Pollen Allergies 101
Trees- March through beginning of June
Grass- June through August
Weeds- Mid-August through October
Mold- after spring thaw and late summer/fall months
• Hot, dry, windy days are usually the worst for pollen allergy sufferers!
Ragweed pollen can travel 500 miles via the wind
• Rainy, cloudy days usually reduce pollen allergy symptoms because the particles get washed away. However, mold growth increases after a rainy spell.
• You can keep track of daily pollen/mold counts in the weather section of the newspaper, on the radio/television, or online at www.aafa.org
How to avoid/reduce contact with pollens?
• Try to stay inside as much as possible in the early morning (5am-10am) when pollen levels are typically highest.
• Schedule outdoor exercise later in the day.
• Avoid walking through uncut fields.
• Consider a lightweight face mask for yard work.
• Keep house and car windows closed.
• Use an air conditioner with the air on recirculation. Avoid using window fans.
o Don’t hand clothes/sheets outside to dry
o Shower/wash hair when coming home from working/playing outdoors. (especially before going to bed)
o Brush/wash your pets outside as often as possible during peak pollen season.
Antihistamines: Loratadine (Claritin), Cetirizine (Zyrtec), Fexofenadine (Allegra)
• Helps relieve sneezing, itching and rhinorrhea.
• Less effective for congestion.
• Start daily at the beginning of your allergy season to reduce severe allergy symptoms.
• I usually find that cetirizine and fexofenadine are more effective in controlling symptoms than loratadine, however this is not the case for all patients
• Loratadine and fexofenadine are non-sedating, whereas cetirizine cause sedation in some patients
• Reduces congestion by shrinking swollen membranes in the nose
• Using a nasal decongestant spray for >3 days in a raw may cause rhinitis medicamentosa, making congestion worse
Corticosteroid Nasal Sprays:
• Decreases nasal inflammation without a rebound effect.
• Helps relieve congestion, rhinorrhea, sneezing, nasal itching, and ocular symptoms.
• These are the most effective medications for the treatment of allergic rhinitis.
• They work best if your start them ~2 weeks prior to the start of allergy season and continue using the, throughout the allergy season.
• Common side effects: sneezing, dryness, burning/stinging of the nose, epistaxis.
o Burning/stinging in the nose is most often seen in preparations containing propylene glycol and benzalkonium chloride (cause local irritation and clarify dysfunction, respectively).
o The only preparation that does not contain either of these two preservatives is Rhinocort
o Nasal sprays without alcohol: Nasacort, Nasonex, Rhinocort, Veramyst and Omnaris
Singulair: leukotriene receptor antagonist
• May be effective as a preventative medication for asthma, but also for treatment of allergic rhinitis and urticarial.
• Many insurance companies will not cover this medication unless there is a concomitant diagnosis of asthma
Antihistamine Nasal Sprays: Azelastine (Astelin), Patanase
• Can be effective in decreasing nasal itching, sneezing and rhinorrhea
• Insurance companies often will not cover until ≥1 nasal steroid spray has been tried (depends on the insurance company)
Antihistamine eye drops: Zaditor (OTC), Patanol, Pataday
• Can be effective in treating itchy, red, watery, swollen eyes.
• Only needs to be used PRN.
• Zaditor is first line and is effective for most allergy sufferers
• Effective for long term control of environmental allergies, including pollen allergies.
• Require weekly injections during the buildup phase, followed by ~ monthly injections for a period of ~ 3-5years.
• If often takes six months to a year to notice the benefit of allergy shots.
• Allergy shots may not be effective for everyone.