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Column originally published Jun 18, 1997

There Is Help For Spring Allergy

Question: We have a very allergic family. Everyone suffers from some allergy problem each spring. We have itchy eyes, itchy nose, sneezing and coughing. We cannot figure out what we are allergic to, and how to deal with our problem. Can you please help?

Answer:

Your family has a problem that is very common around here. It is estimated that in the Maritimes, up to 20% of people have some kind of allergy condition. This can be in the form of hayfever, with itching and swelling of the eyes, sneezing, itchy and stuffy nose, as well as scratchy or itchy throat. It can also affect the bronchial tubes of the lungs and cause asthma symptoms like coughing and wheezing.

The most common triggers for allergy in spring are mostly outdoor allergens: pollens from trees and grasses as well as mildew. People affect by these triggers are miserable during this “allergy season,” although they can be quite healthy the rest of the year.

It is not easy to find out the triggers that affect an individual, and the triggers may be different even among family members. The most effective way to identify triggers is by keen observation. If a person develops allergy symptoms after running through a clover field, the likelihood is that he or she is allergic to clover. Similarly, if a child starts sneezing after playing in a freshly cut lawn, grass can well be an important factor.

Skin test is often recommended for people with allergy. Drops of test material are placed on the skin, usually on the arm of adults and the back of children. The skin under the drops is scratched to stimulate a reaction, that is why it is also called scratch test. After 30 minutes, redness or swelling will develop in the skin under the test material if allergy is present. Unfortunately, it is not a very sensitive test: only about 50% of allergic people will have positive results. A negative test does not mean that the person has no allergy.

The best way to prevent allergy symptoms is to avoid contact with triggers. I don’t mean that allergic people should stay indoors all the time during allergy season. However, there are several general rules which can be helpful. If tree pollen is a known trigger, keeping the windows closed at night until late morning; this can reduce pollen entering the house. Tree pollens tend to be most abundant in early morning hours. Using an air-conditioner can also filter out and prevent pollens from entering the house. Hanging clothes and sheets outside can also trap large amounts of pollen and bring them indoors. Drying clothes and other items in the dryer during pollen season can reduce allergy symptoms.

Unfortunately, many allergy sufferers are still miserable this time of the year after following these preventative measures. Some of them have to use medications to control their allergy symptoms so that they can enjoy this beautiful season. A number of new long-acting antihistamines are available. These medications are effective for twelve to 24 hours and can be taken once or twice a day, depending on the severity of the symptoms. They have very little side effect and can control most of the hayfever symptoms.

Some people have more localized allergy symptoms and prefer to use medicine locally. If itchy eye is the only concern, antihistamine eyedrops are available and can be quite effective. In the same way, itchy nose and sneezing can be controlled by steroids through a nose spray or Turbuhaler. Those who develop asthma symptoms with coughing, wheezing and shortness of breath as a result of allergy should use inhaled steroids during the allergy season.

For best results, these medications should be started early in the allergy season instead of waiting until the problems are serious. At that time, sneezing and stuffy nose can block sinus openings, leading to sinus infection. If this happens, antibiotics may be necessary on top of allergy medicine. Steroid nose spray may not work because of swelling inside the nose. Sometimes a local decongestant is required to reduce the swelling before steroid nose sprays can be effective. You should discuss with your doctor before using any of these medications.

Allergy shots have also been used to control allergy. It is difficult to be certain whether an individual is going to improve after taking allergy shots. To be effective, many injections are required over a long period of time. This can be an option for adults, but most children would rather take medicine instead of needles.

Finally, some allergy sufferers wonder whether they are better off if they move to another part of the country. The short answer is no. Most of them will develop allergy to things in their new environment after one or two seasons.