Seasonal Allergies and Asthma

How's Your Asthma This Summer

Asthma and Allergy
Photo credit: American Academy of Allergy, Asthma and Immunology.. American Academy of Allergy, Asthma and Immunology.

With the onset of summer, you are probably spending a great deal of time outdoors. Whether you are headed to a barbecue, an outdoor wedding, family reunion or a picnic, you are likely to come in contact with all sorts of allergens. Have you noticed sneezing and being irritated by itchy, watery eyes since you began doing more outdoor things?

If your asthma control is not what it should be, it could be that your watery itchy eyes and sneezing are leading to wheezing!

Without some planning, your fun outdoor activity may turn into worsening asthma symptoms or a trip to the ED with an asthma attack.

What Are Seasonal Allergies?

Seasonal allergies, hay fever, and seasonal allergic rhinitis are all referring to the same thing— the sneezing, runny nose, scratchy throat, and irritated eyes that you may experience during summertime. These reactions are in response to your exposure to pollen and mold that are more common this time of year. The exposure sets off an immune response that causes the annoying symptoms.

Pollens are the tiny granules that fertilize plants. In addition to the symptoms described, you know it is pollen season when you see your car or outdoor furniture covered in the dust looking material. The pollen powder is easily spread by the wind and covers such objects. The early spring is mostly from tree pollens, while grass pollen are the culprit in the summer.

If it is warm most of the year where you live, you may have pollen exposure all year long.

Mold spores tend to cause symptoms as the summer warms up and are spread through the air just like pollen. Mold spores live in soil, on plants, and in rotting wood. They occur at their highest levels in late summer and early fall as temperatures rise and can be found year-round in warmer climates.

What Can I Do For My Seasonal Allergies and Asthma

As with most triggers, the best option is avoidance of the allergen. You can try a number of these strategies to limit your exposure this summer:

  • Use air-conditioning. The filters in your air-condition unit clean the air, while the drying and cooling of your air is also beneficial for your asthma. Additionally, keeping windows closed will prevent exposure of pollens aerosolizing into your home.
  • Keep car windows closed. Just as you don’t want pollen flying into your home, you do not want pollen in your car when traveling.
  • Check out pollen counts. If you are able to stay indoors on a ‘bad air day,’ you will have less symptoms. If you are not able to do this you may want to consider wearing a mask that filters air.
  • Change your clothes. If you are outside when pollen counts are high, you will bring the pollen home with you. To decrease exposure change out of clothes as soon as you return home and put the clothes worn into the wash. You may want to also consider taking a shower to wash off any pollen and mold that you were exposed to.
  • Don’t do the lawn. If you are not an asthmatic gardener, avoid raking leaves and cutting grass. These activities stir up pollen and molds and increase your risk for developing asthma symptoms.

What If These Conservative Measures Lead To A Suboptimal Result

You’ve tried these suggesting but am still having watery, itchy eyes and a scratchy throat. What are your next steps? Treatments are both over the counter and by prescription.

Over the counter, treatments include salt water nasal sprays. many of my patients love this treatment because, unlike prescription nasal inhalers, you can use them as much as you want without side effects and there is nor concern about dependence. A common brand you may see in your drug store is Ocean Spray.

Another over the counter treatment for the runny, itchy and watery eyes of summer allergies are antihistamines. This medicine (e.g. diphenhydramine or Benadryl) helps relieve itching, sneezing, and runny nose symptoms. However, be careful as the most common side effect of this over the counter product is fatigue and sleepiness. Pseudoephedrine is an over the counter product, often combined with antihistamines, that reduces nasal symptoms such as your stuffy nose.

Many patients also try alternative therapies such as butterbur, tinofend, or cinnamon bark. While there is some evidence for efficacy, users need to be aware of side effects such as liver problems with butterbur or tinofed.

Medication treatment options that require a prescription include:

  • Nasal steroids- one of the issues that I find with this medication is a lack of communication between doctor and patient. Patients want relief today, but this prescription medication like Flonase can take up to a week before patients notice an effect. They are one of the best medications for congestion and post nasal drip symptoms. Some people using this over longer periods of time develop bleeding from the nose.
  • Cromolyn Sodium- this treatment has few if any side effects, but is not as effective as nasal steroids and requires multiple doses per day
  • Leukotriene modifiers
  • Prescription antihistamines
  • Ipratropium

In some instances, you may need immunotherapy or allergy shots if the previously mentioned treatments do not provide adequate relief. This is a stepped up allergy treatment that makes your body less sensitive to the pollens and mold causing your symptoms. A newer form of this treatment is a pill that can be placed under the tongue.

Hopefully, any of these treatments will lessen not only your seasonal allergies but also:

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