Itchy Eyes . . . . Spring Allergies?

Spring is the time of year that we normally think of when it comes to seasonal allergies. As the trees start to bloom and the pollen gets airborne, allergy sufferers begin their annual ritual of sniffling and sneezing. Each year, 35 million Americans fall prey to seasonal allergic rhinitis, more commonly known as hay fever.

Although there is no magical cure for spring allergies, there are a number of ways to combat them, from medication to household habits.

What Causes Spring Allergies?

The biggest spring allergy trigger is pollen -- tiny grains released into the air by trees, grasses, and weeds for the purpose of fertilizing other plants. When pollen grains get into the nose of someone who’s allergic, they send the immune system into overdrive.

The immune system, mistakenly seeing the pollen as foreign invaders, releases antibodies -- substances that normally identify and attack bacteria, viruses, and other illness-causing organisms. The antibodies attack the allergens, which leads to the release of chemicals called histamines into the blood. Histamines trigger the runny nose, itchy eyes, and other symptoms of allergies.

Pollen can travel for miles, spreading a path of misery for allergy sufferers along the way. The higher the pollen count, the greater the misery. The pollen count measures the amount of allergens in the air in grains per cubic meter. You can find out the daily pollen count in your area by watching your local weather forecast or by visiting the NAB: Pollen & Mold Counts page on the American Academy of Allergy, Asthma and Immunology’s web site.

Here are some of the biggest spring allergy offenders:

Trees

Alder
Ash
Aspen
Beech
Box elder
Cedar
Cottonwood
Cypress
Elm
Hickory
Juniper
Maple
Mulberry
Oak
Olive
Palm
Pine
Poplar
Sycamore
Willow

Grasses and weeds

Bermuda
Fescue
Johnson
June
Orchard
Perennial rye
Redtop
Saltgrass
Sweet vernal
Timothy

Allergy symptoms tend to be particularly high on breezy days when the wind picks up pollen and carries it through the air. Rainy days, on the other hand, cause a drop in the pollen counts because the rain washes away the allergens.

What are the symptoms of spring allergies?

The symptoms of spring allergies include:

• Runny nose
• Watery eyes
• Sneezing
• Coughing
• Itchy eyes and nose
• Dark circles under the eyes

Airborne allergens also can trigger asthma, a condition in which the airways narrow, making breathing difficult and leading to coughing, wheezing, and shortness of breath.

How are spring allergies diagnosed?

If you’ve never been formally diagnosed with spring allergies but you notice that your eyes and nose are itchy and runny during the spring months, see your doctor. Your doctor may refer you to an allergist for tests.

The allergy specialist may do a skin test, which involves injecting a tiny sample of a diluted allergen just under the skin of your arm or back. If you’re allergic to the substance, a small red bump (called a wheal or hive) will form. Another diagnostic option is the radioallergosorbent test or RAST. RAST is a blood test that detects antibody levels to a particular allergen. Just because you are sensitive to a particular allergen on a test, though, doesn’t mean that you’ll necessarily start sneezing and coughing when you come into contact with it.

What's the treatment for spring allergies?

Doctors treat spring allergies with a number of over-the-counter and prescription drugs. Over-the-counter allergy drugs are effective for many people and include the following:

• Antihistamines reduce sneezing, sniffling, and itching by lowering the amount of histamine (the substance produced during an allergic reaction) in the body.
• Decongestants clear mucus out of the nasal passageways to relieve congestion and swelling.
• Antihistamine/decongestants combine the effects of both drugs.
• Nasal spray decongestants relieve congestion and may clear clogged nasal passages faster than oral decongestants.
• Cromolyn sodium nasal spray can help prevent hay fever by stopping the release of histamine before it can trigger allergy symptoms.
• Eye drops relieve itchy, watery eyes.

Even though you can buy these allergy drugs without a prescription, it’s a good idea to talk to your doctor first to make sure you choose the right medication. Some antihistamines can make you feel sleepy, so you need to be careful when taking them during the day (although non-drowsy formulations are also available). Don’t use over-the-counter antihistamines and decongestants for more than a few days without talking to your doctor.

If over-the-counter remedies don’t help allergies, your doctor may recommend a prescription medication, allergy shots, or even oral/sublingual immunotherapy. Prescription nasal sprays with corticosteroids reduce inflammation in the nose. Allergy shots expose your body to gradually increasing doses of the allergen until you become tolerant of it. They can relieve your symptoms for a longer period of time than oral and nasal allergy medications. Although they don’t work for everyone, in people who do see a response, allergy shots can stave off symptoms for a few years.

Some allergy sufferers turn to natural therapies for relief, although the research is mixed on their effectiveness:

• Butterbur. The herb butterbur (Petasites hybridus), which comes from a European shrub, shows potential for relieving seasonal allergy symptoms. In one Swiss study, butterbur was just as effective as the antihistamine Allegra for reducing allergy symptoms.
• Quercetin. This flavonoid, which is found naturally in onions, apples, and black tea, has anti-inflammatory properties and has been shown in research to block histamines.
• Stinging nettle. The roots and leaves of the stinging nettle plant (Urtica dioica) have been used to treat everything from joint pain to prostate problems. Although some people use freeze-dried stinging nettle leaves to treat allergy symptoms, there isn’t much research to show that it works.
• Nasal irrigation. Nasal irrigation with a combination of warm water, about a quarter-teaspoon of salt, and a quarter-teaspoon of baking soda may help clear out mucus and open sinus passages. You can administer the solution through a squeeze bottle or a neti pot -- a device that looks like a small teapot. Use distilled, sterile, or previously boiled water to make up the irrigation solution. It’s also important to rinse the irrigation device after each use and leave open to air dry.

Just because a spring allergy treatment says “natural” doesn’t mean that it is safe. Some herbal remedies can cause side effects or can react with medications you’re taking. Talk to your doctor before you start taking any herb or supplement.

How to manage spring allergies

It’s nearly impossible to completely avoid spring allergies if you live in an area where plants grow. However, you can ease sniffling, sneezing, and watery eyes by avoiding your main allergy triggers. Here are a few tips.

• Try to stay indoors whenever the pollen count is very high (pollen counts usually peak in the mornings). 
• Keep your doors and windows closed whenever possible during the spring months to keep allergens out. An air purifier may also help. 
• Clean the air filters in your home often. Also, clean bookshelves, vents, and other places where pollen can collect. 
• Wash your hair after going outside, because pollen can collect there.
• Vacuum twice a week. Wear a mask because vacuuming can kick up pollen, mold, and dust that were trapped in your carpet

Reviewed by Kimball Johnson, MD on June 16, 2012

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