Allergies and Hay Fever

Millions of Americans suffer from nasal allergies, commonly known as hay fever. An ear, nose and throat specialist can help determine the substances causing your discomfort. The specialist can also develop a management plan that will help make life more enjoyable.

Why does the body develop allergies?

Allergy symptoms appear when the immune system reacts to an allergic substance that has entered the body as though it were an unwelcome invader. The immune system will produce special antibodies capable of recognizing the same allergic substance if it enters the body at a later time.

When an allergen reenters the body, the immune system rapidly recognizes it, causing a series of reactions. These reactions often involve tissue destruction, blood vessel dilation, and production of many inflammatory substances, including histamine. Histamine produces common allergy symptoms such as itchy, watery eyes, nasal and sinus congestion, headaches, sneezing, scratchy throat, hives, shortness of breath, etc. Other less common symptoms are balance disturbances, skin irritations such as eczema, and even respiratory problems like asthma.

What are common allergens?

Many common substances can be allergens. Pollens, food, mold, dust, feathers, animal dander, chemicals, drugs such as penicillin, and environmental pollutants commonly cause many to suffer allergic reactions.

Pollens
One of the most significant causes of allergic rhinitis in the United States is ragweed. It begins pollinating in late August in most of the U.S. and continues until the first frost. Late springtime pollens come from grasses like timothy, orchard, red top, sweet vernal, Bermuda, Johnson, and some bluegrasses. Early springtime hay fever is most often caused by pollens of trees such as elm, maple, birch, poplar, beech, ash, oak, walnut, sycamore, cypress, hickory, pecan, cottonwood, and alder. Flowering plants rarely cause allergy symptoms.

Household allergens
Certain allergens are present all year long. These include house dust mites, pet dander, and some foods and chemicals. Symptoms caused by these allergens often worsen in the winter when the house is closed up, due to poor ventilation.

Mold
Mold spores also cause allergy problems. Molds are present all year long and grow both outdoors and indoors. Dead leaves and farm areas are common sources for outdoor molds. Indoor plants, old books, bathrooms and damp areas are common sources of indoor mold growth. Mold is also common in foods.

How can allergies be managed?

Allergies are rarely life-threatening. Allergies often cause lost work days, decreased work efficiency, poor school performance, and a negative effect on the quality of life. Considering the millions of dollars spent on antiallergy medication and the cost of lost work time, allergies cannot be considered a minor problem.

For some allergy sufferers, symptoms may be seasonal, but for others they produce year-round discomfort. Symptom control is most successful when multiple approaches are used simultaneously to manage the allergy. They may include minimizing exposure to allergens, desensitization with allergy shots or drops, and medications. If used properly, medications, including antihistamines, nasal decongestant sprays, steroid sprays, saline sprays, and cortisone-type preparations, can be helpful. Even over-the-counter drugs can be beneficial, but some may cause drowsiness.

When should a doctor be consulted?

When allergy symptoms are not well controlled with over-the-counter medications, a doctor should be consulted. The doctor will gather a detailed history and complete a thorough examination of the ears, nose, throat and head. The doctor will also offer advice on proper environmental controls to decrease exposure to allergens. The doctor will also evaluate the sinuses to determine if infection or structural problems (deviated septum, polyps) are causing the symptoms.

In addition, the doctor may suggest testing to find the specific allergen that is causing discomfort. In some cases subcutaneous immunotherapy (allergy shots) or sublingual immunotherapy (allergy drops under the tongue), or allergy tablets may be recommended. Immunotherapy is a method of treating allergies by desensitizing individuals to allergens over time, in many cases with the goal that they be cured of their allergies. ENT doctors are specially trained in the diagnosis and management of allergies.

Tips for reducing the exposure to common allergens

  • Wear a dust mask when mowing grass or cleaning house (most drugstores sell them).
  • Change your air filters regularly in heating and air conditioning systems and vacuum cleaners and/or install an air purifier. Consider a HEPA filter in your bedroom or other rooms where you spend a lot of time.
  • Keep windows and doors closed during heavy pollen seasons.
  • Rid your home of sources of mold and mildew.
  • If you have a pet, ask your ENT for suggestions to allow you to enjoy your pet while also enjoying a life free of allergies.
  • Remove carpet from bedrooms.
  • Use over-the-counter antihistamines and decongestants as needed and as tolerated. However, you should talk to your ENT doctor to make sure they are safe. Some patients do better with prescription medications when over-the-counter medications are not controlling their symptoms well.
  • Discuss hay fever and allergy symptoms with a physician when experiencing an allergic reaction.

© 2017  American Academy of Otolaryngology — Head and Neck Surgery