Winter Allergic Asthma Challenges

Dealing with Seasonal Allergic Asthma

Regular doctor visits during the winter can prevent asthma attacks.

You may not think of winter as being a season for allergic asthma, but it all depends on what your particular allergy and asthma triggers are. There are definitely certain allergens, as well as irritants, that are more likely to present problems during the winter months, when colder weather forces you to be cooped up indoors for more hours each day. And, before you know it, you're dealing with sneezing, wheezing and coughing once again.

Common winter allergy and asthma symptoms can include:

Kids with allergic asthma may also have what is known as the allergic salute, where they rub their noses upward because of itching and have allergic shiners, which are dark circles under the eyes caused by nasal congestion. These are all just the typical symptoms of winter allergy and asthma sufferers.

Don't make These Winter Asthma Mistakes

I see patients make 5 common mistakes in winter that can lead to poor asthma control:

  1. Not getting a flu vaccination.
  2. Not having an action plan for when the weather turns cold.
  3. Failure to identify winter triggers of asthma symptoms.
  4. Not having a rescue inhaler available.
  5. Forgetting to take your medications regularly.

Common Winter Allergens and Irritants

Allergic asthma symptoms can come and go at any time of the year.

Winter presents some unique challenges, in that both indoor and outdoor triggers can set off symptoms. Being indoors so much exposes you to substances that you may not notice so much when you're splitting your time between the indoors and outdoors during the other seasons. Plus, turning on the furnace can stir up dust, pollen and other allergens from filters, vents and carpets.

Some common indoor allergens that are especially active in the winter are:

In addition, there may be some triggers that are known as irritants that are more likely to be encountered in the winter. Irritants don't produce the allergic reaction that allergens do, but they do further irritate already inflamed airways in people with allergic asthma.

The most common irritants during the winter months would be:

It's also important to note that if you live in an area that never really gets that cold, such as Florida or other southern United States, outdoor allergens, such as pollen and molds, may never really go away completely, triggering symptoms year-round.

Influencing Factors

Most indoor triggers are affected more by the cleanliness of the indoor environment than anything else. It's almost impossible to ever get rid of indoor allergens entirely but keeping a clean home does help.

Winter weather will vary greatly from region to region, but if you live in a place where winters are cold, then cold, windy air can be a frequent irritant whenever you leave the home.

Cold weather may also mean more wood fires and smoke to irritate your airways. In certain areas too, such as the mountain west in the United States, temperature inversions can cause smoke and pollution to lie like a blanket over the lower atmosphere for days at a time. In more temperate climates, winter may bring lots of rainy damp weather, which can mean higher levels of mold spores.

How Winter Allergies and Asthma Are Diagnosed

If you notice that your allergic asthma symptoms crop up — or worsen — during the winter months, there's a good chance that you have winter allergies. To find out for sure, make an appointment to see your doctor. Your doctor may decide to refer you to an allergist, who can do formal allergy testing to find out exactly what triggers you may be reacting to.

Dealing with Seasonal Allergic Asthma You may not think of winter as being a season for allergic asthma, but it all depends on what your particular allergy and asthma triggers are. There are definitely certain allergens, as well as irritants, that are more likely to present problems during the winter months, when colder weather forces you to be cooped up indoors for more hours each day. And, before you know it, you're dealing with sneezing, wheezing and coughing once again.

Common winter allergy and asthma symptoms can include:

Kids with allergic asthma may also have what is known as the allergic salute, where they rub their noses upward because of itching and have allergic shiners, which are dark circles under the eyes caused by nasal congestion. These are all just the typical symptoms of winter allergy and asthma sufferers.

The good news is, there is no reason why you just have to "grin and bear it" during the winter with allergies and asthma symptoms. There are easy steps you can take to keep symptoms from interfering with your life, work and school. A combination of preventive actions and medication are usually all it will take.

