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Seasonal Allergies

Originally Posted: April 26, 2010

Dr. Richard Nass, M.D., F.A.C.S."

An allergy is a specific, exaggerated reaction to a particular substance.

Southampton - Seasonal allergies are upon us! At this time of year it seems that everyone is complaining about their "allergies." However, not everyone who complains about "my allergies" is actually allergic. What is an allergy? What are allergic symptoms and how are they different from the "common cold" or a simple "irritant response?" How can you control the symptoms of allergies? When should you see a doctor and who should you see? Can we actually cure allergies? If so, how?

An allergy is a specific, exaggerated reaction to a particular substance. Substances which cause this reaction are called allergens. Common respiratory respiratory allergens are pollens, mold spores, house dust, and animal danders. (Non-respiratory allergies include foods, insect bites/stings, and things with which we are in physical contact). An allergic reaction releases chemicals into the body which in turn cause symptoms to occur. For this reaction to occur the person must be genetically predisposed and must have had previous contact with the specific allergen. Allergies can be seasonal-think pollens or perennial-think house dust. In the northeast United States, tree pollination occurs late winter to mid-spring; grass pollination occurs mid-spring to mid-summer; weed pollination from late summer until the frost.

The treatment of allergies falls into three categories. (wordpress.com)

Classic allergy symptoms are bouts of sneezing, watery nasal discharge, "itchiness" of the eyes, nose, and mouth, and tearing. These symptoms may be accompanied by nasal obstruction, sinus pressure, ear fullness, hearing loss, cough, shortness of breath, and "throat irritation." This second symptom group is not "allergy-specific" and can be caused by the common cold and by exposure to environmental irritants such as tobacco smoke, noxious chemicals, or changes in environmental conditions.

The treatment of allergies falls into three categories: (1) Avoidance, (2) Medications, and (3) Allergic "desensitization."

Allergic avoidance is the first line of defense. The seasonal allergies we now face are best avoided by remaining indoors with the windows closed and an air-conditioner in use whenever possible. (Outdoor activities are especially problematic on dry, windy days when pollen is widely disseminated). Surgical masks, eyeglasses/goggles and nasal/sinus "douches" using a Nettie pot or pre-packaged nasal irrigation kits and non-medicated "eye washes" are of some value in decreasing allergic exposure, i.e., the so-called "allergic load."

Both over-the-counter and prescription medications are available to control the symptoms of allergy. Antihistamines work well against the "wet" symptoms of allergy, e.g., Claritin or Zyrtec are non-sedating examples. These can be coupled with a decongestant to treat the "congestive" symptoms, e.g., Claritin-D, Zyrtec-D. Be aware that even these "non-drowsy" antihistamines can be sedating in some people and decongestants can be medically inappropriate for people with certain medical conditions such as hypertension, heart disease, thyroid disease, certain types of glaucoma, men with prostate problems, and in pregnant women. Also, know that there can be interactions between certain medications - so check with your doctor prior to starting any of these if you have any chronic medical issues or take any medications regularly.

You should seek medical attention from your PCP, ENT physician, ENT- or medical-allergist if you cannot tolerate OTC medications or if the symptoms persist. This is done to diagnose and treat non-allergic disease, complications of allergy such as infections of the ears, sinuses, or bronchi, and to better control allergic symptoms. Your doctor has a wide-range of prescription medications which are available for use.

In patients with multiple seasonal allergies, perennial allergies, poor responders to prescription medicines, and for those who cannot tolerate medications or desire no medications, formal allergy testing can be performed by an ENT or medical allergist. This information allows the trained physician to treat the allergy by a modality called "desensitization." Desensitization, also called immunotherapy, is the only method of actually "curing" allergy. (The aforementioned avoidance strategies and medications circumvent or treat allergic symptoms). Traditional desensitization requires several years of periodic injections whereas a new method called sublingual immunotherapy is quite promising. It avoids injections and shortens the duration of treatment.

In conclusion, there is no need to stoically suffer from allergy. Avoid allergens whenever possible, utilize over-the-counter medications with your doctor's approval, and seek trained specialists if and when this fails to afford relief.

For an appointment with Dr. Nass, call 631-324-4900. His office is located at 200 Pantigo Place East Hampton.

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