UAB Medicine News


Seasonal Allergies: Newest Treatments and Latest Advice

Spring Allergies

Spring has sprung, bringing runny noses and watery eyes to those with seasonal allergies.

Allergies affect some 30 percent of adults and 40 percent of children in the United States, or about 50 million people, according to the Asthma and Allergy Foundation of America. There are many types of allergies, including allergies to food, mold, insect stings, and pet dander.

However, a pollen allergy (known as seasonal allergic rhinitis, or hay fever) can be the hardest to avoid and the toughest to manage. This is due to the amount of pollen in the air from trees, grasses, and weeds during certain times of the year, especially spring, early fall, and summer.

Symptoms of pollen allergies can range from irritating (sneezing, runny nose, itchy/watery eyes, and sinus congestion) to life-threatening (difficulty breathing, swelling of the airway).

According to UAB Medicine’s Ear, Nose, and Throat (otolaryngology) Clinic, the best way to treat seasonal allergies is to take a daily over-the-counter oral antihistamine, such as levocetirizine, loratadine, or fexophenadine, when symptoms are at their worst. The corticosteroid nasal spray Flonase (fluticasone propionate) is available over the counter and can reduce inflammation in the nasal passages.

In 2014, the Federal Drug Administration approved two new prescription-only remedies called Grastek and Oralair, which are daily oral medications to fight grass pollen allergies. Both require medical supervision for the first tablet, in case a reaction occurs, and these drugs should only be taken if prescribed since they can interact with other medications. Doctors recommend starting Grastek or Oralair 3-4 months before allergy season and taking it throughout the season. It is unclear whether these drugs pass into breast milk, so consult your doctor if you are expecting or nursing.

The downside of these drugs is that they can be expensive, and they are only indicated for grass pollen allergies. It is recommended that you continue using antihistamines (oral and nasal), a nasal steroid, and possibly a leukotriene receptor antagonist such as Singulair (montelukast sodium). Keeping an epinephrine auto-injector handy is a must for anyone who has serious allergies that can cause their airways to swell.

UAB Otolaryngology advises against nasal spray decongestants, which may work temporarily but are likely to cause “rebound congestion” after about three days. Also, you have to use them more and more for them to work. Instead, rinse allergens out of the nose daily using a saline nasal rinse or neti pot, shower after yard work, and avoid outdoor exercise on days when the pollen count is high.

When should you see a doctor for seasonal allergies? If you are experiencing increased symptoms or getting sinus infections several times a year, see your doctor. The same advice applies if you’ve tried all the over-the-counter medications and still are bothered by allergy symptoms.

Click here for more information on UAB Medicine’s Ear, Nose, and Throat (ENT) services or to make an appointment.