Spring Allergy Season Has Arrived in Sumner County
April 6, 2023
Many of our fellow county residents are appreciating nasal congestion, runny noses, sneezing, and post-nasal drainage known as allergic rhinitis (or “hayfever”) this time of the year. Individuals with allergic rhinitis may also develop itchy watery eyes (allergic conjunctivitis), asthma exacerbations, sinusitis and itchy irritated skin (atopic dermatitis).
What medications are your taking for allergic rhinitis?
Allergy patients now have access to a growing number of over-the-counter and prescribed medications.
Intranasal corticosteroids (fluticasone, triamcinolone, mometasone) can be effective in treating nasal congestion, sneezing, and a runny nose. Intranasal corticosteroids are typically employed for daily use since they take time to become fully effective.
The newer oral “second-generation” antihistamines (cetirizine, fexofenadine, and loratadine) are designed to treat an itchy, sneezy nose. They can be used on an as needed or daily basis. Intranasal antihistamines (azelastine) are now available prescription and over-the-counter.
The leukotriene blockers (montelukast) were originally approved to treat asthma. However, it became apparent that they are helpful in treating allergic rhinitis in some individuals.
It is important to select the appropriate combination of medications for each individual.
What are the side effects of your allergy medications?
Older (first-generation) antihistamines (diphenhydramine, chlorpheniramine, hydroxyzine) can trigger sedation and performance impairment.
Decongestants (pseudoephedrine) can increase blood pressure, elevate heart rate, and lead to insomnia.
Intranasal spray can lead to local irritation and nasal bleeding.
Do you know what your allergy triggers are?
Although our local tree and grass pollen levels are abundant, the most common allergy trigger in Tennessee is house dust mites. 50% of homes have at least six detectable allergens present.
Skin testing by a board-certified allergist can identify specific triggers within 20 minutes of placement. In some cases, a blood test may be appropriate.
Allergists commonly test to pollens (trees, grasses, weeds), dust mites, cats, dogs, molds, and cockroaches. Food testing and tests to other animals are also frequently utilized.
Some patients’ nasal symptoms are not triggered by pollens, pets, molds, and dust mites, a condition known as non-allergic rhinitis. Fragrances, potpourri, tobacco smoke, strong odors, weather changes, and a deviated septum can trigger symptoms.
What environmental control measures are appropriate for you?
The most common local allergen is house dust mites. The average bedroom in central Tennessee is estimated to contain 500 house dust mites per gram of dust. A carpet-free bedroom and vapor proof pillowcase and mattress covers can improve symptoms in allergy suffers who are sensitive to dust mites.
Reduced exposure to pets can be helpful in patients who are allergic to pets. Allergy testing can help guide whether patients would or would not benefit from avoiding pets.
Some patients may improve with nasal rinse or nasal saline.
Reducing exposure to strong odors, tobacco smoke, and fragrances can also potentially be helpful.
Would allergen immunotherapy (or allergy shots) be helpful?
Some patients can improve from a desensitization regimen by receiving gradually injecting amounts of allergens (such as pollen, pets, and dust mites) once or twice a week until the top (or maintenance) dose is reached. At the maintenance dose, injections are administered every two to four weeks, generally for three to five years. All doses must be administered in a physician’s office with a thirty-minute waiting period.
Do allergies ever require hospitalization?
Allergic rhinitis is typically treated in homes, clinics, and physician's offices. Other allergies including allergic asthma, food allergies, anaphylaxis, and medication allergies occasionally require Emergency Department visits and hospitalization.
Board-certified allergists are trained to test for allergies, direct medical management and environmental control, discuss potential side effects, and administer allergen immunotherapy.