Springtime allergies are one of the most common medical problems evaluated by family physicians. At least 50 million Americans suffer from allergy symptoms at some time during the year, and 15% of children reportedly have allergy symptoms, says Dr. Mary Campagnolo, a family physician in Bordentown, New Jersey, and a member of the American Academy of Family Physicians board of directors.
The good news is that allergies are also easily and effectively treated. Here’s what to know.
What Causes Allergies?
Allergy symptoms occur when a person’s immune system reacts to an “allergic trigger,” says Dr. Todd Shaffer, a family physician in Kansas City, Missouri, and an AAFP board member. “When the immune system is triggered by allergens, it makes histamines. Histamines cause swelling in the nose and eyes to stop allergens from entering the body. Histamines also cause sneezing to remove allergens from the nose,” he says.
Common springtime allergies are mainly caused by tree pollen from birch, oak, cedar, willows and poplars, depending on the area of the country, he says. Grass pollen and blooming trees are also common sources of allergens.
Shaffer says the main allergy symptoms are:
— Red and watery eyes.
— Runny nose.
— Itchy eyes, nose, ears and mouth.
— Stuffy nose.
— Puffy eyes.
— Coughing, wheezing or difficulty breathing.
Are Allergies Ever Dangerous?
For most individuals, allergies are just an annoyance, Campagnolo says. “Allergies could be more serious for people who also have asthma, as allergies could trigger an asthma flare up. Allergies also sometimes promote sinus infections or bacterial eye infections such as conjunctivitis,” she adds.
During the COVID-19 pandemic, Campagnolo has seen some patients who mistakenly thought they were experiencing allergies, which were, in fact, early symptoms of COVID-19. “The main distinctions between allergies and COVID-19 infection are that the COVID-19 virus commonly causes a fever, profound fatigue, muscle aches and sometimes diarrhea or other gastrointestinal symptoms. Those symptoms are not usually hallmarks of seasonal allergies,” she says.
Over-the-Counter Treatment Options
Fortunately, many good treatments for allergy are available inexpensively, over the counter, Campagnolo says. For example:
— Oral antihistamines reduce allergy reaction and congestion.
— Nasal corticosteroid sprays can help with sinus and nasal congestion.
— Antihistamine eyedrops reduce redness, itching and watering of eyes.
Saline (salt water) nasal sprays and gels also can help, by flushing pollen from the nose and sinuses and reducing congestion. “This can help alleviate that yucky feeling of mucus at the back of your nose and throat,” she says. “Mucous-relieving medications and cough products, such as expectorants, can also ease some symptoms.”
Other medications, like decongestants, can also help. “While they don’t treat the allergic reaction itself, they do help alleviate miserable symptoms like a stuffed-up nose,” Shaffer says. “If you know what time of year your allergies usually attack, start taking a nonsedating antihistamine each day for a week or so before the allergens in the air become worse. This can help prevent extreme allergic reactions and make it easier for your immune system to fight back.”
What to Do When Symptoms Persist
Patients with more severe symptoms, which are not resolving with over-the-counter treatments, should consult their family physician for evaluation and possible prescription medications, Campagnolo says.
— Prescription-strength antihistamines and decongestants.
Some patients should consider immunotherapy — allergy shots — Shaffer says, specifically “patients with moderate to severe persistent allergic rhinitis that cannot tolerate standard therapies.” These are a longer-term treatments and work toward future prevention, Campagnolo adds, and will not usually affect the current symptoms.
Lifestyle Changes That Can Help
The first line of defense is to avoid allergens to the extent possible. Keep windows and doors closed when pollen counts are high, Campagnolo says. “Tree pollen is the most common inciting factor for spring allergies. In many areas of the U.S., pollen counts are highest between April and early June, as trees leaf out in spring. By Fourth of July, tree pollen should be significantly reduced for the season. So, keep windows and doors closed during those months and stay indoors as much possible on high pollen days.”
Campagnolo also recommends using portable air filters in the home, which can help reduce allergen particles in air. And, she says, “Drink plenty of water to stay well hydrated, which keeps secretions looser.”
Shaffer says to consider wearing a mask if doing spring yard chores to minimize exposure, then use nasal saline to cleanse your nose as soon as you feel sneezing and other symptoms starting. “It is difficult to avoid such allergens, since they exist all around us,” he says, “but getting on top of symptoms early and preventing bad allergic reactions is imperative to not feeling crummy!”
When to See a Doctor
Shaffer says to be sure to call your family physician if your allergy symptoms become severe or if you have questions regarding treatment.
“Talk with your family physician if over-the-counter medications aren’t helping your allergies,” Campagnolo says. “Don’t suffer needlessly. Working together, we can find a solution.”
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