For some, springtime is less about warm afternoons at the park and more about afternoons spent inside with runny noses, scratchy throats and watery eyes. With allergy season starting, Dr. Mark Wenger and Allergy Partners offer tips on combating allergies at home, which signs of allergies to look for in your kids and more!
Q What are some tried and true ways we can help alleviate minor allergy discomfort at home?
Keeping the home sealed can be helpful. This includes keeping the windows closed, as well as avoiding the use of ceiling fans. Watch the pollen levels and avoid outdoor activities when elevated as best you can and venture out after rain when pollen levels temporarily lower. If sneezing with itchy nose and eyes are your primary symptoms, over-the-counter non-sedating antihistamines, like Allegra, may be helpful. However, these do not treat nasal congestion very effectively. For congestion, nasal sprays, such as Flonase, will work better.
QAt what age can children start showing signs of seasonal allergies?
Typically a prior season of exposure is required before allergies develop. A child born in March would not develop allergies that summer from grass pollen or in the fall from weed pollen, though they could the following year.
QWhat age can children show signs of food allergies?
Food allergies can develop as early as infancy and can manifest in many ways including hives and eczema.
QWhat exactly are allergy shots and is it safe to get them while pregnant?
With allergy shots, we give patients a serum that is made up of what they are allergic to. Starting at a very small amount, that dose is increased to a level that induces the body to tolerate the allergen. It is very effective for significantly allergic patients and the dose is high enough. It is essential that the dose is appropriate. The guidelines from the American Academy of Allergy, Asthma, and Immunology and the American College of Allergy, Asthma, and Immunology recommend that this be done in a physician’s office. There is a rare risk of anaphylaxis with shots that are appropriately dosed, and because of this we do not start allergy shots on a patient who is pregnant. However, if a patient who is already on allergy shots becomes pregnant, we continue them, though we decrease the dose significantly.
QWhy does pollen make us react in the first place?
For many patients, the body produces an antibody to external things called Immunoglobulin E (IgE). Pollen can attach to the IgE and will then cause cells in the body to release inflammatory compounds, such as histamine, that leads to symptoms such as sneezing, itch, congestion and asthma.
QMy kids are dying to get a pet, but a member of the family is allergic to pet dander. Is there anything we can do?
Yes, there is! Many allergic patients who have problems with pets will respond to immunotherapy/allergy shots. As with the prior question, the shots have to be done at a high dose to be effective. One thing that does not work is the adoption of a “hypoallergenic” pet. While they may shed less, the amount of dander they produce is just as much as other dogs. Interestingly, it turns out that there is significant dander variation between dogs of the same breed, that one golden retriever may have far more or less dander than another golden.
QDo seasonal allergies typically get better or worse with time?
They can go either way. However, only about one-fifth of patients will have near-resolution of symptoms in time.
QAt what point, should we nix the over-the-counter medications and make an appointment with an allergist?
My greatest concern is if allergies are impacting activities of daily living. Do your allergies keep you from work or school? Do they keep you from enjoying the outdoors? Are you unable to visit friends and family with pets? If the answer is yes, despite the use of over-the-counter medications, we may be able to help you. Other reasons to see an allergist would be if you have side effects to medications or if you have a desire not to be on medications long-term.
QWhat is a typical appointment like?
The visit starts with detective work. With allergy, the history is very important, so initially we will discuss different exposures to allergens you may have and symptoms that may be associated with them. If there is a question of asthma, we will likely do a simple breathing test that will help us quantify the problem. We may do allergy testing, and the most accurate way to do this is with a scratch test during which a plastic “scratcher” disrupts the surface of the skin after being dipped in an allergen. You will get a temporary hive where the scratch was performed if you are allergic to the substance.
QShould I see an allergist multiple times throughout the year?
Patients with asthma should see their allergist or other provider every six months. As long as patient is doing well, we will follow them on an annual basis. Typically, there is no reason to repeat allergy testing to environmental allergies in patients on allergy shots who are doing well unless there is a change in symptoms and there is concern about new sensitivities. We will see patients about every six months who are allergic to foods that are typically outgrown in time.
QIf my allergies become worse during pregnancy, will they typically stay that way once the baby is born?
Not necessarily. There is something called rhinitis of pregnancy where 30 percent of pregnant women suffer from significant nasal congestion. This will resolve after delivery. In patients who are allergic already, about one-third will get worse, stay the same or get better after the pregnancy from where they were initially.
Have questions for Dr. Mark Wenger?
He’ll be chatting live with us on our Facebook page on March 9, 2017 at 8:00 pm. Come join the conversation!