A Practical Guide to Managing Seasonal Allergies

Spring has arrived— the season of warmer weather, beautiful flowers, and for many, allergies.

What Are Seasonal Allergies?

Allergies occur when the immune system overreacts to certain things in the environment; this overreaction leads to allergic symptoms such as a runny nose or itchy eyes.¹

Seasonal allergies, otherwise known as allergic rhinitis or hay fever, may occur due to different allergens. An allergen is a substance that causes allergic reactions.

Common seasonal allergens include tree pollen, grass pollen, ragweed, and mold.² Depending on the season, environmental allergens may change or become more prevalent.³

What Are Common Seasonal Allergy Symptoms?

Nasal symptoms

• Nasal congestion
• Sneezing
• Runny nose

Eye symptoms

• Itchy & watery eyes
• Eye redness
• Swollen and darkening of areas around the eyes

Throat symptoms

• Itchy throat
• Post nasal drip
• Coughing

Other symptoms

• Fatigue
• Itching of the inner ear
• Itching of the palate
• Headaches

Related Conditions:

These are conditions that frequently occur hand in hand with allergies:

• Asthma
• Atopic dermatitis/Eczema
• Ear infections

How are Seasonal Allergies Diagnosed?

No testing is required to make the diagnosis. Primary care providers (PCPs) diagnose and treat a majority of patients with seasonal allergies or allergic rhinitis.

However, for patients who need more specific identification of their allergen, an allergist can perform a prick skin test to identify the specific allergen. This is for patients whose allergy is not obvious by their history alone, have more severe or uncontrolled symptoms, or have asthma.

How to Manage Seasonal Allergies: Everyday Tips

Allergies have significant impacts on children and adults – with studies showing 10-30% prevalence in the US and other high resource countries.⁴ Symptoms such as a runny nose or itchy eyes can make it hard to focus during school or work. Congestion can make it difficult to fall asleep, causing fatigue. If you experience many symptoms, it can not only affect your physical health but your mental health as well.

Here are some practical steps you can take to help you manage pollen allergies in the spring:

Monitor pollen counts & stay indoors on high count days

A great way to manage allergies is to manage your exposure to allergens. If you are allergic to pollen, consult a weather service for your area for pollen counts. On high pollen days, stay indoors to limit exposure or wear a protective mask when outdoors.

Shower/change clothes after outdoor exposure

If you must go outside on high pollen days, shower or change your clothes once you are home. Pollen can attach to your clothes or your skin and continue to cause symptoms, even when you are not exposed directly to the allergen.

Keep your home allergen free

Regular dusting and vacuuming your floors are great ways to remove allergens from your home. You might also consider investing in an air cleaner that uses High-Efficiency Particulate Air (HEPA) filters to filter the air in your home.⁵ If installing a filter is not possible, keeping your windows closed can limit the amount of allergens that get into your home through the air. Wash bed linens weekly to keep your bed sheets clean and pollen-free.⁶

Treatment Options for Seasonal Allergies

Medications

There are various medications you can use to manage symptoms. Many are over the counter, and there are also some prescription medications you can use. Over the counter (or OTC) medications do not require a health care provider’s prescription to buy and can be purchased at your local pharmacy or supermarket.

Medications include antihistamines, nasal sprays, oral decongestants and for more severe cases, steroids. Speak to your provider if you have any concerns regarding taking medications for your allergies.

Nasal sprays

Steroid nasal sprays are the first line treatment recommendation for relieving nasal symptoms. Some examples include triamcinolone (Nasacort Allergy), fluticasone propionate (Flonase Allergy Relief) and budesonide (Rhinocort Allergy).⁷ Be sure to administer it correctly – ask your PCP to review the proper administration. These medicines take some time to work, so if it doesn’t initially provide relief, allow a two-week trial before discontinuing use. If you can, start using steroid nasal sprays at least a week or two before the expected allergen exposure.

Antihistamine nasal sprays are also helpful for some patients who do not tolerate the steroid nasal sprays or want another option. Azelastine (Astelin, Astepro) and olopatadine (Patanase) are two commonly available OTC nasal sprays.⁸

Cromolyn Nasal Spray is another option for nasal sprays. However, it must be taken 30 minutes before an exposure, so it is only effective as a prophylactic medication. That means you can use cromolyn nasal spray as a preventative medication and not after symptoms already develop.

