When spring is in the air, can pollen be far behind?

Protect yourself from allergies during hay fever season

With spring comes longer, warmer days and budding landscapes. It also marks the start of hay fever season, which in Southern California can last well into fall, says UCI Health allergist Dr. Ravi Gutta.

It’s a time when newly blossoming trees, weeds and grasses release billions of microscopic pollen spores into the air. Inhaling certain pollens sends the immune systems of more than 17.5 million Americans into overdrive, triggering the classic symptoms of hay fever: sneezing, a runny nose and itchy, red or watery eyes.

Hay fever, also known as seasonal allergic rhinitis, is the fifth leading chronic disease in the United States, with an estimated cost of more than $14 billion in health costs and lost productivity each year.

What’s an allergy sufferer to do?

Know your symptoms

Is it a cold or an allergy?

“A cold typically won’t cause sneezing, persistent congestion or postnasal drip,” says Gutta, an assistant clinical professor of allergy and immunology at UC Irvine School of Medicine.  “A cold will have other symptoms, like fever, chills, a sore throat. And a cold usually doesn’t last much more than a week.”

Avoid exposure

Even if you don’t know what pollens trigger your allergy, keep windows and doors shut, especially on days when the pollen count is high, and change your routines. 

“We know that certain pollens are more prevalent during certain hours of the day,” Gutta says.  “For example, if you like to jog in the park and you have a grass allergy, don’t do it in the afternoon. Trees are more active in the morning hours. If you’re allergic to tree pollens, close your windows in the mornings, and close them in the afternoons if grasses bother you. If it’s hot, use your air conditioner.”

Try over-the-counter remedies

Decongestants and antihistamines can help in mild cases, but Gutta says their effectiveness diminishes after a few days and they do nothing to address the underlying cause.

Antihistamines can be taken by mouth or as a nasal spray. But some cause drowsiness, so it’s important to avoid those that cause sedation while driving or operating machinery when using them.

Decongestants can help to reduce stuffiness and congestion, but they should not be used for more than three days.

Know when to seek medical help

If your hay fever symptoms are severe or don’t respond to common treatments, your doctor may prescribe a more potent intranasal steroid spray, also known as a corticosteroid spray.

“When used consistently on a daily basis, the spray can give significant relief,” Gutta says. Unlike many other steroid treatments, nasal sprays are safe for daily application, although they can cause dryness in a few patients. “About 3 percent to 7 percent of people who use them may experience some bleeding in the nasal passage, so it’s very important to learn to use these sprays properly.”

An allergist also may prescribe a medication called a leukotriene inhibitor to block formation of the chemicals (leukotrienes) released by the body to attack the allergen, causing your symptoms.

Consider allergy shots if you have severe, hard-to-control seasonal allergies

“When my patients tell me, ‘I’m not getting better,’ it’s time to see if allergy shots are an option,” Gutta says.

Allergy shots can sensitize the body to the offending substances, but first your physician needs to know which substances are causing your symptoms.

Blood tests can identify potential allergens in your system with about 70 percent accuracy. Gutta prefers a 15-minute skin test, which allows him to check for reactions to as many as 80 types of allergens with about 97 percent accuracy. The most common pollen allergies are to grasses in Orange County and much of Southern California, where the growing season is nearly year-round.  Next are trees — especially oak, California juniper and maple — followed by weeds and mold spores.

Once or twice a week for several months, patients receive shots — each containing a larger dose of the allergen(s) — to build a tolerance. After that, maintenance injections may be given only once a month and reassessed for effectiveness after a year.

“Injections are very effective in carefully selected patients,” Gutta says. “Studies have found that in 85 percent of patients, the savings from over-the-counter medications and prescriptions, fewer symptoms and complications, regained productivity and improved quality of life far outweigh the costs of the shots.”

Get tested at the first sign of serious allergies

Untreated allergies often worsen, a phenomenon known as allergen priming, Gutta says. Essentially, it takes progressively smaller amounts of exposure to an allergen to trigger a reaction and increases your susceptibility to develop reactions to other allergens.

“If you’re having symptoms at onset of spring, it’s better to come see us earlier than later in the growing season,” Gutta says. “Over-the-counter medications won’t work for very long.”

For an allergy consultation, please contact Gutta and the UCI Health allergy team at 714-456-7002.

— Kristina Lindgren, UCI Health Marketing & Communications