Allergy season is already underway, and if you suffer from seasonal allergies, you're already sniffling and sneezing, trying to make it until fall. Don't worry, there's hope! You don't have to suffer—there are plenty of options available that spell relief. Let's talk a look at them.
Whether you're still suffering the effects of springtime allergies, or you don't think you'll see relief through summer and fall, there's plenty you can do to get outside and enjoy the good weather. We sat down with Dr. Dan Weiswasser, a primary care physician, and asked him what he would recommend to his patients who would come to him suffering from similar allergy symptoms. Here's what he said:
Start with Behavioral Changes
Start with the basics. Keep your home clean and minimize your exposure to pollen, mold, and other air contaminants. It goes a long way towards staying comfortable in the spring and summer months. There's a lot to be said for just making sure to keep the windows closed whenever possible, and using the air conditioner—even at modest temperatures—to filter out the allergens that make you sneeze and your nose run. We talked about how to keep your home clean and allergy-friendly before. Take care of your home and surroundings, and you'll always have a safe place to retreat to if the going gets tough.
Enjoy a spring breeze from time to time, but retreat when you feel your symptoms beginning to flare up. When you shut the windows, wash your face and hands. If you've been outside for a while, consider changing your clothes entirely. It may seem extreme, but whenever I go hiking, I always make sure to toss my clothes in the wash and take a shower as soon as I get home. It helps to wash the pollen, mold, and everything else out of my hair, off my skin, and out of those clothes. Dr. Weiswasser also suggested bathing before bed, just so you're not rolling around in sweat and pollen all night. You might also consider a bottle of basic saline nose spray, just to clear out your sinuses from time to time.
Know the Differences Between Antihistamines
Simple changes to your lifestyle are your first line of defense. Beyond that, you likely know there's a plethora of over-the-counter antihistamines that all promise relief. However, choosing one can be difficult. They're not all alike. Here are the primary differences:
- Claritin, Allegra, and Zyrtec: These "second generation" antihistamines (Loratadine/Claritin, fexofenadine/Allegra, cetirizine/Zyrtec) are the most popular antihistamines available, largely because they're the most effective in the most people. They last longer than other allergy medicines, and they don't cause drowsiness. We asked Dr. Weiswasser what the differences between them were, and he explained that studies haven't shown significant efficacy differences in large groups of people, so a cheap generic and see if it works for you. Keep in mind that at recommended doses, Allegra and Claritin don't cause drowsiness. Zyrtec may, depending. Either way, if you're going to start with regular allergy medication, start with these, and look for generics and store brands.
- Dimetapp, Benadryl, Chlor-Trimeton, and Tavist: For many, these "first generation" antihistamines are the ones we grew up with. They're effective as well, but usually for shorter periods, and most of these medications have side-effects that may cause drowsiness. Dr. Weiswasser explained that in older adults, they can cause dry mouth and eyes, and even confusion or urinary hesitancy. Still, if you don't have anywhere to go and you have nothing else, they're an effective, short-term option.
- Eye drops (Zaditor/Naphcon) and Nasal steroid sprays (Nasacort): Over the counter eye drops with naphazoline or ketotifen as active ingredients and nasal sprays like the relatively-new Nasacort can also alleviate allergy symptoms. They act quickly (since you're putting them right into your sinuses or into your eyes) and can help with all allergy symptoms when taken routinely—or at least regularly during allergy season. They can be pricier than other methods, but they're effective. It's important not to confuse these with other nasal sprays and eye drops, like saline sprays or vaso-constricting eye drops like Visine, which clean out your sinuses or eyes and reduce swelling or redness, but don't address the immune reaction behind allergy symptoms. Always check the active ingredients before buying.
You'll notice that many of these are similar, even though their active ingredients are different. Dr. Weiswasser explained that he would advise most people start with a second generation antihistamine, but beyond that, choose the one that's least expensive where you live and where you shop. If you can find generics with the same active ingredients and dosages, go with those—as we mentioned in our article about generic drugs, there's no substantive difference.
Also, remember that short term ones allergy medications well if you take them as needed or when your symptoms flare up. Others however, like Claritin or Allegra, are best taken regularly all year, or at least through the spring and summer months. Having your body ready for the onslaught of pollen and mold instead of just getting used to a new medication will help you weather the season better, without having to suffer the first few weeks.
See Your Doctor: They Have More Tools Available
If you still can't get relief, or if you experience side effects with over-the-counter antihistamines, see your doctor. There are a number of other tools in their toolkit that we didn't mention here. Dr. Weiswasser mentioned a number of nasal sprays and eye drops that could be just what you need, but are only available by prescription. Similarly, if your symptoms are just out of control even with these medications, your doctor may suggest you see an allergist for additional testing.
They may also propose immunotherapy, where you get regular shots of tiny amounts of the allergen in question to suppress the immune reaction (kind of a way to get your body used to it) over the course of many many months. Most people don't need to go to this level, but for those that do, it's the difference between being able to go outside or staying locked in the house. Dr. Weiswasser also explained that there are new developments on the immunotherapy front, so if you're not keen on shots, stay tuned—your doctor may have good news for you soon.
We hope this helps, Crawling. Start at the top and work your way down. Everyone should begin their allergy management with behavioral, household changes. Step up to a second generation antihistamine, and then experiment in the category with other medications or nasal sprays and eye drops if you need to. If all else fails, see your doctor. Your symptoms may require something a little stronger if you just can't get relief.
Dr. Daniel Weiswasser is a board-certified internist and pediatrician who's been in outpatient practice in Western Massachusetts for nine years. He offered his expertise with this feature, and we thank him.
Photos by Dana Robinson, rick, and Katy Warner.
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