San Diego is known for consistent sunshine and a mild climate, but our wonderful weather also means that allergy season lasts all year long. May is National Asthma and Allergy Awareness Month, and here in San Diego, May is when grass, weed and tree pollens wreak the most havoc on allergy sufferers. That means sneezing, coughing, congestion and irritation of the eyes, nose and throat. If you have asthma or eczema, high pollen counts can make your symptoms worse.
When allergies bother you, here are some tips to fight back.
1. Treat mild symptoms with over-the-counter remedies.
Fortunately, plenty of treatments are available to help you fight back against pollen allergies, and many that were previously prescription-only are now sold over the counter. For minor symptoms such as itching and sneezing, oral antihistamines are a good first option. I recommend avoiding first-generation antihistamines such as Benadryl and other allergy medications that tend to have a sedating effect. These can make you tired and interfere with your ability to drive or work. In children, these products may impede their ability to learn during the school day. Instead, stick with second-generation, non-sedating antihistamines such as Claritin, Zyrtec, and Allegra. Drugstores sell the brand name products over the counter, and the generic versions work just as well.
2. Relieve nasal congestion with steroid sprays.
If antihistamines don’t completely relieve nasal congestion, you may need to add another weapon such as an intranasal steroid spray. Sprays such as Flonase and Nasacort AQ are now available without a prescription and attack the root of the problem, which is the inflammatory response of nasal tissues to the allergen.
Though nasal steroid sprays can begin to take effect quickly, you generally need to use them for several days to clear out the inflammation and get the full benefit. Continue until the pollens have subsided. Also, it is very important to use them correctly. Don’t aim inward toward the septum, which can cause bleeding. Instead, place the tip of the device just next to the opening of the nostril (not inserted into the nostril), and aim ever so slightly toward the corner of the eye on the same side, then spray. If you look down at your toes while spraying, the product will not drip down the back of the throat.
3. Consult an allergist.
Symptoms still not improving? The next step is to make an appointment with an allergist. Other illnesses may be mistaken for allergies, so you want to make sure that you in fact have allergies and not something else. An allergist can test you for sensitivity to pollens as well as other common allergens and let you know the best treatment options. For example, many people test positive to ragweed allergy, but since there is no ragweed in San Diego, that is not an allergen that needs to be treated.
4. Consider allergy immunotherapy.
The only treatment available to actually change how your body reacts to allergens, immunotherapy works by administering increasing amounts of the allergens over time. Traditional immunotherapy shots can be very effective, but this treatment requires three to five years of shots in an allergist’s office, and you must remain in the office for 20 minutes after each shot to ensure you don’t have an allergic reaction.
Another effective alternative is sublingual therapy. Approved by the Food and Drug Administration to treat grass pollen allergies, sublingual tablets dissolve under the tongue and are taken every day during allergy season. Because San Diego has year-round allergies, some patients use the therapy all year long. Tablets do not have the same long-term effectiveness as shots, but they can be taken at home and do not require a waiting period.
5. Minimize your exposure.
Where you live can make a difference to your pollen exposure. San Diego’s frequent onshore breezes can help minimize exposure along the coast. As those breezes blow through the canyons, however, they pick up pollens and carry them inland. If you exercise outdoors, consider exercising closer to the coast to take advantage of onshore breezes that aren’t laden with pollen. If that is not possible, try to exercise early in the morning before the wind picks up.
After being outdoors, a saline nasal rinse can be helpful to rinse pollen out of the nose and sinuses. Follow directions carefully, and be sure to use only distilled or sterilized water—tap water is not safe to use as a rinse.
Finally, try to keep pollen out of the house by closing windows on breezy days. An indoor HEPA air filter can help remove pollen, dust and other irritants from the air.
Woessner is an allergist and immunologist with Scripps Clinic. ”To Your Health” is brought to you by the physicians and staff of Scripps Health. For more information or to make an appointment, please visit www.scripps.org/SNS or call (858) 914-2297.
