The Truth About Adult-Onset Allergies

While growing up in New Jersey, Johanna Kellett didn’t suffer from allergies even when people around her were sniffling and sneezing. But in the spring of 2004, she began experiencing symptoms she’d never had before — itchy, watery eyes, congestion and an itchy, runny nose. In her mid-20s at the time, Kellett was working as a scientist in a quality control lab so she thought she might have been reacting to a chemical. She went to an urgent care center where a doctor took a full medical history and examined her. The diagnosis: seasonal allergies.

“It came as a complete shock to me,” says Kellett, now 39, a research and development scientist and new product development director in respiratory health at GlaxoSmithKline Consumer Healthcare. “I was accustomed to spending a lot of time outdoors — eating dinner on the deck, riding my bike or going for a run at the park. I couldn’t believe that spending time outside was what was making me feel this way.”

Her experience isn’t a fluke. It’s possible to develop adult-onset allergies — to pollen, certain foods, cosmetic ingredients or other culprits — at any time in your life. What’s more, “the prevalence of adult-onset allergies is on the rise,” says Dr. Sunit P. Jariwala, director of allergy/immunology research at Montefiore Health System and Albert Einstein College of Medicine in the Bronx, New York. There may be several reasons for this, he says, including “longer and more severe pollen seasons, possible environmental triggers such as pollutants and other unexplained factors that might turn on the immune system.” It turns out that throughout much of the world, nasal allergies are most intense in the spring, according to a study in the January 2018 issue of the journal Asia Pacific Allergy.

[See: 8 Surprising Facts About Asthma and Seasonal Allergies.]

Who’s at Risk and Why

If you have a genetic susceptibility or family history of allergies, you could be especially likely to develop an allergy for the first time during adulthood. But what triggers the reaction may depend on your personal vulnerability and environmental exposures. For example, you could develop an environmental allergy if you move to a new geographical area (from, say, California to New York City) that has different plants or pollutants or if you get a new pet (say, a cat if you’ve only had dogs in the past).

As an adult, you also can develop an allergy to a chemical that you work with or come in contact with at home, notes Dr. Cosby Stone, Jr., a postdoctoral research fellow in allergy/immunology at the Vanderbilt University Medical Center in Nashville, Tennessee. “It takes several years of exposure to develop skin or lung allergies. And over time, you can lose your tolerance to chemicals in makeup or fragrances and develop contact allergies,” often called atopic dermatitis, he says. In fact, 42 percent of adults with atopic dermatitis (an itchy rash) developed it in adulthood, most commonly on their hands, head or neck, according to a study in a November 2017 issue of the Journal of Allergy and Clinical Immunology: In Practice.

“The one that’s really hard to explain,” Stone says, “is a food allergy where you used to tolerate shellfish or nuts but then suddenly don’t. Being an allergic person can put you at higher risk for developing a new allergy: 15 percent of food allergies have an adult onset.” In other instances, people can outgrow one allergy (to perhaps milk or eggs), then later develop an allergy to something completely different (like tree pollen). The exact reasons for this aren’t clear, Jariwala says, adding that “the immune system is constantly changing over time.”

[Read: How to Tell the Difference Between Allergies and a Cold.]

Meanwhile, in other people, “allergies may have been present but milder and under-recognized in the past and [they] become more bothersome in adulthood,” notes Dr. Princess Ogbogu, director of allergy and immunology at The Ohio State University Wexner Medical Center in Columbus. “More commonly, people develop nonallergic rhinitis as they get older, particularly those who have never had problems with allergies before.” With nonallergic rhinitis, she explains, you can develop nasal congestion, postnasal drainage and other symptoms that are often associated with an allergy, but the symptoms are triggered by irritants (such as scents, dust, cigarette smoke or cleaning agents), barometric pressure changes or certain medications, rather than allergens.

Among the telltale symptoms that distinguish nasal allergies (or, allergic rhinitis) from nonallergic rhinitis is itching of the eyes, nose, throat and skin. “The itching is a hallmark of nasal allergies,” Stone says. Other symptoms can include watery eyes, a runny nose, sneezing and red, itchy circles under the eyes (often called allergic shiners).

The Keys to Obtaining Relief

If you suspect you’re suffering from seasonal allergies for the first time, you could try taking an over-the-counter antihistamine and/or steroid nasal spray or flushing your nose with saline (or a neti pot, a container you use to rinse mucus and irritants from your nasal passages). But “it’s never too early to see an allergist,” Stone says. “You can spend a lot of time and money chasing relief with over-the-counter products without really knowing what you have.” If you think you may have a food allergy, swing into action quickly, though, because these can be life-threatening, which is why “everyone with a food allergy gets an epinephrine injector,” Stone says.

[See: How to Survive Ragweed Allergy Season.]

An allergy expert can identify the specific triggers of your allergic symptoms, suggest ways to avoid them and offer medications (including oral antihistamines, nasal sprays, eye drops or others) to ease what’s bothering you most. (If it turns out that you have nonallergic rhinitis or another sensitivity, an allergist can help you manage those symptoms, too.) An allergist also can discuss immunotherapy, including allergy shots or sublingual tablets that dissolve under the tongue. “Immunotherapy is a great long-term solution for those who do not want to be on allergy medications yearly or who cannot avoid their allergens,” Ogbogu says.

A couple of years after her allergy symptoms emerged, Kellett went to an allergist to have skin testing done. That’s when she found out that she’s allergic to grass pollen and discovered a protocol (especially a steroid nasal spray) that relieves her symptoms. “When grass pollen is high, if I didn’t take something to treat my allergies,” she says, “I would be completely miserable.” As she discovered, there’s no reason to suffer needlessly.

More from U.S. News

8 Surprising Facts About Asthma and Seasonal Allergies

How to Survive Ragweed Allergy Season

How Do I Find the Best Allergist?

The Truth About Adult-Onset Allergies originally appeared on usnews.com

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