Preventive Actions You Can Take

Here are some of the best preventive actions you should work on:

  • Pay attention to weather forecasts for your area. When the weather is especially dry and cold or wet and rainy, it may make sense to stay indoors as much as you can. If you must go outdoors in cold weather, wear a neck scarf or gaiter that you can pull up over your mouth to warm the air you breathe in.
  • Maintain a clean environment. Vacuum and dust the house at least weekly to keep dust mites and other allergens from settling.
  • Avoid having wood fires in the home if you are sensitive to smoke. If you don't want to stop using your fireplace or woodstove, then at least make sure it's well-maintained and vented.

You'll find a number of other strategies for avoiding mold here and for avoiding dust mites. There are a few more tips on avoiding pet dander and secondhand smoke here.

Medications You Can Take

There are a number of medications that can be used to treat winter allergies and asthma. For asthma, you should be taking your inhaled steroid every day as prescribed to prevent symptoms, and using your rescue inhaler if symptoms do arise.

(If you need to use it twice a week or more, though, it's time to call the doctor for a more effective preventive medicine.) Medications used to treat winter allergy symptoms can include:

  • Oral Antihistamines. Antihistamines are the most tried and true medications for treating most allergy symptoms. They work directly on the underlying allergic response. They can include first-generation medicines, such as Benadryl (diphenhydramine) and Chlortrimeton (chlorpheniramine). These are cheap and available over the counter and generally effective but can make you feel drowsy. The newer antihistamines, such as Claritin, Zyrtec and Allegra are effective and nonsedating but may be more expensive. Claritin and Zyrtec are both available over the counter, but Allegra is not. Some antihistamines are also combined with a decongestant to combat nasal congestion.
  • Nasal decongestant sprays. These can work well for relieving nasal symptoms on a short-term basis, but they cannot be safely used throughout the fall allergy season. If they are used too much, they can actually make nasal symptoms worse.
  • Nasal steroid sprays or nasal chromolyn sodium. These prescription nasal sprays, such as Flonase, are some of the most effective medicines, and because they act only where needed, they are also some of the safest.
  • Eye drops. There is a wide variety of eye drops that can be used for eye allergies. Use caution in using drops, such as Visine Allergy, though, as they can make symptoms worse if overused. Natural tears type eye drops are the gentlest and may work for mild symptoms. More severe symptoms may respond well to an antihistamine eye drop, such as Alaway or Zaditor, both of which are available over the counter. There are also prescription eye drops available that may be helpful.

For those who want a more "natural" approach, a saline nasal rinse/irrigation is both gentle and effective.

The idea is to wash out molds, other allergens and mucus from the nasal passages by flushing them with salt water (saline). These preparations are available over the counter in most drug stores.

In Summary

If your allergies and asthma get worse in the winter months, don't feel as though you just have to suffer. Take action! You can feel better and continue to live a full and active life, even in the face of winter allergies. Talk to your doctor to develop an allergy and asthma management plan that makes sense for you. If you take an oral antihistamine, it can take up to 2 weeks for it to reach full effectiveness, so be sure to take it regularly if you expect winter allergies to be an issue for you.

When you have allergies, it's important to stay on top of the symptoms, so that you can nip them in the bud quickly. When nasal allergies spiral out of control, asthma often follows, even if it has been stable before.

Sources:

American Academy of Allergy Asthma & Immunology. "Allergic Rhinitis." . AAAAI. 13 Apr 2008

AAAAI, "Tips to remember: indoor allergens." American Academy of Allergy Asthma & Immunology. 01 January 2006. AAAAI. 31 Aug 2008 http://www.aaaai.org/patients/publicedmat/tips/indoorallergens.stm

"Expert Panel Report 3: Guidelines for the Diagnosis and Management of Asthma." NHLBI Guidelines for the Diagnosis and Treatment of Asthma. 28 Aug 2007. National Heart Lung and Blood Institute. 18 Dec. 2007 <http://www.nhlbi.nih.gov/guidelines/asthma/asthgdln.pdf>

"Tips to remember: outdoor allergens." 2007. American Academy of Allergy Asthma & Immunology. 31 May 2008

It's Time to Take Control The good news is, there is no reason why you just have to "grin and bear it" during the winter with allergies and asthma symptoms. There are easy steps you can take to keep symptoms from interfering with your life, work and school. A combination of preventive actions and medication are usually all it will take.

