Spring is in the Air: A Guide to Seasonal Allergies

Meredith Porter, MD is a board certified family physician with 23 years of clinical experience and a lead physician for Inova Urgent Care. Inova Urgent Care centers are open seven days a week – including holidays, except Christmas Day – and treat walk-in patients of all ages. Select centers offer specialized pediatric care where staff is cross-trained in pediatric emergency medicine. Click here to learn more about Inova Children’s Urgent Care services.

Flowers are blooming.  Green grass and leaves are sprouting everywhere.  Spring brings sunshine, warmth and color to our world.  But, for all its beauty, spring also brings pollen – a common trigger of seasonal allergies (also known as allergic rhinitis or hay fever).  Symptoms often include sneezing, itchy eyes and a stuffy nose. 

Allergic rhinitis is common and affects one in every six children and adults in the United States.  The onset can happen at any age from childhood through adulthood.  Most suffer from allergic rhinitis seasonally – typically in the spring, summer and early fall – when there’s an influx of mold spores and grass, tree and weed pollens floating in the air.  Allergy symptoms tend to be worse on windy days as pollen and grasses blow in the breeze.  Allergy symptoms may also occur perennially – or, year-round – from exposure to dust mites, pet hair or dander, cockroaches and mold.

Common allergy symptoms

Common symptoms of allergic rhinitis include:

• Nasal congestion
• Runny nose
• Coughing
• Itchy, watery or red eyes
• Sneezing
• Frequent clearing of the throat due to postnasal drip

Less common symptoms can include:

• Sinus pressure
• Facial discomfort
• Decreased sense of taste
• Scratchy throat
• Breathing problems – allergic rhinitis can worsen breathing problems for people with asthma. Click here to learn more. <hyperlink to asthma/allergies blog>

Children may only complain of fatigue and cough.  They may also have darkening or puffiness of lower eyelids, known as “allergic shiners.”   Chronic allergies can cause children to frequently rub their nose and breathe through their mouth more often.

How is allergic rhinitis diagnosed?

Allergic rhinitis is most commonly diagnosed based on your symptoms and a medical exam. However, specific allergy testing can be performed by an allergist. Skin and blood allergy testing can help identify specific triggers and target treatment. Allergy shots – or, immunotherapy – build tolerance to the offending allergen(s), but can have side effects and therapy may continue for several years.

How do I treat allergic rhinitis? Avoid triggers!

The best approach to allergy treatment includes avoidance:

• Stay indoors on days with high pollen counts. Pollen count levels can be found online by zip code at https://www.pollen.com/. Counts are also reported on local news stations. 

• Keep windows closed

• Wear glasses or sunglasses to keep pollen out of eyes

• Use air conditioners in homes and cars

• Shower or bathe after being outside

• Use nasal saline to flush nasal cavities

• Humidifiers can be used in bedrooms

• Check and change air filters when dirty or every three months

Other treatment options include eye, nasal or oral medications:

Treatments for watery, itchy eyes:

• Artificial tears can dilute allergens

• Avoid rubbing eyes

• Cold compresses are helpful

• Over the counter antihistamine eye drops are effective for local eye symptoms

For nasal congestion, sneezing and runny nose:

• Steroids: Intranasal steroids are the most effective medicine to treat symptoms of allergic rhinitis.  However, full relief may not occur for several days.   For proper use, the sprays are aimed away from the septum (midline of nose).

• Antihistamines: Intranasal antihistamines may also aid in local symptom relief and can work faster than oral antihistamines. Common side effects include bitter taste, nosebleeds, headache and nasal burning. 

Newer over-the-counter oral antihistamine medications (Cetirizine, Fexofenadine or Loratadine) tend to have little sedation compared with the older antihistamines (Diphenhydramine or Benadryl).  Children under two years of age should not use antihistamines unless advised by your doctor.

• Oral decongestants:  Over-the-counter oral decongestants (Pseudoephedrine) can be used to help alleviate a stuffy nose and sinus pressure, but they can cause insomnia.  Decongestants should not be used in patients with high blood pressure or children under six years of age unless advised by your doctor. 

Additional medications can also be prescribed by your doctor if symptoms persist after trying the options above.

Inova Urgent Care wishes you a healthy, safe and wonderful spring!