Spring has sprung, and with it comes flowers and, for many people, allergies. These little particles trigger mucous irritation in our airways from the tip of our noses down into the depths of our lungs.
For most allergy sufferers the symptoms are near where our noses catch all the pollen. Sneezes, red eyes, itchy throat, and runny nose are the most irritating. Deeper sinus fullness, fatigue, or resulting asthma can result in missed work. There are often simple steps to reduce allergy symptoms. If those measures fail, you might find comfort in medication.
So what should allergy and asthma sufferers do during this season? First, try to remove and avoid your triggers. HEPA air filters can remove 99% of airborne particles in your home. Keeping your windows closed also helps keeps out pollen.
Use a gentle warm salt solution two or three times per day to remove allergens from your nasal cavity. This can be made at home with warm water, a teaspoon of salt and a pinch of baking soda. The solution can be snorted, sprayed in with a spray bottle or dribbled through with a neti pot.
In general, there are two types of medications for allergies: short acting (rescue) and longer acting (controller). Many rescue medications do not require a prescription. Controller medications generally need a doctor's prescription and are used daily.
If allergies aren't new for you, remember what worked for you in past years. Check your medicine cabinet and call your doctor for refills if you are out. If your allergy symptoms are already severe, it's often best to start with a fast-acting medicine, like an antihistamine. Diphenhydramine (Benadryl), Sudafed and Claritin all work the same day.
If over-the-counter medicines don't provide relief for allergy symptoms, you may need prescription medicine. For allergic rhinitis, this includes nasal steroids (Nasarel, Beconase and Flonase) and cromolyn. These may take a week or two to work.
There are few effective over the counter medications for asthma. Doctors usually recommend fast-acting inhalers, such as albuterol or Xopenex, and often (unless it's very mild) begin a steroid asthma inhaler (Flovent, Azmacort and Qvar) at the same time to calm irritation in the lungs. Advair is a combination of short-acting bronchodilators and a steroid inhaler. Most of these "controller medications" take a few days to work, and need to be taken regularly.
To get the most from your controller inhaler:
- Use it early, before severe symptoms develop.
- Always use a spacer (except for Advair).
- Take them regularly (usually once or twice a day) regardless of symptoms.
Continue using the quick-acting medicine as long as symptoms persist. Knowing when to stop the steroid inhaler can be difficult. Generally, tapering the usage over a few weeks is best. If the symptoms worsen, resume both the quick-acting medicines and the steroid inhaler.
Allergic symptoms of the eye, such as redness, itching and watering are treated most effectively with eye drops such as Patanol or Pataday, which act quickly. Cromolyn eye drops are also effective, but may take days to work.
Weekly allergy shots by an allergist to address specific allergies are safe and effective, and don't contain steroids, but are usually reserved for severe allergies and not for asthma.
Dr. Pepper practices family medicine at the Martinez Health Center.
Healthy Outlook is written by the professional staff of Contra Costa Health Services, the county health department. Send questions to series coordinator Dr. David Pepper at firstname.lastname@example.org. For more health information, go to www.cchealth.org.