And so it begins. You walk out to your car and see the dreaded dusting of yellow-green pollen so innocently blanketing your beloved ride.
All too soon, the reactions come: the itchy eyes, the runny nose, the sneezing fits, and the tickle in your throat that even a gallon of water can’t seem to relieve.
Allergy season has hit with a vengeance. According to the FLONASE® Allergy Tracker (powered by The Weather Channel), Charleston was among the first cities in the country to get hit with allergy season this year.
We chatted with Dr. Tania Elliott, Board-Certified Allergist and Associate Attending at New York University School of Medicine and Dr. George F. Harris, IV, pediatric ear, nose, and throat surgeon with Summerville Pediatric Specialists, about the early onset of allergy season, its related symptoms, and advice on how to combat those symptoms.
Question: Why has allergy season hit Charleston and the surrounding areas early this year, and when does it normally tend to begin?
Dr. Elliott: Mild winters tend to bring earlier allergies. Usually, allergy season begins at the start of spring [March 20th this year].
Dr. Harris: I agree. We had a warmer than expected January and February, we had moisture and higher temperatures, and though we see molds year-round, their presence was stronger earlier this year than I’ve seen before. Because of the warm weather, the plants began their natural cycles.
Question: How would you describe pollen and allergies to someone who has never experienced them? In other words, what is pollen and what is occurring in our bodies because of it?
Dr. Elliott: Pollen is the little yellow stuff you see on cars. Produced by trees and other plants, it is small pieces of matter suspended in the air that can travel distances of 50 to 100 miles.
Dr. Harris: Exactly. Pollen is the reproductive cell for a plant – it’s a part of the plant’s reproductive system, which means that the plants are interested in spreading it far and wide. When we inhale or swallow pollen, it coats the mucus that’s in our bodies. When it’s dissolved in the mucus, our cells interact and histamine is released.
Dr. Elliott: Yes, allergies to pollen are essentially an abnormal reaction to something that is normally in the air, and even trace amounts can cause issues. Even if a person is not necessarily allergic to pollen, a large amount of it can cause enough irritation to the eyes and nose to trigger sneezing, coughing, itching, or congestion. The main chemical released from the body is called histamine [as mentioned previously by Dr. Harris], which is responsible for causing swelling, itching, redness, and congestion. As annoying as these reactions are, it is actually the body’s way of fighting the allergen.
Question: Have you noticed a steady rise in patient numbers over the years due to allergies? If so, what do you think is causing this?
Dr. Elliott: Absolutely. There are several factors that can cause this. One is related to the Hygiene Hypothesis which surmises that parents’ efforts to decrease their children’s exposure to germs early on actually prevents the immune system from properly learning what is a foreign invader and what is not, making the body over-reactive and susceptible to allergies. We also see more pollen production due to global warming, and more potent pollen as a result of increased pollution in the air, such as diesel exhaust.
Dr. Harris: I have certainly seen a steady rise in patients suffering from allergies – 1/3 to a quarter of my patients have them. It is very common, and to be honest, allergies in the Low Country are a way of life. They’re a fact. They are present in large numbers, and it can be familial – many of my patients’ future children will be affected and their children will be affected. With the many allergy diseases present, continued climate change, longer growing periods, and less dry periods, the number of patients suffering from allergies will continue to rise.
Question: What range of symptoms do you see in allergy sufferers, and are there some symptoms that patients seem surprised are related to allergies?
Dr. Elliott: Symptoms range from runny noses, coughing, and sore throats to asthma symptoms, shortness of breath, headache, fatigue, difficulty sleeping, and facial pain and pressure. Patients tend to be surprised to learn that dark circles under their eyes can be related to allergies. Known as “allergic shiners,” these dark circles are caused by the dilation of the blood vessels, and are visible because the skin under the eye is so thin. A nasal crease, skin findings, dry skin, and eczema are also unexpected symptoms of allergies.
Dr. Harris: Additional symptoms that patients seem surprised about are bloody noses (due to increased mucus and then crusting, children scratch their noses and cause bleeding), as well as sleep disturbances correlated with obstruction of the upper air way. This can cause grades to suffer, and children may not do as well in school because of not getting proper sleep.
Question: Are senior citizens at a higher risk for allergies, and do you notice a difference in the severity of symptoms between youth, young adults, older adults, and senior citizens?
Dr. Elliott: No, senior citizens are not at a higher risk for allergies. Allergies are actually more common in children and teens and peak again between ages 35-45. The elderly tend to lose their allergies over time (the immune system becomes less robust over the age of 50). However, they can still react to irritants in the air, especially on high pollen count days.
Dr. Harris: Agreed. My practice serves children from birth to age 17, and the initial appearance of allergies in the first two years of life seems to be the worst. We are dealing with smaller anatomies, as well as the fact that babies can’t talk, so they struggle to verbalize. Therefore, allergies can go undiagnosed and untreated for longer periods. School aged children can have significant trouble having these issues addressed and treated.
Question: Can allergies ever be life threatening?
Dr. Elliott: Yes. There have been rare cases of anaphylactic reactions to environmental allergies. People at highest risk for severe reactions are those with asthma.
Dr. Harris: Absolutely. There are patients who experience anaphylaxis due to severe food allergies, nut allergies, and environmental exposures. Allergies can also cause changes in blood pressure and difficulty breathing.
Question: What helpful tips, sage advice, and/or simple steps can people take to reduce allergen exposure, and what allergy medicines do you recommend?
Dr. Elliott: For outdoor allergies: While driving, keep your windows closed and the air conditioner on. Upon arriving home, take off your shoes (ideally before you walk in the house) and wash your clothes right away (or at least place them in the laundry room). Rinse off or shower right away, as pollen can get in your hair, on your eyelashes, etc.. Avoid using heavy or sticky hair products. If you wear contacts, consider switching to glasses, and if not, wear sunglasses.
For indoor allergies (depending on what you are allergic to): wash your pets at least once a week or wipe your pets down with hypo-allergic wipes.
Use an air purifier. Vacuum your carpet at least once a week with a HEPA vacuum. Be sure to keep a home that does not invite the unexpected allergens of mice and cockroaches (yes, these vermin are allergens!).
You can do this by caulking holes in the walls and reducing/eliminating excess moisture in your home. Use dust mite-proof bed covers, and wash your bed sheets once a week on the highest heat setting.
Medication wise, the first line of treatment that I recommend is a nasal steroid spray, such as FLONASE®, to be started two weeks before the start of allergy season. In order for the treatment to be most effective, it needs to build up in the system to prevent allergy symptoms from occurring.
Fun Tip: Spicy foods help thin out mucus and help to drain your nasal passages.
Dr. Harris: Be aware that children can suffer and it can be a significant burden. Recognition is the first step. If we know that someone is susceptible, then we should rewash bedding, use filters on the air panels in our home, and change air filters. Come up with a treatment plan that helps address those problems.
Medication wise, antihistamines are available over the counter, including non-drowsy liquid antihistamines. Topical nasal steroids have been shown to be very safe, but you must commit to using it as instructed. You may also introduce the concept of a nasal mist. We use a nasal mist to reduce the amount of contaminated mucus. A nasal rinse can be used if the mist is not quite enough (neti-pots can be used for children 6 to 7 years old).
If you are worried about your or your child’s allergies, do not hesitate to see the doctor.