Oral Decongestants

Another medicine that helps with nasal congestion is oral decongestants. An example of this is pseudoephedrine (Sudafed).⁷

Antihistamine eye drops

For patients with both allergic rhinitis and allergic conjunctivitis, or red eyes from allergies, antihistamine eye drops can help. Examples include olopatadine (Pataday) and ketotifen (Alaway).⁹ These medications help with itching and drying effects of allergies.

Antihistamines

Antihistamine medications also can relieve a variety of symptoms such as sneezing, itching, runny nose, and watery eyes. Some examples of this include loratadine (Claritin), cetirizine (Zyrtec), and fexofenadine (Allegra).⁷

Systemic steroids

For patients with severe allergic rhinitis, short courses of steroids can help reduce symptoms. These must be prescribed by your primary care provider.  

Non-medication options

There are also non-medication options to help manage your allergy symptoms.

Saline Solution

One method is using a saline solution. Using a saline solution can help relieve nasal congestion by using salt water (saline) to flush out the mucus in your nasal cavities. Saline solutions can be bought as ready-made kits or you can create one at home.⁷

If you would like to use a saline solution, here are the steps you can follow:

1. Using the irrigation device (rubber ear bulb syringe or saline rinse bottle), draw up 8 ounces of the saline solution.
2. Tilt your head downward over a sink or shower and rotate to the left. Gently squeeze half of the solution into your right nostril. Then, breathe through your mouth. After a few seconds, the solution should come out through the left nostril.
3. Repeat on the other side (left nostril).
4. Blow your nose gently to prevent the solution from going into your ear.
5. It is recommended to do a saline rinse once a day if you have nasal congestion.¹⁰

Allergy shots (immunotherapy)

Allergen immunotherapy shots, or allergy shots, are recommended for people who have severe allergy symptoms which are not remedied by medicine, or by changes in their environment. Allergy shots work by decreasing the severity of your allergic symptoms. Allergy shots do not cure allergies.¹¹

If you are interested in having allergy shots, speak to your provider. If needed, your provider can refer you to a specialist to administer the shots. Allergy shots are administered by an immunologist or allergist, who specializes in treating allergies. Allergy shot treatment lasts from 3 to 5 years; benefits include the complete remission or significant reduction of allergy symptoms.¹²

Biologics

Another option is biologics like omalizumab, which require consultation with an allergist. This can be very helpful for patients with severe allergic rhinitis and asthma.

When to See a Health care Provider

When should you consider a visit to your provider? Here are some signs to look out for:

• You also have asthma or eczema.
• Your home treatments are no longer helpful
• You have questions about optimal treatment plan for your allergies

At the Charles B. Wang Community Health Center, we provide care for the whole family. Our compassionate and highly skilled pediatric doctors, internal medicine, and family medicine providers are here to help you find solutions for your allergy symptoms. Book an appointment online today at Schedule Online | Charles B. Wang Community Health Center  

FAQs

1. What month is allergy season the worst?

It depends on what you are allergic to. Generally in the United States, spring and fall tend to be peak seasons for allergies.¹³ For pollen allergies, pollen usually peaks in May.³ In June, grass pollen peaks. Ragweed pollen usually peaks in September. These timings can vary depending on your location.

2. Can seasonal allergies be cured?

Unfortunately, there is no cure for allergies, however, symptoms can be managed and reduced. Reach out to your health care provider for treatment options that work best with your body and your lifestyle.

3. How do you use a nasal spray?

Here are the steps to using a nasal spray correctly:

1. Blow your nose before you use the spray to clear any mucus in the nose.
2. Check to see if you need to shake the nasal spray before use. You can find this in the nasal spray instructions.
3. Sit upright with your head tilted forward slightly. Hold the nasal spray in the opposite hand of the nostril you will be spraying into. Position the nozzle inside the nostril, pointing outwards, not towards the center of the nose.
4. Breathe in through your nose when taking the nasal spray. Be careful to not sniff hard. Breathe out through your mouth.¹⁴