Runny nose, itchy eyes, brain-rattling sneezes … must be spring! In many parts of the U.S., allergy season begins in February and can last until early summer.
Allergist Frank J. Eidelman, MD, MBA, FAAAAI, explains what can make spring allergies so brutal and how you can manage the sneezing, wheezing, sniffling and more.
Why your allergies are so bad in the spring
Allergic rhinitis (hay fever) and nasal allergies can significantly affect your quality of life. In fact, the American College of Allergy, Asthma and Immunology reports that allergies are the sixth leading cause of chronic illness in the United States.
“They can really make you miserable. Your eyes get itchy and swollen, your nose is congested, you sneeze a lot and your lungs can become irritated,” Dr. Eidelman says. “And further along the spectrum, the severity can become disabling. You can’t get out of bed, you can’t sleep, you can’t focus on your work — it can be intense.”
Dr. Eidelman explains why spring allergies in particular can be so debilitating.
- Everything’s in bloom: “When we talk about spring allergies, we’re talking about tree pollen,” Dr. Eidelman says. Trees are, of course, blooming in the spring, which means people with tree pollen allergies are especially miserable this time of year.
- Your geography matters: Temperate climates see three basic pollen seasons: spring (tree pollen), summer (grass pollen) and fall (weed pollen and mold). In subtropical areas, grass pollen season can be much longer — and without winter weather or frost to stop trees and plants from producing pollen, allergy seasons don’t end.
- Blame climate change, too: If you feel like your spring allergies have gotten worse, you’re not imagining it. “With climate change, spring pollination has gotten worse in the last 10 to 20 years,” Dr. Eidelman notes. “As the seasons get hotter, we’re seeing more pollen, longer and more intense pollination seasons. This seems to be a worldwide trend.”
Can spring allergies be prevented?
If you have mild allergies, you may tend to just grin and bear it. But if your allergies are more intense, they can really interfere with your life.
Dr. Eidelman recommends starting a topical nasal steroid spray one or two weeks before the start of allergy season. These sprays can prevent inflammation in your nose and block some of your worst symptoms before they begin.
To get the most benefit, though, start using them before allergy season even starts so it’ll be effective by the time the pollen starts flying. And use them daily until the season ends.
How to manage spring allergies
Dr. Eidelman says many of the best nasal medications are now available over-the-counter. They fall under a few different categories.
1. Antihistamines
The first category of medications is antihistamines, which fall into two basic groups of their own:
- First-generation antihistamines: These older medications, like Benadryl® (diphenhydramine), cause drowsiness and slow reaction times, which can impact your day-to-day work and your ability to operate machinery (like your car). “You might think the medication isn’t affecting you,” Dr. Eidelman warns, “but you’re probably not functioning as well as you think you are.”
- Second-generation antihistamines: Newer medications like Claritin® (loratadine), Allegra® (fexofenadine) and Zyrtec® (cetirizine) are less sedating or non-sedating. “They’re the preferred medications for basic symptoms like itching, sneezing or runny nose,” Dr. Eidelman advises.
2. Nasal sprays
If you’re experiencing nasal congestion, postnasal drip and sinus pressure, antihistamines aren’t particularly effective, Dr. Eidelman says. But you can add a topical nasal steroid like Flonase® (fluticasone), Rhinocort® (budesonide), Nasonex® (mometasone) or Nasacort® (triamcinolone).
These nasal sprays are non-sedating and don’t have side effects, but you have to use them every day for them to work.
“They’re the gold standard for moderate to severe nasal allergies,” Dr. Eidelman says. “They work well, but the thing to keep in mind is that they don’t have an immediate effect.”
3. Decongestants
Another option for treating nasal congestion, postnasal drip and sinus pressure is to add a Sudafed® (pseudoephedrine) to your daily antihistamine. Pseudoephedrine is a decongestant, meaning it can help with congestion.
But decongestants aren’t recommended if you have hypertension or heart problems. And there are some other risks to know about.
Pseudoephedrine, which is also found in combo medications like Allegra-D®, Claritin-D® and Zyrtec-D®, can cause serious side effects, like:
- High blood pressure.
- Heart palpitations.
- An enlarged prostate.
“Overall, I don’t recommend it for people with heart problems, and I wouldn’t recommend that people over 40 take it regularly,” Dr. Eidelman says. If this is you, stick to a topical nasal steroid instead.
4. Allergy shots
If over-the-counter medicines and nasal sprays don’t seem to work, you might want to consider allergy shots, also known as immunotherapy. “Allergy immunotherapy is the only treatment that has the potential to cure allergic rhinitis,” Dr. Eidelman says.
They can lessen your sensitivity to pollen and other things you’re allergic to. If you’re allergic to tree pollen, for example, you would get an allergy shot made out of tree pollen protein.
“In a lab, they extract the protein from tree pollen and they make an extract with it,” Dr. Eidelman explains. “That extract is then used to desensitize or make the patient less sensitive to tree pollen.”
Watch out for “natural” allergy remedies
Neti pots and nasal rinse squeeze bottles can provide relief if you’re looking for medicine-free ways to treat your allergies. Most of these methods just involve flushing out your nasal cavity with salt water, and they’re fairly safe when used correctly. Just be sure to use distilled water with them to avoid infection, and don’t use cold water unless you enjoy brain freeze.
If you have tree pollen or plant allergies, though, steer clear of any alleged herbal remedies. “I don’t recommend anything herbal,” Dr. Eidelman says. They can actually make things worse.
For example, people who are allergic to ragweed sometimes have serious allergic reactions to echinacea, a common immune stimulant. This herbal product comes from the purple coneflower — a close relative of ragweed.
With that example in mind, Dr. Eidelman offers a final warning about herbal remedies: “Keep in mind that just because something’s natural, it doesn’t mean that you’re not going to be allergic to it.”
