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If you are experiencing runny nose, nasal stuffiness/congestion, sneezing, itchy eyes, nose and throat you most likely are experiencing nasal allergies or “Seasonal Allergic Rhinitis” to the airborne trees or grass pollen. If your symptoms are in the fall, autumn time of the year airborne ragweed pollen allergens is causing your symptoms. The symptoms of Seasonal Allergic Rhinitis are caused by allergic inflammatory reactions in the nose and eyes to wind born pollen allergens. Patient can become allergic or “sensitized’ to pollen proteins (tree, grass, and ragweed) and these are referred to as pollen allergens. Allergens are natural substances that trigger respiratory allergies. Typically, in the north and east United States, tree pollens are released into the air between March and May, grass pollens from mid-May through June, and ragweed pollen from mid-August until early October. Persons experiencing nasal allergy symptoms all year round may have “Perennial Allergic Rhinitis”, from being sensitized to allergens found in the home and these may include house dust mites, cockroach, and animal danders from household pets (cats and dogs).<
Nasal allergy symptoms can affect sleeping and performance at work or school, as well as interfere with recreational activities. Many patients remain indoors avoiding allergen exposure while missing fun outdoor events affecting the overall quality of life. Decreased performance in school and work can also affect individuals suffering from seasonal allergy symptoms. The good news is that most nasal allergy sufferers can be treated successfully by a qualified board certified allergist. The allergist will carefully take a medical history and complete a physical exam. Allergy skin tests are usually required to confirm specific allergies to outdoor (pollen, mold spores) and indoor allergens (cat, dog, dust mite, cockroach, mouse). Skin prick testing is done by placing small drops of allergen solutions on the forearm skin and gently pricking the skin through the drop with a sterile plastic device. The skin test indicates the presence of allergy if the skin test site becomes red, raised, and itchy after 15 to 20 minutes.
Treatment for seasonal allergies is determined by the severity and persistence of the symptoms and how these affect daily activities including sleep. Aside from staying indoors, avoiding exposure to seasonal pollen allergens is not always possible. Mild (barely noticeable) and intermittent symptoms can usually be controlled with over-the-counter (OTC) antihistamines. Those anti-histamines that do not cause drowsiness or interfere with driving and daily activities are usually preferred. For moderate nasal symptoms which interfere with normal daily activities and sleep, prescription nasal steroid sprays are considered the most effective drug therapy for persistent allergic rhinitis. There are many brands of nasal steroids and the board certified allergist will evaluate the severity of your symptoms and prescribe the best nasal steroid for your condition. Nasal steroids are safe, but 10% of treated patients experience nasal bleeding as a side effect requiring the discontinuation of the medication. The allergist may also prescribe antihistamine nasal sprays to relieve allergy symptoms.
For persistent, moderate or severe allergy symptoms that do not respond to medications, allergen injections (“allergy shots”) may be prescribed by your allergist. Allergen immunotherapy injection treatment is a series of injections of sterile allergens in solution that are given under the skin (subcutaneous). This begins with a buildup phase lasting 6 to 8 months that begins on the initial visit with very small doses, and increasing allergen dose on each visit. The effective maintenance dose is finally achieved at the end of the buildup phase, and then given every two-four weeks for the next 3 to 5 years. Studies have shown that many patients can stop taking their allergy injections after three or more years and continue to do well. Allergy shots are effective in reducing allergic nasal symptoms and the need for allergy medications in 75 to 80% of treated patients.
Your board certified allergist will work with you to select the best and most effective treatment for your seasonal allergic rhinitis symptoms which will hopefully improve the overall quality of your life.
Cheryl K. Bernstein, RN, BSN, CCRC