Your Doctor Discussion Guide: Seasonal Allergies
Seasonal allergies are a drag, but going to your doctor's office armed with the right questions will make getting through the sneeze season a lot easier.
Getty ImagesFor millions of Americans, the changing of the seasons is less about pretty foliage than it is sneezing, runny nose, and watery or itchy eyes. These classic symptoms of seasonal allergies, which can occur at any time of the year, happen when your immune system has an overblown reaction to substances in the air, usually tree, grass, or weed pollen. The allergies are usually harmless, but they do produce unpleasant symptoms. Fortunately, there are ways to cope and cope well, no matter what the season. "The vast majority of patients with seasonal allergies have mild to moderate symptoms and do just fine with medications," says Karim Dhanani, MD, an allergist with Scott & White Healthcare in Round Rock, Texas. Lifestyle changes can help as well.
Your doctor can give you a game plan for managing your seasonal allergies. Here are 10 questions to ask at your visit (download a PDF to save to your smartphone or to print and bring with you).
How do I know I have seasonal allergies and not a cold?
One of the first questions your doctor will ask: "How long do the symptoms last?" While colds typically only linger a week to 10 days, seasonal allergies can persist for two to three months, although the symptoms may wax and wane during that time.
There are other clues that you have seasonal allergies rather than a cold: your symptoms appear only at certain times of the year; your mucous is clear, watery, and runny (colds produce yellow discharge); you don't run a fever.
Can I develop seasonal allergies as an adult if I didn't have them as a child?
The unfortunate answer is yes. Kids who have allergies may or may not hang on to them as they grow older. But for adults, allergies can appear seemingly out of nowhere and are unlikely to disappear. They may even get worse as you age. "When it's an adult, it's a little more permanent," says Dr. Dhanani. "There's a higher chance you're going to have it off and on conceivably for your whole life."
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Some adults develop allergies after moving to a new region of the country. This usually doesn't happen right away, though, as it takes time for your body to become sensitized to a new allergen, says Lauren Fine, MD, assistant professor of allergy, asthma, and immunology at the University of Miami Miller School of Medicine. Once you're a long-term resident, you may be suffering with lots of other people in the area.
How can I find out what I'm allergic to?
You can narrow it down somewhat just by the time of year. If your symptoms appear in late winter and early spring, you could be allergic to trees, which pollinate at that time. Grasses, on the other hand, pollinate in late spring and summer.
But to really nail it down, you need to get a skin-prick test, which is easily performed in your doctor's office. "It basically involves making a very, very tiny scratch on the surface of the skin, usually the back, and introducing different allergens to the body," explains Dr. Dhanani. If you're allergic to whatever allergen is being introduced, you'll develop a small itchy rash on your back.
Blood tests will also provide answers but are more involved and take more time.
Next Page: Are there ways to prevent seasonal allergies? [ pagebreak ]
Are there ways to prevent seasonal allergies?
We can't get rid of seasonal allergens but knowing what you're allergic to can help you minimize your exposure. One way to do this is to stay inside as much as possible during your particular allergy season, says Dr. Fine. And while inside, keep the windows closed and the air-conditioner (or heater) on. "They do filter out the air quite well," says Dr. Dhanani. (All that said, even if you block outdoor allergies, you could still suffer from indoor allergies; read up on how to allergy-proof your home.) Similarly, in your car, keep the windows rolled up.
Wearing an N95 mask—available at Home Depot or Lowe's—while you're outside and especially when you're gardening or mowing the lawn, can keep allergens out of your airways. When you come inside, take a shower, change clothes and put your outdoor clothes in the wash.
Can my pets make seasonal allergies worse?
Pets themselves aren't seasonal, but they can definitely drag pollen into the house. "You may not be allergic to your pets, but you may be allergic to the pollen that likes to settle all over them," says Dr. Fine. If you have a pet that goes outside a lot, keep it confined to certain areas of the house when it's indoors and don't let it sleep in your bed. "If you have to have pets in the house, at least keep them out of the bedroom and keep the bedroom door shut at night so when you sleep, you can have an allergy-free zone," says Dr. Dhanani.
Will antihistamines help?
For most people, yes: "The best treatment always is to start with antihistamines," says Dr. Dhanani. Antihistamines block histamines, the compounds that cause allergic symptoms. Many different brands are available on regular pharmacy shelves including some that used to be prescription only, such as Claritin, Zyrtec, and Allegra.
Benadryl, also over-the counter, is another option—but it will make you sleepy, so it's best to take at night.
Antihistamines come in in the form of pills, eye drops, and nasal sprays. "Nasal antihistamines especially help with the itchy, sneezy sensations," says Dr. Dhanani.
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What if antihistamines aren't enough?
Nasal steroids can pick up where antihistamines leave off. A common brand is Flonase, which is available only with a prescription. Unlike steroids taken in pill or shot form, these nasal sprays don't carry many side effects because they only act locally. "There's minimal absorption in the body," says Dr. Dhanani. "It mainly goes to the source, which is the nose."
For most people, antihistamines and nasal steroids sprays are enough to manage symptoms, he adds. "If you really have allergies, these things should work," says Dr. Fine. "We have so many different combinations we can offer it's very unusual for someone to just not improve at all."
Do I have to take medication all the time?
You may not have to take meds all the time, but you will for at least as long as you have symptoms. Antihistamines such as Zyrtec and Allegra work for 24 hours so you may be taking them as often as once a day during your allergy season.
Prescription nasal sprays, on the other hand, take longer to build up in your body. "These need to be taken daily for full effect and don't really work well when used 'as needed,'" says Dr. Fine. Allergy sufferers may need to take a nasal spray for months or years, stopping only when symptoms are controlled with other medications or when the trigger is gone, she adds.
What are allergy shots and will they work for me?
Most doctors won't start you off on allergy shots—they'll first want to see if medications work, since immunotherapy requires a doctor's visit once or twice a week for three to six months, and then a maintenance phase that can last up to five years. That said, injections can be effective for people with severe allergies or for those who don't want to take drugs for long periods of time. These shots work like vaccines and involve injecting you with a small amount of whatever you're allergic to so your body will build up resistance. "About 90% of patients get at least moderate relief if not great relief from shots," says Dr. Dhanani. Of course, you'll first have to be tested to see what you're allergic to so the doctor can match the shot with the allergen.
In April 2014, the U.S. Food and Drug Administration approved the first "sublingual" allergy drop which works much like the shot only it comes in the form of a tablet that is dissolved under the tongue. It's certainly more convenient than a shot, but "right now there isn't enough research to support them," says Dr. Dhanani.
How often will I need to see a doctor?
If you're getting allergy shots, you'll need to visit your doctor's office regularly. Otherwise, plan on seeing your doctor when you first notice allergies and when symptoms aren't getting better with over-the-counter medications. If symptoms are mild and well controlled, a once-a-year check-in should be enough, says Dr. Dhanani.