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Hay Fever - 'Tis the Season

Last Modified: September 16, 2012

Family Medicine

Ahhhh - chooo! Hay fever season is upon us. Many of my patients, who suffer with seasonal allergies, have been miserable for months because of the crazy weather since early Spring.What can you do about allergies?

"Hay fever" refers to weed allergies (weeds like ragweed, lamb's quarter, pigweed, thistle cocklebur and others). Normally, weed season lasts from August through the first good, hard frost in the Fall (in late October or early November.

Those of you who suffer know the drill. Allergy symptoms include itchy, red or watery eyes; stuffy or runny nose; post-nasal drip and cough or hoarseness. Allergies can flare up asthma as well, leading to wheezing, shortness of breath or cough.

What can you do about allergies?

You can start with trying to avoid the things that you are allergic to. Unfortunately, if weed pollen is the culprit, that's hard to avoid in the Fall. The best you can do is to stay in air conditioning as much as possible, and shower (or at least wash your hair) before you go to bed at night. The pollen will collect in your hair during the day and you'll wake up feeling better in the morning if you wash it out at night.

The next step would be to try allergy medication. Loratadine® and Cetirizine® are now available over the counter. Other allergy pills are available by prescription. All antihistamine allergy pills are equally good at treating symptoms, but some have fewer side effects than others; for example, diphenhydramine and chlorpheniramine tend to cause drowsiness, whereas Loratadine and Cetirizine do not (for most people). If allergy pills are not enough to control your symptoms, then a prescription nasal steroid spray (like Fluticasone nasal or others) or allergy eye drops can be very helpful. Your primary care doctor can help you sort through the medication options.

As a last resort, for difficult allergies, allergy skin testing and allergy shots can be helpful. I perform allergy skin testing in my office (for airborne allergens, not foods) and there are several good allergists in the area who can do this as well. Allergy skin testing can tell you exactly what you are allergic to, and allergy shots can gradually, over time, make you less likely to react to your allergens so that you feel much better (with less medication or no medication). Allergy shots require a pretty big time commitment – once- or twice-weekly shots to begin with, spacing to monthly over time, for at least 3-5 years. The shots are just under the skin, like insulin shots, so that they don't hurt as much as deeper shots (like a tetanus shot).

Finally, you can follow pollen counts to know which allergen levels are high on any given day – check out the American Academy of Allergy Asthma and Immunology web site for more info or the National Allergy Bureau pollen counts.

What have you found to be most helpful in managing your allergy symptoms? Do you have any advice to share with fellow allergy sufferers?

Loratadine ODT is a trademark of Leiner Health Services Corp.

Cetirizine is a trademark of Teva Pharmaceuticals USA Inc.

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