritants, such as cigarette smoke, perfume and diesel exhaust can also exacerbate symptoms in patients with hay fever.
Treatment
The management and treatment of allergies includes avoiding triggers by making changes to your home and to your outdoor activities as well as medications and immunotherapy, also known as allergy shots. Many allergens that trigger allergic rhinitis are airborne, so you can’t always avoid them. Here are a few tips that will help you manage your symptoms.
• Stay indoors as much as possible when pollen counts are at their peak, usually during the midmorning and early evening and on windy days.
• Avoid using window fans that can draw pollens and molds into the house.
• Wear a pollen mask when mowing the lawn, raking leaves or gardening, and take appropriate medication beforehand.
• Don’t hang clothing outdoors to dry; pollen may cling to towels and sheets.
• Try not to rub your eyes, as doing so will irritate them and could make your symptoms worse.
• Wash your hands after petting any animal and keep your pet frequently groomed.
• Make sure to keep your air conditioning unit clean and change your filter frequently.
• Use dust mite covers for pillows, comforters and mattresses and box springs.
• Wash your bedding frequently, using hot water.
• Keep windows closed during high pollen periods. Use air conditioning in your home and car.
• Use a dehumidifier to control mold.
• Wear glasses or sunglasses when outdoors to keep pollen out of your eyes.
Some commonly available over-the-counter medications include decongestants, antihistamines and nasal steroid sprays. Immunotherapy (allergy shots or sublingual tablets) are also very effective for controlling symptoms long term and minimizing the need for medications. They are also better for some of the systemic symptoms we see with allergies, such as fatigue.
For an allergy diagnosis you should see a board certified allergist. He or she will start by taking a detailed history, looking for clues that will help pinpoint the cause of your symptoms. Your allergist may recommend a skin test in which small amounts of suspected allergens are introduced into your skin. Skin testing is the easiest, most sensitive and generally least expensive way of identifying allergens.
If your symptoms can’t be well-controlled by simply avoiding triggers, your allergist may recommend medications that reduce nasal congestion, runny nose, sneezing and itching. They are available in many forms:  oral tablets, liquid medication, nasal sprays and eye drops. Some medications may have side effects, especially over-the-counter medications, so discuss these treatments with your allergist. Immunotherapy or allergy shots may be recommended for people who don’t respond well to treatment with medications or who experience side effects from medications, who have allergen exposure that is unavoidable or who desire a more permanent solution to their allergies. Immunotherapy can be very effective in controlling allergic symptoms.
Don’t let allergies control you. Take control and see your allergist to discuss treatment options.