By Shelby Deering
Here in Wisconsin everyone gets a little giddy when the weather forecast predicts rising temperatures after a long, cold winter. And with that warmer weather the days get longer, the grass gets greener and flowers start blooming.
Spring is a lovely time in the Midwest, but in the midst of all that springtime glee many may look upon it with a bit of dread. According to the Asthma and Allergy Foundation of America (AAFA), over 20 million American adults each year experience pollen allergies or seasonal allergic rhinitis —commonly known as hay fever.
On the AAFA’s 2019 list of Spring Allergy Capitals, or the most challenging places to live with spring allergies, Madison was No. 60 and Milwaukee was No. 85.
So, are all spring allergy sufferers destined to a season filled with endless trips to Walgreens and too many tissues to count? We’ll offer suggestions on how to alleviate symptoms so you can enjoy spring once again with the help of two allergists.
For those of us who deal with spring allergies, there are some common culprits that steadfastly return every spring: tree and grass pollen.
Mark Moss, M.D., an allergist with UW Health, says, “The first tree pollen is released beginning in late March or early April and is followed by grass pollen release in mid- to late-May.”
Dr. Nathan Lebak, allergist and immunologist with Aurora Health Care, agrees that spring’s top allergy trigger is pollen, or “tiny grains released into the air by trees, grasses and weeds,” he explains. “The higher the pollen count, the worse the allergies,” Lebak says.
Lebak adds that during the spring another concern can be outdoor mold, which releases spores into the air. “Mold spores can be present in any season but tend to be higher in late fall,” he says.
With Wisconsin’s natural beauty comes plenty of allergens. “Mold, trees and grass allergies are all common in Wisconsin,” Lebak says. “These pollens are windblown and can travel considerable distances in the air, so it’s not necessarily what is in your backyard, but in your region.”
You might be wondering when you can expect your spring allergies to start kicking in. It tends to be the same across the board for everyone — it’s when those glorious warm temperatures return.
Moss says, “The warmer weather triggers plants such as trees and grasses to release pollen as part of the process of exchanging genetic information from one plant to another. The season begins when warmth triggers the pollen release and ends by late spring for trees and by mid-summer for grasses.”
While you may be suffering each spring, perhaps your family and friends don’t seem to have the slightest sign of spring allergies. Why is this?
Lebak takes us through this conundrum, saying, “Allergies occur when your immune system reacts to a foreign substance. Your immune system produces substances known as antibodies. When you have allergies, your immune system makes antibodies that identify a particular allergen as harmful, even though it isn’t. When you come into contact with the allergen, your immune system’s reaction can inflame your skin, sinuses, airways or digestive system. Not everybody has the same reaction — or any reaction — to being exposed to certain foods and substances in the world around us. Therefore, the effects and severity of allergies varies from person to person.”
As it turns out, spring allergies triggered by tree and grass pollen can be highly individualized, and sufferers tend to struggle every year at the same time. The timeframe can extend from late March all the way through early June with peak periods changing slightly due to weather variations.
Moss points out, “Climatic change has caused some variability from year to year. For example, in 2018 there was a snowstorm and cold weather in April that postponed the start of spring pollen season until the beginning of May.”
Symptoms of spring allergies often include nasal congestion, runny nose, sneezing, nasal itching and watery eyes. For those with asthma, their condition can be exacerbated by spring allergies and they can experience wheezing, coughing and shortness of breath. Lebak says that if allergens are affecting your breathing, you should consult your physician immediately.
There can be other complications resulting from spring allergies. Moss says, “Some people develop a sinus infection. Many people develop repeated sinus infections, a possible sign of allergy, and may even develop sinusitis every spring.”
HOW TO TREAT SYMPTOMS
Although it might be difficult, especially when warmer weather replaces winter’s chill, Moss advises staying indoors in an air-conditioned environment to decrease allergy symptoms.
But if you do venture outside, Moss recommends “changing clothes or taking a shower after being outdoors,” especially for prolonged periods of time when doing yardwork or gardening. “This can reduce pollen exposure in the home,” he says.
Lebak suggests becoming aware of when pollen counts are elevated and how changing weather can impact their rise. He says that morning tends to bring higher pollen counts so it’s best to go outdoors in the afternoon. And of course, keep your windows closed to prevent pollen from entering your home.
While many homeopathic remedies have yet to be backed medically, Moss does believe that nasal saline rinses are effective in reducing congestion, removing pollen and irritants, and moisturizing nasal membranes. Lebak also supports nasal irrigation, saying, “Flushing out your sinuses with a neti pot or nasal washes may help break up thick mucus and ease swelling. Follow directions using distilled water and keep your equipment clean.”
He also says that a teaspoon of honey can soothe an irritated throat, adding that children under a year old should never be given honey.
If you’ve tried these methods and you’re still miserable, you can take over-the-counter medications, such as oral antihistamines, steroid nasal sprays and eye drops.
Moss says, “Compared with even a few years ago, there are many over-the- counter options for treating allergies.”
In his opinion, the most effective treatments include nasal steroid sprays such as fluticasone (Flonase and Flonase Sensimist), triamcinolone (Nasacort) and budesonide (Rhinocort). He shares that the most popular antihistamine treatments are cetirizine (Zyrtec), fexofenadine (Allegra), loratadine (Claritin) and levocetirizine (Xyzal). As for eye drops, he recommends ones geared toward eye allergies, like ketotifen (Zaditor).
SEEING AN ALLERGIST
Let’s say you’ve tried everything and you’d like to explore prescription medication options that may have fewer side effects or those that pinpoint specific allergens that are giving you grief. In this case, make an appointment with an allergist.
Lebak says, “It’s important to know what treatment options are available. When over-the-counter allergy medications aren’t enough, it’s time to talk with your primary care physician who can place a referral if needed.”
Testing can include allergy skin prick testing (a panel of common airborne allergens) or a blood test if skin prick testing isn’t appropriate for you or doesn’t appeal to you. Just be aware that skin testing is the preferred diagnostic tool among doctors.
Moss shares that there are long-term options as well. They include allergy shots and something called sublingual immunotherapy, a prescription tablet placed under the tongue.
With spring’s first warm days and those first few sniffles, you may seek treatment or power through your symptoms with at-home remedies. Just keep in mind, your spring allergies are temporary. Before you know it, the pollen levels will lower and summer will be here.