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Spring is here, and if you are among the estimated one in four adults In the United States, those who suffer from seasonal allergies may have already started sneezing and scratching.
As climate change affects temperatures and plant growth, you may need to be vigilant sooner than ever. It can be difficult to distinguish the symptoms of an allergy from those of a cold, but experts point out some telltale signs.
Is allergy season getting worse?
Spring allergy seasons are starting about 20 days earlier than they used to, according to an analysis by pollen count data from 60 stations in North America from 1990 to 2018.
That change may have important health consequences, said William Anderegg, an author of the study and an associate professor of biology at the University of Utah. Other research has shown that the very early onset of spring is associated with higher prevalence of allergic rhinitis, also known as hay fever. When people end up sick or in the hospital because of uncontrolled allergy symptoms, he said, “it’s because they weren’t expecting it and they didn’t have medication on hand.”
Researchers also found that pollen concentrations have increased about 20 percent nationwide since 1990, with Texas and the Midwest seeing the largest increases. Warmer temperatures, higher concentrations of carbon dioxide and increased precipitation can help plants grow and produce more pollen for longer periods of time, Dr. Anderegg said.
Dr. Gailen Marshall, chair of the department of allergy and immunology at the University of Mississippi Medical Center, said that when he began practicing nearly 40 years ago, allergy seasons were limited to about eight weeks each. Tree pollen arrived in the spring, grass pollen increased in the spring and summer, and ragweed pollen recovered in late summer and early fall.
Back then, people “could at least get some relief” between those cycles, said Dr. Marshall, who is also president of the American College of Allergy, Asthma and Immunology, a professional organization. “Now, these seasons end up becoming one long season.”
How do you know if it is allergies or a cold?
Many people with a stuffy or runny nose may assume they have a cold. Although allergy and cold symptoms can be similar, allergies often cause itchy eyes, nose, throat, mouth or ears, said Dr. Rita Kachru, chief of clinical allergy and immunology at UCLA. Health. In allergies, the immune system mistakes a trigger, such as pollen, for a harmful substance. When repeatedly exposed to that trigger, Dr. Kachru said, immune cells release chemicals, including histamine, that cause itching and inflammation.
Patients also often experience congestion and postnasal drip, or mucus that drips down the back of the throat. Some people may develop cough, wheezing, and difficulty breathing.
In the case of a viral infection, on the other hand, muscle fatigue, joint pain or fever may occur.
If your symptoms appear every year around a certain season and last more than a week or two, there is a good chance they are caused by allergies. Doctors said a personal or family history of allergies, eczema or asthma can also be an important clue.
What if I’ve never had allergies before?
Most people first develop symptoms in childhood or early adulthood. But several experts said it’s not unusual for someone to have seasonal allergies for the first time in adulthood.
Moving to another part of the country and being exposed to different allergens can trigger a response, Dr. Kachru said.
New allergy symptoms in adulthood could also be “an inevitable consequence of skyrocketing pollen counts,” said Dr. Neeta Ogden, a New Jersey allergist.
Increased winds associated with climate change could be spreading pollen further, potentially exposing people to new varieties of it, said Dr. Mary Johnson, a Harvard research scientist.
Research has also shown that hormones, including estrogen, progesterone and testosterone, can affect the development of allergic diseases.
Children often have food allergies or eczema as babies and seasonal allergies or asthma in childhood, but those conditions go away when they reach puberty, Dr. Kachru said. But symptoms can reappear when they reach their 30s and 40s.
For some women, major hormonal changes, including those that occur during puberty, pregnancy and menopause and while taking birth control, can affect the onset and severity of allergy symptoms, Dr. Kachru said.
How do I manage the symptoms?
The first step is to reduce exposure. Keep windows closed to prevent pollen from entering your home.
“The key is to prevent outdoor allergens from becoming indoor allergens,” said Dr. William Reisacher, a professor of otolaryngology who treats allergies at Weill Cornell Medicine and New York-Presbyterian.
To help, take off any clothes you wore outside when you get home and store them outside your bedroom. Then take a shower to rinse the pollen from your skin. Doctors recommend a saline nasal rinse to remove pollen from the nose. (If you make your own, be sure to use boiled, sterilized or distilled water.)
Over-the-counter medications fall into two main categories: antihistamines and steroids. Both act on your immune system’s inflammatory response. Antihistamines are available as nasal sprays, eye drops, and oral pills, including loratadine (Claritin), cetirizine (Zyrtec), levocetirizine (Xyzal), and fexofenadine (Allegra).
Steroids come in the form of nasal sprays, including fluticasone (Flonase), budesonide (Benacort), triamcinolone (Nasacort), and mometasone (Nasonex).
If you have symptoms for the first time and aren’t sure how severe they will be or how long they will last, Dr. Kachru said, try an antihistamine to see if it helps.
If symptoms persist, or if you know you suffer from severe allergy symptoms every spring, doctors recommend nasal sprays. Unlike antihistamines, which should be used only as needed, these steroids work best if you start using them a week or two before symptoms begin.
Doctors warn against using pseudoephedrine products, such as Sudafed, for more than a day or two because they can increase heart rate and blood pressure. In 2020, a working group of doctors publishing guidelines for treating allergies recommended against using Benadryl to treat allergic rhinitis; Doctors said it can have sedative effects and cause confusion.
If avoiding environmental triggers and taking medications doesn’t work for you, allergy shots or tablets that increase your tolerance to allergens may be helpful.
“It’s the only option available that actually makes the body less allergic,” Dr. Reisacher said.
