Advice from your Allergist: Six Things You Need to Know about Allergic Rhinitis
1. What is allergic rhinitis?
An allergy is your body's reaction to a substance that is normally harmless. With allergies, your body sees the substance as harmful or foreign and your immune system reacts to the substance. Substances that can cause an allergic reaction are called allergens.
Allergic rhinitis is a type of allergic reaction that causes nose, ear, and eye symptoms. Allergic rhinitis takes two different forms: seasonal and perennial.
Symptoms of seasonal allergic rhinitis surface in spring, summer and fall and usually caused by allergic sensitivity to pollens from trees, grasses or weeds, or to airborne mold spores. These allergens get into the air and cause a type of allergic rhinitis called hay fever. Other allergens, such as mites in house dust or animal dander, cause symptoms year-round a condition called perennial allergic rhinitis.
2. What is the cause?
Your immune system is your body's natural defense against bacteria, viruses, and other foreign substances. Before you can have a reaction to a particular substance, your immune system must first be sensitive to it. Usually this means your body has to have been exposed to the substance at least once before. Once it is sensitive to it, your body will react every time you have contact with the substance. The substances that most often cause allergic rhinitis are:
- Pollen in the air from grasses, weeds, and trees
- Mites (tiny bugs) in house dust
- Animal dander (dried skin flakes)
3. What are the symptoms?
Symptoms of allergic rhinitis may occur year-round or just during certain times of year, depending on what you are allergic to. Common symptoms are:
- Stuffy or runny nose
- Itchy nose, throat or ears
- Ear pressure or fullness
- Red, itchy, watery eyes
- Coughing, wheezing or shortness of breath
4. How is it diagnosed?
Your healthcare provider will ask about your symptoms and medical history and examine you. Tests may include:
- Blood tests
- A skin prick test, which uses a drop of allergen extract (liquid) put under your skin using a needle.
5. How do you manage allergy symptoms?
Avoiding exposure to allergens is the first step in managing allergy symptoms. For outdoor pollen allergies, remember that pollens from grasses, weeds and some trees can be carried through the air for miles. These pollens land in the eyes, nose and airways, causing the symptoms of allergies or asthma. Although it is hard to avoid pollens completely, some suggestions are:
- Keep doors and windows shut in the pollen season.
- Use an air conditioner, if you have one, in your house and car. If a room air conditioner is used, recirculate the indoor air rather than pulling air in from outside. Wash or change air filters once a month. Do not use window or attic fans.
- Stay away from trees and grasses as much as you can in the pollen season.
- After being outside during allergy season, shower and change your clothes right away.
- Do not keep the dirty clothes in bedrooms because there may be pollen on the clothes.
- Dry your clothes in a vented dryer, not outside.
- The worst time for pollen allergens is in the morning, so if you need to go out, do it after 10 AM.
For indoor allergens like dust mites and pet dander and indoor molds, the following environmental control measures may be helpful:
- Keep the pets out of bedroom and shut the door or at least try to keep pets off the bed and other furniture.
- Cover the pillows and mattress in allergen impermeable covers. Wash bedding in hot water weekly.
- Keep the humidity around 40-50% relative humidity to keep the dust mite growth down.
6. How is it treated?
Some symptoms are so mild that they don't need treatment. Several kinds of medicines may be used to treat your symptoms:
- Antihistamines are first line medications in treatment of allergies. Antihistamines block the effect of histamine. Histamine is a chemical your body makes when you have an allergic reaction. Do not give antihistamines to children under the age of 4. If your child is between the ages of 4 and 6, ask your healthcare provider before giving antihistamines.
- Oral decongestants can be used for short periods of time but use with caution in very young children or adults with heart or blood pressure or urinary issues. Use of nasal decongestant sprays like Afrin or Sinex is not recommended long-term due to problems with rebound congestion and habit forming.
- Steroid nasal sprays treat irritation and swelling in your nose. Regular use is important and you should be under the care of a physician if you are using them long-term.
- Immunotherapy is a type of treatment that includes shots or pills containing small amounts of the substances you are allergic to. It may take several months of treatment for your symptoms to decrease.
- If you have symptoms that come and go, you may be able to take a nonprescription decongestant or antihistamine. Ask your healthcare provider or pharmacist which medicine is best for you and how to use it. Nonprescription medicine may have side effects. Read the label and take as directed.
- Your healthcare provider also may recommend eye drops to relieve your symptoms.
- Use "artificial tears" eye drops to help wash out your eyes. Antihistamine eye drops may help, too. You can get these eye drops at the store without a prescription.
- You may find that nasal saline rinses help. This can remove dirt, dust and pollen, and help to loosen thick mucus. Saline rinses also can help to relieve symptoms of allergic rhinitis. You can buy a nasal saline rinse kit at the store, or you can make your own: Mix 8 ounces of water (1 cup) with 1/2 teaspoon of non-iodized table salt and a pinch of baking soda. Use lukewarm distilled or previously boiled water. Having the right mix helps prevent irritation.
- If you smoke, try to quit. Cigarette smoke can make hay fever symptoms worse. Also try to stay away from others who are smoking.
- Follow the full course of treatment prescribed by your healthcare provider. Make sure you know when you should come back for a checkup. Keep all appointments for provider visits or tests.
Fatima Mohiuddin, MD is an allergist at SwedishAmerican's Brookside Specialty Center, 1253 North Alpine Road, in Rockford. For more information, or to schedule an appointment, call (779) 696-9201.