Spring Allergy Questions Answered

While most people gratefully welcome the longer days and warmer weather of spring, more than 35 million people in the United States dread the itchy eyes, runny nose, and sneezing that comes with the season. These people suffer from seasonal allergies, more scientifically known as "seasonal rhinitis." Ronald A. Strauss, M.D., at the Cleveland Allergy and Asthma Center answers questions about seasonal rhinitis and what can be done to ease the discomfort.

Question:  What causes my allergies to flare up in the spring?

Answer:  Pollen is the most likely cause. Your immune system has mistakenly learned to remember the pollen released by various plants as potentially harmful, and responds with the familiar allergic symptoms. Each species of plant releases pollen at about the same time every year. Trees are usually the first plants to release pollen, usually in the early spring. Grasses come next in the spring and early summer. Weeds generally release their pollen in late summer and fall. The specific types of pollen and the time of their release depends upon the local climate and varies around the country. People with seasonal rhinitis are often allergic to more than one type of pollen.

Question:  How can I tell whether I have allergies or just a cold?

Answer: Generally, allergies last longer than a cold, often for a few weeks. If you notice a pattern in which you suffer the same symptoms at the same time year after year, you are likely suffering from allergies. Frequent sneezing and itchy, watery eyes are more frequently associated with an allergy rather than a cold. Also, a clear nasal discharge suggests that you are suffering from allergies. When you have a cold, the mucus is more often greenish or yellowish. A fever is also indicative of a cold. Sometimes it can be hard to tell the difference between seasonal allergies, a cold, or another condition. That's where a skin test comes in.

Question:  What is a skin test? How does it work?

Answer:  A skin test detects the presence of antibodies to a particular allergen, a substance that causes an allergic reaction. A positive test suggests that you may have an allergy to the particular substance. However, your doctor will review your skin-test results, your medical history, and a physical exam to confirm which allergens are causing your symptoms. The test is performed by placing a drop of an allergen extract on the skin then pricking the skin with a needle. If you have a positive reaction to the extract, a red welt will appear on your skin in about 20 minutes. The size of the welt indicates the strength of the reaction. If you do not react to the extract, you are most likely not allergic to the substance.

Question:  What can influence the severity of the allergy season?

Answer:  Weather can influence the timing and severity of the season. A mild winter often leads to a more severe pollen season. The grass season varies the most. If the spring is warmer and wetter than usual, that can provoke more grass to grow earlier, leading to a more severe season during the late spring and summer. Rain does have benefits, as well. It washes pollen that has already been released out of the air.

Question:  How do I treat seasonal allergies?

Answer: There are three main strategies: 1) avoidance; 2) medication; and 3) immunotherapy.

1. Avoidance
   Although it can be difficult to avoid pollen, there are several steps you can take to reduce your exposure. Keeping your windows closed and using air conditioning even on days that are not extremely warm can keep pollen outdoors. You can also avoid outdoor activities during the peak pollen times of day. Grass pollens are most prevalent during afternoon and early evening, while ragweed pollens are most prevalent during early midday. Pollen counts are also commonly high during dry, windy afternoons. It can be helpful to take a shower after spending time outside; a shower washes off the pollen that can stick on your skin or in your hair.

2. Medication
   Prescription inhaled steroids are often used to decrease nasal congestion. Antihistamines can reduce runny nose, sneezing and itchy, watery eyes. First generation antihistamines, such as Benadryl®, are available over the counter but can cause drowsiness. The non-sedating antihistamine, Claritin®, has recently become available over-the-counter. Other non-sedating antihistamines are available by prescription from your doctor. Itchy eyes can be helped by antihistamine eye drops, also available by prescription. You should talk to your doctor to decide what medications are best for you.

3. Immunotherapy
   If avoidance and medications fail to control your symptoms, immunotherapy can usually help. Also known as allergy shots, immunotherapy consists of a series of injections containing the allergen that triggers your symptoms. Over time, the shots reduce your sensitivity to the allergens. Immunotherapy usually begins with injections of a weak solution of the allergen given once or twice a week. The strength of the solution is gradually increased. Once the strongest does is reached, shots continue about once a month until the allergy symptoms are controlled, often three to five years.

Question:  Does immunotherapy cure my seasonal allergies?

Answer:  No. Right now, there is no cure for allergies. Immunotherapy can, however, provide a protective effect for up to several years.