For seasonal allergy sufferers, spring takes on a whole new meaning. Roughly 35 million Americans are saddled with a host of symptoms, leading to 3.4 million missed days of work.
For those who do make it to the office, a 25 percent decline in productivity is the norm. Allergies are also behind 2 million days of missed school and $3.4 billion in direct costs for prescriptions, doctor visits and more.
“The incidence of allergies in Western society is affecting more and more people, though no one’s quite sure why,” says Joseph Smith, an otolaryngologist with Ear, Nose and Throat Associates of Chester County.
Smith cites the so-called “hygiene hypothesis” as a potential cause. Our hyper-sanitized environment—vaccines, less exposure to outdoor pathogens, etc.—hasn’t required the ramped-up immune system of previous generations, who spent more time outdoors.
The most common cause of seasonal allergy symptoms is tree pollen. It’s found just about everywhere—especially in Pennsylvania, where nearly 60 percent of the state is covered by trees. And the news gets worse from there. As you read this, the pollination process is in full swing. Branches may be bare, but the stuff has been in the air since February—maybe ever earlier—thanks to this year’s unseasonably warm winter.
Moving into April and May, mold spores are another concern as temperatures heat up. “Mold does best in humidity, especially when there’s cool evenings and rain,” Smith says. “Then, during the day, when there are leaves on the ground and the temperature gets into the 60s, the spores really break out into the air.”
Classic allergy symptoms include runny nose, watery eyes and sneezing. More obscure side effects include chronic sinusitis, worsening asthma and ear infections—symptoms one may not always associate with allergies.
Among the different treatment options, the first is simply a modification of one’s daily schedule. “You can’t really live in a bubble, but you can decrease the problem by avoiding outside activity midday, when pollen counts are at their highest,” says Smith.
If you must be outside during that time, Smith recommends changing your clothes and washing your hair afterwards, since fabric and hair trap pollen.
When medical intervention is needed, the over-the-counter route typically involves antihistamines like Benadryl and Claritin. Smith tells patients to be wary of decongestants and nasal sprays, which may provide temporary relief but don’t treat the allergy itself. The body doesn’t always respond well to constant decongestion. When sprays like Afrin are used frequently, the immune system overreacts, and the rebound effect can be worse than the initial stuffiness, usually with increased swelling. On the other hand, prescription-based steroid sprays are perfectly fine to use on a daily basis, says Smith.
Often seen as a last resort, allergy shots modulate the immune system by restoring the balance among its response cells. “It essentially presents the allergen protein to the immune system, where the cells can build up a memory,” Smith says. “It modulates the system in a more controlled environment.”
Immunotherapy isn’t a cure, but it will reduce sensitivity to certain triggers. The dose and frequency of allergy shots or oral drops (placed under the tongue) vary depending on the severity of the symptoms, but they are quite effective. “They’re very safe,” says Smith. “And even though there’s the risk of anaphylaxis with the shot, it’s less than one percent—even less so with the oral drops.”
There’s also the homeopathic route. Anecdotal evidence supports certain methods, though some are less conventional than others. “Eating local pollen doesn’t work,” says Smith, drawing on his beekeeping experience.
And while even acupuncture may offer relief to some, it’s best to consult your physician for an allergy test, and then discuss the options from there. “It’s the gold standard,” Smith says. “It gives us the best results, so we can treat the allergy the best way we can.”