Allergic rhinitis (often called hay fever) and allergic conjunctivitis are frequent and annoying problems for children, adolescents and adults. The most common symptom is a sensation of difficulty breathing through the nose. This is called nasal congestion; most people refer to it as a stuffy nose. Nasal congestion is a symptom of a nose that isn’t working well. The common cold, sinus infections, growths in the nose called polyps, and irritant reactions to chemicals like perfume, smoke, and diesel exhausts can all cause nasal congestion. Sneezing, nasal and eye itching, sniffing, watery eyes and clear mucous from the nostrils distinguishes allergic rhinitis and allergic conjunctivitis from these other common disorders.
Treating Allergic Rhinitis and Allergic Conjunctivitis
There are three methods for treating allergic rhinitis and allergic conjunctivitis (1) avoiding the allergens that trigger symptoms (2) using medications to control symptoms and (3) immunotherapy to create tolerance to allergens and often cure the disease. The choice of allergy treatments vary depending on the type and severity of your allergy problem or problems. Based upon your response to treatment your allergist will periodically review your current treatment plan, discuss additions, deletions, or alternatives, and introduce to new developments in the field of allergy that may significantly impact your treatment and prognosis. The goal is to substantially reduce symptoms and improve quality of life and do so safely.
Avoiding the allergens that trigger your symptoms may be relatively easy as with house dust mites or molds or difficult as with plant pollens and pet danders. Allergy testing determines the cause of your allergy symptoms and directs the necessary steps to reduce exposure. Allergy testing may be performed on the skin or through a blood test. Your allergist will help you decide which test is best for you.
Possibly the most commonly used remedy for symptoms of allergic rhinitis and related conditions are nasal sprays. There are several types of sprays in use, many may be purchased available over the counter while others are available only by prescription The different types of sprays include:
- Steroid Sprays - These nasal sprays reduce inflammation and mucus production in the nasal passages working best for individuals with allergic rhinitis or nasal polyps. Steroid sprays provide effective relief from nasal stuffiness or congestion, something that oral antihistamines cannot do.
- Antihistamine Sprays - These sprays work by blocking the effects of histamine, a chemical released by your immune system’s mast cells during an allergic reaction.
- Decongestant Sprays – While decongestant sprays provide immediate relief of nasal congestion their frequent or chronic use will result in decreasing effectiveness and drug dependence
- Anticholinergic Sprays- Ipratropium bromide nasal spray may be used in place of decongestant sprays. It provides similar relief and is not habit-forming
- Mast Cell Stabilizers – Nasacrom® is a safe and effective nasal spray for treating allergic rhinitis. It is available over the counter. Sustained relief of symptoms requires using this medication three to four times daily.
- Saline Nasal Sprays - Saline sprays are saltwater solutions providing temporary relief of symptoms by dissolving thick mucus, diluting allergy chemicals like histamine, flushing out trapped debris and soothing inflamed nasal tissues.
Other medications can help to reduce your body’s reaction to allergens. These can be taken as liquids or pills. They include:
- Antihistamines - work by blocking the effects of histamine, a chemical released by your immune system’s mast cells during an allergic reaction. Classical antihistamines like Benadryl are effective but wear off after a few hours and commonly cause adverse reactions including drowsiness, slowed reflexes, constipation and, in some seniors, difficulty emptying the bladder. Long-acting non-sedating antihistamines like Allegra®, Claritin®, Xyzal® and Zyrtec® are as effective and fast-acting as classical antihistamines but work for about 24 hours and rarely cause side-effects.
- Decongestants – The sensation of resistance to breathing through your nose, called nasal stuffiness or nasal congestion can be relieved by decongestant tablets, antihistamine sprays, and steroid sprays. Decongestant tablets may raise blood pressure, trigger a sensation of restlessness and contribute to insomnia. For those reasons decongestant tablet use should be limited to periodic use of a few days or less.
- Leukotriene Modifiers – Can be as effective as long-acting non-sedating antihistamines in the treatment of allergic rhinitis. Leukotriene modifiers like montelukast also treat asthma, a benefit if you have both conditions. Occasional episodes of adverse effect on mood, especially in children, have been reported. These medications are available in generic form by prescription from your doctor.
- Steroids – Systemic steroids are rarely used to treat allergic rhinitis. Because safer agents are available steroids are reserved for severe cases.
Immunotherapy is a form of treatment to decrease or prevent allergic reactions and symptoms by teaching your immune system to ignore or tolerate the allergens to which it is currently overreacting. This is accomplished through controlled exposure over time to the some or all of the allergens to which you may be allergic.
- Allergy Injections - With allergy shots, the allergy nurse under the guidance of your allergist injects tiny amounts of allergen or allergen mixtures under the skin to stimulate the immune system without causing a major allergic reaction. At each subsequent office visit the amount injected is slowly increased with adjustments made depending on your clinical progress. Allergy immunotherapy is a form of vaccination, directing your body’s immune system to develop tolerance to the allergens injected. They are typically given over the course of three to five years.
- Allergy Drops - Sublingual immunotherapy, known commonly as SLIT or allergy drops, is a new way to receive allergens. A dose of an allergen, in liquid or dissolvable tablet form is placed under the tongue; it is not swallowed. This form of therapy is taken at home every day. SLIT is useful for patients with one or at most very few inhalant allergies. Unlike allergy shots SLIT is not covered by all forms of medical insurance.
See Your Doctor Today!
If you’re struggling with managing your allergies, make sure to contact your doctor sooner rather than later to figure out which treatment works best for you!