The Pitt Prescription: Springing into seasonal allergy treatments

As winter comes to an end, the weather gets more bearable, and spring break is right around the corner. More time is spent outdoors enjoying nature and getting fresh air as the temperature increases, but along with the warmth comes a silent aggressor that affects many people, including myself — pollen.

As the warmer weather rolls in, one of my favorite ways to de-stress is going to Schenley Park and lounging in my hammock. However, I have to be cautious because if I go on a particularly windy or high pollen-count day, what was supposed to be a relaxing activity turns into a cycle of sneezes and itchy eyes. 

What is allergic rhinitis — AKA seasonal allergies?

Pollen is a common allergen, and its levels rise significantly during the transition from winter to spring as new plants bloom. An allergen — also called an irritant — is a substance that can cause an allergic reaction. Pollen is an allergen that can cause rhinitis, which is the inflammation or swelling of the nose. There are several kinds of rhinitis, with the most common allergen-induced one being seasonal allergic rhinitis, also known as “hay fever” or “seasonal allergies.” A March 2019 study done by several environmental and health scientists found that the allergy season is getting increasingly worse and longer each year, likely due to climate change and ongoing elevated temperatures. 

Seasonal allergies affect many people each year and are typically the result of an allergic reaction to pollen in the air discarded from trees, grass and weeds. Tree pollen is often the most abundant in the spring, with grass and ragweed pollen picking up more towards the summertime. It is sometimes hard to differentiate between seasonal allergies and the common cold. However, typical symptoms of seasonal allergies consist of itching in the nose and eyes, sneezing, stuffy nose, runny nose and mucus in the throat. While many of these are cold symptoms as well, duration is the main difference. Seasonal allergies typically last as long as the allergen is present in the air — usually about two to three weeks, but sometimes longer — while colds typically last about one week. 

Medications for seasonal allergies

There are many different treatment options for seasonal allergies ranging from medications to non-pharmacological recommendations.

According to the Asthma and Allergy Foundation of America, the following medicinal treatments are the most common treatment options for seasonal allergies:

• Nasal corticosteroids are usually prepared in nasal spray form. They help diminish the inflammation in the nose and stop allergic reactions. They are typically seen as the most effective medicine type for seasonal allergies because they can reduce most symptoms and have few side effects. These products were more recently approved to be sold over-the-counter. Commonly used nasal corticosteroids are fluticasone propionate (Flonase Allergy Relief) and triamcinolone acetonide (Nasacort Allergy 24HR). 
• Antihistamines can either be oral medications or contained in nasal sprays. Antihistamines may help relieve itching in the eyes and nose, sneezing and runny nose. Commonly used antihistamines include diphenhydramine (Benadryl), cetirizine (Zyrtec), fexofenadine (Allegra) and loratadine (Claritin). In recent years, cetirizine, fexofenadine and loratadine have become more popular than diphenhydramine because they have fewer side effects but a similar efficacy.
• Decongestants come in the form of oral medications, nasal sprays and drops. Decongestants help decrease swelling and mucus formation which helps relieve nasal stuffiness. They are very useful in more acute situations and generally should not be used as long-term solutions. Commonly used decongestants (for both allergies and colds) come in both nasal spray and oral formulations, including oxymetazoline nasal (Afrin), phenylephrine oral (Sudafed PE) and pseudoephedrine (Sudafed). The oral formulations are also commonly found in combination products with the antihistamines, like loratadine and pseudoephedrine (Claritin D).
• Leukotriene receptor antagonists are available as oral medications, but they’re prescription-only. Leukotrienes are released when you breathe in allergens and cause many of the symptoms of allergies, such as swelling and tightening of airways. Leukotriene receptor antagonists block the production of these leukotrienes. The most commonly used medication in this class is montelukast (Singulair).

Non-pharmacological recommendations

While allergies are fairly easy to treat with medications, there are some recommendations that can prevent or lessen the chance of symptoms. 

• If your seasonal allergies flare up significantly with high pollen, you can use online sites like pollen.com to check the pollen levels in your area. On days where there is a high level, it is recommended to keep your windows closed and to avoid extended periods outside. 
• When you do go outside during high pollen levels, it is recommended that you wear sunglasses and a hat to avoid getting pollen in or around your eyes. Taking a shower and changing clothes right when you get home is also recommended to reduce the spreading of allergens throughout your home.
• Do not touch or rub your nose and make sure you wash your hands frequently.
• Keep pets out of your bedroom because they can carry pollen and other allergens in their fur.
• Wash your sheets and pillowcases often to reduce the presence of allergens.

Seasonal allergies are a common illness in the spring season, which is quickly approaching. There are many treatment options that are over the counter and easily accessible to anyone who needs them. If you have any questions or need guidance regarding these options, you can always ask your local pharmacist for help.