Preventive Actions You Can Take

Here are some of the best preventive actions you should work on:

  • Pay attention to weather forecasts for your area. When the weather is especially dry and cold or wet and rainy, it may make sense to stay indoors as much as you can. If you must go outdoors in cold weather, wear a neck scarf or gaiter that you can pull up over your mouth to warm the air you breathe in.
  • Maintain a clean environment. Vacuum and dust the house at least weekly to keep dust mites and other allergens from settling.
  • Avoid having wood fires in the home if you are sensitive to smoke. If you don't want to stop using your fireplace or woodstove, then at least make sure it's well-maintained and vented.

You'll find a number of other strategies for avoiding mold here and for avoiding dust mites. There are a few more tips on avoiding pet dander and secondhand smoke here.

Medications You Can Take

There are a number of medications that can be used to treat winter allergies and asthma. For asthma, you should be taking your inhaled steroid every day as prescribed to prevent symptoms, and using your rescue inhaler if symptoms do arise. (If you need to use it twice a week or more, though, it's time to call the doctor for a more effective preventive medicine.) Medications used to treat winter allergy symptoms can include:

  • Oral Antihistamines. Antihistamines are the most tried and true medications for treating most allergy symptoms. They work directly on the underlying allergic response. They can include first-generation medicines, such as Benadryl (diphenhydramine) and Chlortrimeton (chlorpheniramine). These are cheap and available over the counter and generally effective but can make you feel drowsy. The newer antihistamines, such as Claritin, Zyrtec and Allegra are effective and nonsedating but may be more expensive. Claritin and Zyrtec are both available over the counter, but Allegra is not. Some antihistamines are also combined with a decongestant to combat nasal congestion.
  • Nasal decongestant sprays. These can work well for relieving nasal symptoms on a short-term basis, but they cannot be safely used throughout the fall allergy season. If they are used too much, they can actually make nasal symptoms worse.
  • Nasal steroid sprays or nasal chromolyn sodium. These prescription nasal sprays, such as Flonase, are some of the most effective medicines, and because they act only where needed, they are also some of the safest.
  • Eye drops. There is a wide variety of eye drops that can be used for eye allergies. Use caution in using drops, such as Visine Allergy, though, as they can make symptoms worse if overused. Natural tears type eye drops are the gentlest and may work for mild symptoms. More severe symptoms may respond well to an antihistamine eye drop, such as Alaway or Zaditor, both of which are available over the counter. There are also prescription eye drops available that may be helpful.

For those who want a more "natural" approach, a saline nasal rinse/irrigation is both gentle and effective. The idea is to wash out molds, other allergens and mucus from the nasal passages by flushing them with salt water (saline). These preparations are available over the counter in most drug stores.

In Summary

If your allergies and asthma get worse in the winter months, don't feel as though you just have to suffer. Take action! You can feel better and continue to live a full and active life, even in the face of winter allergies. Talk to your doctor to develop an allergy and asthma management plan that makes sense for you. If you take an oral antihistamine, it can take up to 2 weeks for it to reach full effectiveness, so be sure to take it regularly if you expect winter allergies to be an issue for you.

When you have allergies, it's important to stay on top of the symptoms, so that you can nip them in the bud quickly. When nasal allergies spiral out of control, asthma often follows, even if it has been stable before.

Sources:

American Academy of Allergy Asthma & Immunology. "Allergic Rhinitis." . AAAAI. 13 Apr 2008

AAAAI, "Tips to remember: indoor allergens." American Academy of Allergy Asthma & Immunology. 01 January 2006. AAAAI. 31 Aug 2008 http://www.aaaai.org/patients/publicedmat/tips/indoorallergens.stm

"Expert Panel Report 3: Guidelines for the Diagnosis and Management of Asthma." NHLBI Guidelines for the Diagnosis and Treatment of Asthma. 28 Aug 2007. National Heart Lung and Blood Institute. 18 Dec. 2007 <http://www.nhlbi.nih.gov/guidelines/asthma/asthgdln.pdf>

"Tips to remember: outdoor allergens." 2007. American Academy of Allergy Asthma & Immunology. 31 May 2008

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