Maybe it starts with a sneeze or a cough. Or your eyes turn red and itchy. There’s no mistaking the cause: allergies.
Environmental allergies occur when the body mistakes something in the environment as a danger and develops a reaction to fight it off. Common triggers are animal dander, insect droppings, mold spores, pollen and dust.
Allergies can happen at certain times of the year—these are called seasonal allergies or hay fever—or year-round. About 1 in 4 adults and 1 in 5 children have seasonal allergies, according to the Centers for Disease Control and Prevention.
No matter what is causing them, there are ways to manage allergy symptoms, say Brent Senior, MD, and Charles Ebert Jr., MD, MPH, who are ear, nose and throat physicians at UNC Health.
“The bottom line is that allergies are a quality-of-life disease,” Dr. Senior says. “It can make you feel miserable. I’ve had patients come in who are very congested, and they’ve been living like that for years. Others are more sensitive and want to get rid of all symptoms. It’s a personal decision.”
If you’re suffering from seasonal allergies or other environmental allergies, take these steps to find relief.
Avoid Your Allergens
Environmental and seasonal allergies are hard to avoid, but a good first step is to try, Dr. Senior says.
“For example, if you are allergic to dogs, try to stay away from them,” he says. “Cats are more challenging. They have sticky, oily dander that gets on surfaces and is hard to remove. It gets in upholstery, carpet, draperies. People who are sensitive can react even if the cat hasn’t been there for some time.”
Avoiding other allergens is harder still.
“Dust is around us all the time,” Dr. Senior says. “You can try reducing dust by eliminating carpet, trading curtains and drapes for blinds, or using leather or vinyl furniture.”
You can also use a high-efficiency particulate air (HEPA) filtration system to remove allergens from the air, he says. Wash linens in hot water at least once a week, and use dust covers on pillows and bedding.
But none of these steps will completely rid your home of dust and mites, he says.
“It’s not a cleanliness issue, per se,” he says. “Dust and mites are everywhere, and it’s a challenge to reduce them.”
Take Over-the-Counter Medicines
Many medicines that help control allergy symptoms are available over the counter, meaning you don’t need a prescription to get them, Dr. Ebert says.
“It’s not terribly important to know what you’re allergic to,” he says. “The over-the-counter medications will usually control symptoms for most people.”
Antihistamine pills or sprays can offer temporary relief within about 30 minutes, he says. For lasting relief, he recommends nasal steroid sprays.
There’s a catch: It can take weeks or months of regular use before nasal steroids significantly relieve symptoms. “A lot of people give up after a week or two if they’re still having symptoms,” Dr. Ebert says. “We recommend at least three months of regular use before discontinuing the medication.”
For this reason, allergy sufferers should start using nasal steroids several weeks before known seasonal allergens appear, meaning about mid-July for fall allergies and mid-February for spring allergies, he says. People who have symptoms all year will benefit from using nasal steroids all year.
Another vital step is knowing how to use the spray correctly, he says. “You don’t just spray it straight up your nose,” he says. “Tilt your head forward a small amount, insert the applicator in your nose and aim it toward the outside corner of your eye on the side you’re spraying. Squirt, then sniff.” If you are taking two squirts per nostril, alternate sides between sprays, he adds.
Dr. Ebert also recommends washing out your sinuses with buffered saline nasal irrigation (a neti pot or squeeze bottle) to clear out mucus, pollen and dust before using nasal steroids.
Antihistamine pills can be helpful if you know you are going to be exposed to something you’re allergic to, Dr. Senior says. “Maybe you’re going to see a friend or family member who has a pet,” he says. “If you take an antihistamine before you go, it can give you some relief.”
Talk to Your Doctor About Immunotherapy
If over-the-counter medicines are not providing relief, you might consider seeing a doctor about allergy shots or allergy drops. These immunotherapies can help desensitize you to the environmental allergens that are causing your coughing, sneezing and red, itchy eyes.
“We give the patient tiny doses on a regular basis of the things they’re allergic to,” Dr. Senior says. “We try to train the immune system not to react against these allergens.”
Often, people get allergy shots in the doctor’s office. Usually, they start off weekly. Some people learn how to give themselves the shots, but they still get the medicine from their doctor. After two or three years, the doctor may retest for allergies to determine whether the person is still allergic. If there is no reaction to the test, then treatments can be stopped.
Allergy drops are an alternative to shots, Dr. Senior says. These come in a vial, and the person puts a few drops under the tongue. The drops are quickly absorbed.
“We start with low doses and gradually increase the dose until the patient is getting the full concentration,” says UNC Health certified medical assistant Loytoa Torain. “With weekly shots, it takes about a year to get up to full concentration. The daily drops take about 12 weeks to get up to full concentration. Once you get through the buildup phase, you hit the maintenance phase, and that’s where you’ll stay for the remainder of your therapy.”
Many people prefer drops to getting a shot in the arm every week, Torain says, but most insurance plans do not cover the drops.
See Your Doctor If Symptoms Get Worse
Allergies can get worse over time if they are not treated, Dr. Ebert says. Some people can develop asthma if their allergies are untreated.
“Both allergies and asthma are inflammation,” he says. “Allergies are inflammation in the nose, and asthma is inflammation in the lungs.”
Also, nasal polyps and chronic sinusitis may develop if allergies are not controlled, he says.
Surgery May Help When Nothing Else Works
Some surgical procedures reduce stuffiness in the nose, although they don’t eliminate allergies, Dr. Senior says.
“It depends on the patient,” he says. “Some people want to reduce their allergy medicines, and they don’t want to do immunotherapy, but they still want to feel better. There are potentially some procedures that can be done.”
If ragweed, dust, mold or other environmental allergens are making you miserable, see your primary care doctor. Need a doctor? Find one near you.