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Seasonal Allergies (Allergic Rhinitis)

  • The body's immune system overreacts to outdoor stimulants such as mold spores and pollen
  • Symptoms include itchy, watery eyes; tickly throat; and stuffy, runny nose
  • Treatments include over-the-counter or prescription medicines, sometimes allergen immunotherapy
  • Involves allergy & clinical immunology, internal medicine, pediatrics

Overview

If you’re one of the 50 million Americans who suffers from allergies, your symptoms may bloom when the seasons shift. Itchy, watery eyes, a tickly throat, and a stuffy, runny nose can make you dread springing ahead—and falling back. Likely triggers include tree pollen, grass, mold, and ragweed.

Whatever the cause, allergies can make you feel miserable. “One aspect of allergies is that you can be really tired or fatigued, so it wipes you out,” says Christina Price, MD, a Yale Medicine allergist and immunologist. The fatigue can cause confusion about the source of your discomfort: Do you have allergies or a cold? It matters because you should treat them differently.

At Yale Medicine, our allergists help determine if you do have allergies, and if so, what you’re reacting to and what treatments will help you. They care for patients with the entire spectrum of allergic and immunologic disorders. In addition to treating seasonal allergies, they also focus on allergic sinusitis, chronic sinusitis, asthma, and other complex allergy-related conditions associated with food and medications. Our goal is to help pinpoint what’s causing your allergic flare-ups and manage them—so you can get back to enjoying the activities you love.

What are allergies?

When you come in contact with a substance that you’re allergic to, called an allergen, your immune system treats it as an intruder. In response, your immune system releases chemicals such as histamines, leukotrienes and prostaglandins, which cause a cluster of allergic symptoms: runny eyes and nose, itchy, watery eyes, sneezing and coughing.

The severity of your reaction depends on how much of a threat your body perceives an allergen is. Take pollen, for example. “Most people don’t have an immune response to pollen, but a certain percentage of people’s immune systems see it as foreign and dangerous and they treat it like a pathogen or infection,” says Dr. Price. 

When people who are allergic to it breathe in, pollen that was in the air gets trapped in their nasal passages. The pollen particles stick to mucus membranes, causing inflammation and irritation to the nose and eyes. For those who suffer extreme reactions, their breathing is affected, and they may develop asthma.

What are common seasonal allergy symptoms?

  • Congestion
  • Sneezing
  • Itchy eyes, nose and throat
  • Runny nose and eyes
  • Post nasal drip (drainage in the throat)
  • Fatigue
  • Coughing

What are the most common seasonal allergens and when do they occur?

  • Tree pollen—March/April
  • Grass pollen—June/July
  • Ragweed—Fall
  • Mold—Fall

Not all environmental allergies are seasonal. So-called “perennial allergies” can affect you all year long. They include allergies to cat hair and dust mites.

What is an allergy test?

An allergist performs tests to pinpoint the cause of your allergic reactions.

There are two kinds of tests:

  • Skin tests: The doctor pricks the surface of the skin, usually on the upper arm, and injects a tiny amount of suspected allergens. If an allergy exists, the skin will react by becoming inflamed, red and swollen, which may cause temporary discomfort. Skin tests give fast results—usually within a half hour or 24 to 48 hours.
  • Blood tests: Blood is drawn and sent to a lab. The disadvantage is that it may take several days for the results to come back. However, more allergens can be tested with blood tests than with skin tests, Blood tests are used to identify seasonal allergies as well as perennial allergies, plus allergies to food, medications, and insect bites or stings. If you have chronic skin conditions such as psoriasis or eczema, blood tests are recommended instead of skin tests to prevent further irritation.

It’s important to tell your allergist about any medications you are taking because some can compromise your allergy test results.

How are seasonal allergies treated?

Seasonal allergies are treated in a variety of ways. Most often, over-the-counter or prescription antihistamines help suppress the body’s immune response, providing relief from symptoms. Decongestants can be used to relieve congestion. Over-the-counter cough medications are commonly recommended as well.

For people who need additional relief, antihistamine or steroidal nose sprays can be prescribed by your doctor. These help calm the body’s immune response to seasonal airborne allergens.

If you need more specialized care, your doctor may recommend allergen immunotherapy. This helps your immune system build up a tolerance against an allergen by exposing you to the irritant in small doses. Allergen immunotherapy can be given in two ways:

  • Subcutaneous injections: Once your doctor determines what you’re allergic to, she administers a series of shots containing those specific allergens. The shots are given in the doctor’s office over many months or years, usually in the arm.
  • Sublingual immunotherapy: As an alternative to injections, you can try prescription tablets or drops that dissolve under the tongue (sublingually). Sublingual immunotherapy is only available for grass and ragweed allergies, however.

Are there ways to reduce your allergy exposure?

Here are several ways to minimize your exposure to seasonal allergies:

  • Pay attention to daily pollen and mold spore levels, so you can avoid outdoor activities as much as possible when counts are high. To check out the American Academy of Allergy Asthma & Immunology’s allergen tracker, click here.
  • Begin taking medications before the start of the allergy season—when pollen, grass, ragweed, or mold counts soar.
  • Shut the windows and doors in your home, office, and car to seal out pollen.
  • Wear a hat when outdoors or wash your hair before bed to keep pollen off your pillow and away from your face.
  • Change your clothes after spending time outdoors to minimize your exposure to pollen. Studies show that half of the pollen that accumulates on clothing remains even if you try to shake or brush it off before you go indoors.
  • Avoid mowing the grass or raking moldy leaves if those are your triggers, or wear a mask when doing so.

Does Yale Medicine offer specialized allergy care?

Yale Medicine’s Allergy & Clinical Immunology physicians have  expertise in diagnosing and treating allergies and immunologic diseases. The department schedules weekly conferences to guide care of complex allergy cases, so patients benefit from multiple expert opinions.

In addition, we conduct research to determine the molecular basis of allergic disorders in order to develop new ways to treat people with allergies. Our goal is to help you better enjoy the seasons as they turn by keeping the achoos in check.