Allergic Conditions

Seasonal Allergies

What are seasonal allergies? - Seasonal allergies, also called “hay fever,“ are a group of conditions that can cause sneezing, a stuffy nose, or a runny nose. Symptoms occur only at certain times of the year. Most seasonal allergies are caused by:
· Pollens from trees, grasses, or weeds (figure 1)
· Mold spores, which grow when the weather is humid, wet, or damp

Normally, people breathe in these substances without a problem. When a person has a seasonal allergy, his or her immune system acts as if the substance is harmful to the body. This causes symptoms. Many people first get seasonal allergies when they are children or young adults. Seasonal allergies are life-long, but symptoms can get better or worse over time. Seasonal allergies sometimes run in families. Some people have symptoms like those of seasonal allergies, but their symptoms last all year. Year-round symptoms are usually caused by:
· Insects, such as dust mites and cockroaches
· Animals, such as cats and dogs
· Mold spores

What are the symptoms of seasonal allergies? - Symptoms of seasonal allergies can include:
· Stuffy nose, runny nose, or sneezing a lot
· Itchy or red eyes
· Sore throat, or itching of the throat or ears
· Waking up at night or trouble sleeping, which can lead to feeling tired during the day

Is there a test for seasonal allergies? - Yes. Your doctor will ask about your symptoms and do an exam. He or she might order other tests, such as a skin test. A skin test can help figure out what you are allergic to. During a skin test, a doctor will put a drop of the substance you might be allergic to on your skin, and make a tiny prick in the skin. Then, he or she will watch your skin to see if it turns red and bumpy.

How are seasonal allergies treated? - People with seasonal allergies might use one or more of the following treatments to help reduce their symptoms:
· Nose rinses - Rinsing out the nose with salt water cleans the inside of the nose and gets rid of pollen in the nose. Different devices can be used to rinse the nose.
· Steroid nose sprays - Doctors often prescribe these sprays first, but it can take days to weeks before they work. (Steroid nose sprays do not contain the same steroids that athletes take to build muscle.)
· Antihistamines - These medicines help stop itching, sneezing, and runny nose symptoms. Some antihistamines can make people feel tired.
· Decongestants - These medicines can reduce stuffy nose symptoms. People with certain health problems, such as high blood pressure, should not take decongestants. Also, people should not use decongestant nose sprays for more than 3 days in a row. Using these nose sprays for more than 3 days in a row can make symptoms worse.
· Allergy shots - Some people with seasonal allergies choose to get allergy shots. Usually, allergy shots are given every week or month by an allergy doctor. Many people find that this treatment reduces their symptoms, but it can take months to work.

Reference: Patient information: Seasonal allergies (The Basics) In: UpToDate, Basow, DS (Ed), UpToDate, Waltham, MA, 2012.

Allergy Testing and Procedures:

Skin Tests: Skin testing is most often performed to evaluate patients with nasal allergies, asthma, food allergies, hives or insect venom allergy. Skin tests are performed to identify what you may be allergic to (e.g., pet dander, pollens, dust mites, foods, bee venom). A small amount of allergen is put into your skin by making a small indentation or “prick“ on the surface of your skin. If you are sensitive to the allergens, a positive reaction (red, itchy bump) will occur within 15 minutes. If skin testing is recommended, we require patients to be off of antihistamines for 5 days prior to the test.

Spirometry: This is an in office breathing test that measures air flow and volume to diagnose and evaluate patients with asthma. The NIH Asthma Guideline recommend spirometry at initial assessment, after treatment and symptoms have stabilized and at least once yearly to assess the maintenance of airway function.

PATCH Testing for patients with eczema or dermatitis. Red, itchy, inflamed skin may result from an allergic reaction to substances in skin care products, makeup, soaps, clothes, dyes, rubber products, leather, metals, medications and other products that your skin may come in contact with. PATCH testing is the gold standard for identifying whether a substance is causing or aggravating your dermatitis.

Figure 1

Other Patient Services:

  • Immunotherapy
  • Training on how to use
    a. Inhalers, Nebulizers
    b. Epipens
    c. Peak Flow Meters
    d. Valved Holding Chambers(Spacers)
    e. Nasal saline spray, irrigation, sinus rinse, netty pot
  • Patient Education
    a. Avoidance to pollens, dust mites, dander, mold spores
    b. How to read a food label, avoiding cross reactive foods, dietary counseling
    c. Medication side effects
  • Asthma Action Plan
  • Food Action Plan
  • Anaphylaxis Action Plan
  • School forms for medication authorization
  • Desensitization to aspirin
  • Oral food challenges