Q: What is the best reliever for seasonal allergies? I am currently taking the over-the-counter antihistamine Claritin. This helps some, but I still have itchy and watery eyes, as well as a constantly running nose.
A: Unfortunately, there is no “best” treatment. Just as each and every person has their own body reactions to seasonal allergies (runny nose, sneezing, itchy throat, burning eyes, etc.), so too do they vary in their response to different medications. This makes it especially important to meet with your doctor to devise a treatment approach that targets your specific allergy sensitivities and symptoms.
Seasonal allergies tend to occur in a predictable pattern during certain times of the year. For some, that means springtime allergies to tree pollen. For others, late spring to early summer grass pollen allergy. And ragweed season affects many in late summer to early fall. Additionally, mold spores can trigger symptoms in susceptible individuals on a seasonal or yearly basis.
To determine the best treatment approach for seasonal allergies, your doctor will need to know the answers to the following questions:
- What are your symptoms? For instance, if your problem is limited to a runny nose, antihistamine or anti-inflammatory nose sprays may provide relief.
- What time of year do they occur? This is important because you can “predict” the symptoms and begin treatment to control or prevent your allergic response before they begin.
- How long do the symptoms last? If it is only a problem for several days or a week, you might use anti-inflammatory or antihistamine medications on a temporary basis. If your symptoms last many months and greatly interfere with your life, allergy shots may be considered.
- Do you have asthma? This may indicate a need for longer-term medical treatment with a combination of medications, including the possible use of an anti-leukotriene medication.
- At what age did your seasonal allergies begin? For instance, are they long-standing and predictable, or do they seem to change with the season in an unpredictable pattern?
- What medications (over the counter, prescription, herbal preparations) have you used in the past, and which—if any—provided some relief?
- Have you ever had allergy shots?
It is also important to know that certain foods—bananas, chamomile tea, melons, sunflower seeds, Echinacea and others—may trigger oral allergy symptoms in about one-third of people with ragweed pollen allergies. Those with allergies to certain tree pollens may also be affected by eating foods such as cherries, apples, carrots, almonds and others.
Fortunately, we have many options to help seasonal allergy sufferers. While some target avoidance measures as well as environmental controls (air conditioners, air filters, etc), others involve medications or immunotherapy (allergy shots) that target specific chemical, inflammatory, or immune reactions in the body. The goal is to decrease, or eliminate, the allergy symptoms. Treatment approaches include but aren’t limited to:
- Antihistamines help to prevent a reaction to histamine, a chemical released by our body during an allergic reaction. By stopping this process, they are better able to decrease—or even prevent—many seasonal allergy symptoms, especially mucous production and itching. Different preparations are available, including pills and liquids (with or without added decongestants), nose sprays and eye drops.
- Decongestants that decrease the nasal congestion frequently experienced in reaction to those seasonal allergy symptoms. These may be found in pills, liquids and nose sprays. However, if used as a nose spray, please do not take for more than three days in a row; it may lead to a rebound effect, meaning an increase in nasal congestion.
- Antileukotriene medications block chemicals known as leukotrienes. This action helps to decrease the inflammation of the airways caused by the effects of these chemicals. One product in this category, montelukast, is approved for the treatment of allergic rhinitis.
- Mast cell stabilizers help to control inflammation by stopping the release of chemicals triggering this reaction before they occur. This category of medication is available in forms such as drops, sprays or inhalers. They are most effective when started prior to the seasonal allergy season.
- Corticosteroids are anti-inflammatory medications (not muscle-building anabolic steroids) that, when properly used, have been proven to be very helpful in the treatment of seasonal allergies and asthma. They are available in pill, liquid, inhaler, drop, spray, and injectable formulations. The duration, as well as type of corticosteroid used, is tailored to a person’s specific symptoms and condition.
- Immunotherapy—allergy shots—is considered when symptoms are not adequately controlled by medications, last for many months at a time, or occur to substances that are not easily avoided (pollens, mold spores, others). While treatment often occurs over the span of a three- to five-year period, many people begin to experience significant relief within the first year.
Other options to discuss with your physician include the use of nasal irrigation with saline solution (available without a prescription), acupuncture (may provide some relief from the symptoms triggered by seasonal allergies), and even herbal preparations such as butterbur (check with your physician first).
Seasonal allergies can by annoying at the very least, and life-altering in their more severe forms. This makes it very important to meet with your primary care doctor, ear nose and throat or allergy specialist to devise a treatment plan that will work best for you.
For further information, please visit the American Academy of Allergy, Asthma and Immunology at www.aaaai.org.
