HCA Virginia Physicians March 27, 2018

by Luisa Caparoula, DO, at Primary Health Group – Ironbridge

About 7% of Americans suffer from hay fever, an allergic condition that often causes a runny nose, sneezing, and teary eyes. Hay fever usually peaks when particular plants pollinate or when molds flourish, usually in the spring, summer, or fall. Hay fever is known officially as allergic rhinitis, allergic sinusitis, or allergic conjunctivitis, depending on whether symptoms manifest mainly in the nose, sinuses, or eyes. Some allergy sufferers have year-round hay fever (perennial rhinitis) and may be allergic to persistent allergens in the environment coming from sources like dust mites, mice, and cockroaches.

Here's how hay fever works. In response to the triggers noted above, the immune system of an individual prone to allergies overreacts to an allergen. When you breathe in an allergen cells in your nasal passages release a chemical called histamine. Histamine causes your nose to feel itchy and creates swelling and mucus production in the nasal passages, dripping, itching, and aching. While the mechanism of allergic response is well understood, why some people react so excessively to small amounts of pollen remains a mystery.

Risk Factors

Factors that increase your chance of having allergic rhinitis include:

  • Family members with allergic rhinitis, eczema, or asthma
  • Eczema
  • Asthma
  • Food allergies

Non-Medicinal Treatments

Minimizing exposure to the allergen is the most effective way to treat allergies. Specific steps will depend on allergen such as:

  • Dust mite reduction:
    • Wash pillows and bed sheets regularly in hot water.
    • Remove carpeting, feather pillows, and upholstered furniture, especially in the bedroom.
    • Keep clothes off the bedroom floor.
    • Use acaricides solutions to kill dust mites.
    • Keep humidity levels at less than 50%.
    • Use double-bag vacuum bags and HEPA filters.
  • Mold exposure reduction:
    • Wear facemasks when working with soil, leaves, or compost.
    • Try to avoid moist, damp areas within the home.
    • Use a dehumidifier in places like your basement that may encourage mold growth.
    • Repair leaky roofs or pipes.
  • Animal allergen reduction:
    • Removing a pet from the home is the most efficient option. It may take 4-6 months to clear the home of pet allergens.
    • If you wish to keep pets, keep your pets out of the bedroom and off of furniture.
    • Frequently vacuum or remove rugs.
  • Pollen reduction:
    • Be aware of pollen levels and limit your exposure on high days.
    • Stay indoors and keep windows closed.
    • Consider using an air purifier inside.
    • Do not dry clothes outside.
    • Shower when you get home. Keep clothes contaminated with pollen out of the bedroom.
  • General reduction techniques:
    • Use petroleum jelly on the nostrils. The jelly may catch some of the allergens before they pass into the nose.
    • Nasal filters—Device inserted into the nostrils that can filter allergens before they reach the nose.
    • A Neti Pot, nasal sinus rinse, or saline nasal spray may help clear irritants from the nasal passage after exposure and loosen congestion.

Though reducing allergens can help, it is not possible to completely eliminate all allergens.

Conventional and Natural Treatments

Conventional treatment for hay fever involves non-sedating antihistamines and nasal steroids that are usually quite effective. In addition, some people treat their allergy symptoms with allergy shots. Known as immunotherapy, the idea behind the treatment is to reduce allergic symptoms and increase immunity against the allergic substance by exposing the body to small amounts of the substance. Traditionally, exposure is done through injecting the allergic substance into the upper arm. This is extremely effective for treating allergic rhinitis and has minimal adverse effects when done under the supervision of an allergist.

What about natural remedies? Some homeopathic treatments show promise, with several small studies having positive results using medicinal herbs to treat allergy symptoms. One study looked at a combination tablet containing Cinnamomum zeylanicum, Malpighia glabra, and Bidens pilosa versus the well-known antihistamine, loratadine. The researchers found that both loratadine and the combination herbal tablet reduced nasal symptoms.

Another study compared the herb butterbur against fexofenadine (an over-the-counter allergy medication) and placebo. Butterbur and fexofenadine were found to be equally effective, while both were more effective than the placebo. Other promising natural remedies include acupuncture and sub-lingual immunotherapy (SLIT), an alternative to shots, where the allergic substance is placed under the tongue.

Be sure to talk with your doctor first before taking any herbal remedy. Some herbal therapies may interact with medications you may already be taking or may cause undesirable side effects. There are options for those seeking allergy relief both with conventional medicine and outside of the pharmacy aisle - ask your doctor which may be the right solution for you.