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 (allergen) 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 re-enters the body, the immune system rapidly recognizes it, causing a series of reactions. These reactions often involve blood vessel dilation, and production of many inflammatory substances, including histamine. Histamine produces common allergy symptoms such as itchy and watery eyes. It can also produce sneezing, stuffy nose, runny nose, scratchy throat, hives, and, shortness of breath. Other less common symptoms are eye irritations, skin problems such as eczema, and even breathing problems like asthma.

What are common allergens?

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

Early springtime allergic rhinitis 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. Often fragrant flowers are blamed for the uncomfortable symptoms, yet they are rarely the cause; their pollens are too heavy to be airborne. Late springtime pollens come from grasses like timothy, orchard, red top, sweet vernal, Bermuda, Johnson, and some bluegrasses. One of the major causes of allergic rhinitis in the United States is ragweed pollen. It begins pollinating early to mid-autumn.

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

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.

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 medication for allergies and the cost of lost work productivity, allergies cannot be considered a minor problem.

For some allergy sufferers, symptoms may be seasonal. For others allergies produce year-round discomfort. Symptom control is most successful when multiple approaches are used together to manage the allergy. They may include reducing exposure to allergens, medications, and allergy shots or drops. If used properly, medications, including antihistamines, steroid sprays, antihistamine sprays, and decongestants, can be helpful. Even over-the-counter drugs can be helpful, 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.
Copyright © 2015 American Academy of Otolaryngology–Head and Neck Surgery. Reproduction or republication strictly prohibited without prior written permission.