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Allergic Rhinitis

After the long cold snowy winter most people look forward to warm spring days. However, nothing ruins a spring day quicker than allergy symptoms. Allergies occur when the body is exposed to substances that trigger an inflammation in the eyes, nose and throat. In allergy patients the immune system is hypersensitive and overreacts when exposed to the substance that causes allergies.
Allergies occur year round but are typically worse in the spring and fall when the plants are pollinating. In the spring the trees produce pollen, a fine powdery substance that can travel miles. Many trees can cause allergies but in the DC area the most common are oak tree and maple tree. The pollen tends to be worse on warm windy days and better when it is raining. However the benefit of the rain doesn’t last long. Almost as soon as it stops raining the pollen dries out and starts blowing again.

Symptoms of Seasonal Allergies

The symptoms of seasonal allergies are: sneezing, runny nose, nasal congestion, and itchy watery eyes, nose and throat. If the nasal congestion goes on to long you may develop a sinus infection. In fact many patients only get one sinus infection a year during the spring allergy season.
There are three ways to treat seasonal allergies: (1)medical treatment,(2) avoidance and (3)immunotherapy also known as allergy shots. Medical treatment involves giving the patients medicine to block the effect of the allergies. It controls the symptoms but does not produce long-term results. Antihistamines block the effect of histamine, which is released by the body when exposed to the substance that causes allergies. Common antihistamines include Benadryl, Claritin, Zyrtec and Allegra. Most patients have tried several antihistamines before coming to see the doctor. It is important to realize that antihistamines have no effect on nasal congestion and nasal obstruction. The symptoms of nasal congestion and nasal obstruction are not caused by histamine but by other chemicals released by your body.

Treatment of Allergy Symptoms

To treat nasal congestion you need to block the chemicals that lead to those symptoms. To do this we rely on inhaled nasal steroids. There are many nasal steroids two common ones are Flonase and Nasonex. The nasal steroids work topically on the nasal mucosa to reduce inflammation. Very little of the steroid is absorbed by the body so there is little if any risk to other parts of the body. It is a good idea to rinse the nose with a nasal saline rinse prior to using the nasal steroids. This washes away the mucus so the steroids can act directly on the lining of the nose.
The second option to treat allergies is avoidance. Avoidance means limiting your contact with the substance that causes your allergies. With seasonal allergies this is harder than it sounds because whenever you are outside you are exposed. There are however some tricks to help reduce your exposure. First, remember to close the windows to your home and car. Second, you should always shower prior to bed to rinse the pollen off. Finally, if you have been outside for an extended period of time you should shower, change your clothes and rinse your nose to flush out the pollen.

Allergy Shots

The most effective treatment for allergies is immunotherapy or allergy shots. This is the only treatment that actually reduces your body’s tendency to be allergic. The first step is to test you to see what you are allergic to and how severe your allergies are. This information is used to create a customized allergy serum, which contains very precise amounts of the substances that you are allergic to. The dose for the shot is gradually increased to the point where your body no longer over reacts when exposed to the substance that causes your allergies. It typically takes 1-2 years to reach your goal known as maintenance dose. Once at maintenance dose the shots will be spread out to once a month or so. It takes time to build up level for the allergy shots so you will not notice improvement immediately. Most patients begin to notice the benefits of allergy shots after 3-4 months and continue to see improvement for 1-2 years.
Allergy shots are a great option for patients whose symptoms are not controlled by medications or who wish to limit their use of chronic medications.
The DC area is notorious for having bad allergies particularly in the spring. Don’t let your symptoms prevent you from enjoying the beautiful weather. Let us work with you to control you allergy symptoms.