Don’t let seasonal allergies keep you stuck in the house this spring.
From nasal congestion, runny nose and sneezing to itchy eyes, headache and wheezing, there is no ignoring allergies when they attack. The risk factors for environmental allergies are diverse and include genetics, seasonal shifts, increased exposure and geographic moves. But through relatively simple tests, allergy sufferers can learn their triggers and empower themselves to leverage the assortment of ways to reduce symptoms.
The best defense against allergies is for people to know the cause and decrease exposure where possible, according to Dr. Magee DeFelice, division chief of allergy and immunology at Nemours/Alfred I. duPont Hospital for Children.
“It is important to be tested by an allergist to confirm whether or not allergies are causing symptoms, in order to determine which medications would be safe and most beneficial to use,” DeFelice says.
The main method to determine environmental allergies is skin testing, which entails light pricks of different allergens to the surface of the skin and can be performed during an outpatient visit; small hives will form if an allergy exists. The scratch tests take approximately 15 minutes and cause little discomfort, according to Dr. Joseph Cavallaro III, of Cavallaro Family Practice. “It feels like a Brillo pad on your arm,” Cavallaro—who is board certified in family medicine–says.
If additional information is required, a small amount of allergen may be injected under the skin, DeFelice notes. Results are available within 20 to 30 minutes of the test being placed.
Although the majority of insurers pay for a portion, Cavallaro says the tests are not always covered, and it may depend on whether deductibles and/or out-of-pocket expenses have been met.
Having the tests done, however, lays the foundation for finding appropriate solutions–and relief. “Allergy testing either via skin or blood helps providers decide the best medications to use to treat patients’ symptoms,” says Dr. Jay Mirmanesh, a board-certified pediatrician with Advocare Pediatric and Adult Medicine.
Allergy symptoms manifest when patients reach a certain threshold of exposures, according to Dr. Saba Aftab, a board-certified otolaryngologist at Advocare ENT Specialty Center. “If you have an allergy to cats and dust, you may not feel symptoms when exposed to a cat,” Aftab says. “But if you go to a friend’s house where it is very dusty and they have a cat, the combination of the two allergens can trigger your symptoms.”
People suffering from multiple environmental allergies may try to avoid exposure to each and every thing, Aftab says. But she says it is important to recognize some are impossible to avoid altogether and not become overwhelmed.
Refraining from smoking or being around people who smoke is an important step in alleviating allergy symptoms. “Smoke is extremely irritating and inflames already-swollen membranes in the nose and sinuses,” Aftab says.
The top six allergens in South Jersey are ash, birch, cedar, elm and maple trees, along with grass, according to Cavallaro. He gave a forecast for what area residents can anticipate in 2015. “Because of a wet winter and a warm, dry spring, this year is expected to be a bad year for allergy suffers,” he says.
But Aftab says South Jersey residents have it mild compared to other regions; the southern part of the U.S. has the highest rate of allergens due to warmer weather and longer pollen seasons. Pollen counts do vary day-to-day based on local weather conditions, with more exposure on hot, dry and windy days, Aftab explains. However, a global phenomenon is also taking a toll.
“Due to the effects of climate change, allergy seasons will be longer and more severe across the country,” Aftab says. “We are already seeing this effect in comparing pollen counts now to 20 years ago.”
On the defense
There are currently several medications available, both over-the-counter and prescription, to combat allergy symptoms. “Antihistamines such as Benadryl and Claritin work on blocking histamine receptors,” Mirmanesh explains. Additionally, nasal steroid sprays can be used to control inflammation.
Antihistamines can cause fatigue, and nasal sprays can lead to nose bleeds, Cavallaro notes. Nasal saline irrigation, used alone or in combination with other treatments, can be helpful for congestion. “Devices for nasal irrigation are available over-the-counter,” DeFelice says. “Distilled or sterilized water should be used, and devices cleaned regularly, to avoid infection.”
Leukotriene antagonists such as Singulair may also be used for wheezing and other allergy symptoms, according to Mirmanesh.
People generally tolerate congestion, sneezing and some itching, but seek medical help when symptoms progress and over-the-counter drugs do not provide relief. “Immunotherapy has been shown to be very helpful in those with severe symptoms that are not relieved by conventional treatment or the symptom relief requires multiple medications,” Mirmanesh says.
Generally performed over a span of two to three years, allergy shots build immunity against positive allergens, Cavallaro explains. And DeFelice says that allergy shots are effective in treating both children and adults. “Unlike medications, which only treat the symptoms of allergies, allergy shots teach the immune system to become tolerant of allergens,” DeFelice says. “As a result, most patients receiving shots feel a considerable decrease in symptoms and require less medication.”
Left untreated, allergies can lead to potentially serious health issues, including recurrent ear and sinus infections or trigger asthma and breathing problems.
A majority of asthma cases in children are caused by allergies, Aftab says, compared with half the cases in adults; common asthma symptoms include coughing, wheezing, chest tightness and shortness-of-breath. “In the most serious cases, people can develop anaphylaxis–a more serious and sometimes fatal allergic reaction that can cause severe trouble breathing, low blood pressure and swelling of the airways,” Aftab says.
Defend against outdoor allergies • Keep windows closed and air conditioning on. • Avoid being outside in the hottest part of the day. • Upon returning home, take a shower, change clothes, wash hair and rinse nose with saline. • Leave shoes outside to avoid tracking pollen in.
Defend against indoor allergies • Wash all bedding frequently in hot water, and use dust-proof covers on pillows and mattresses. • Keep pets out of the bedroom. • Vacuum regularly and with a vacuum that has a good filter. • Avoid carpeting, upholstery and as much as possible. – Dr. Saba Aftab, MD, FACS, Advocare ENT Specialty Center
Allergy myths dispelled
Myth : There are breeds of dogs and cats that are hypoallergenic. Fact: While individual animals might produce varying amounts of allergen, there are not certain breeds that are less allergenic than others.
Myth : Moving to another geographic location will cure allergies. Fact: Although there are geographic differences in the most common allergens, allergic triggers are present everywhere.
Myth : It is best to wait for symptoms before starting medication for allergies. Fact: Although some allergy medicines can be used as needed when symptoms occur, there are a number of situations when daily or preventative use may be more beneficial.
Myth : : Changing the medication brand will help allergies. Fact: Only if there are side effects with certain allergy medications should people switch the brand; if symptoms are not relieved, people should be evaluated by their primary provider.
Advocare ENT Specialty Center
406 Lippincott Drive
Advocare Pediatric and Adult Medicine
651 Route 73 N. | Marlton
800 Liberty Place | Sicklerville
100 Route 73 N. | Voorhees
Cavallaro Family Practice, P.C.
432 Ganttown Road
Nemours duPont Pediatrics
Locations across South Jersey
Published (and copyrighted) in the Art of Living Well pull-out section of Suburban Family Magazine, Volume 6, Issue 2 (April, 2015).
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