Coping With Allergies During the Spring

Over 25 million people in the United States have allergies to pollen from trees, grass, or weeds. Coping with allergies can be a challenge any time of year, but particularly in the spring for many people. Spring allergies are one way to describe hay fever, allergic rhinitis (inflammation of the mucous membranes of the nose) is another such term. 

But no matter how a person refers to the spring allergy season, it can be a miserable time for those coping with allergies. Fortunately, there are some practical tips that can alleviate some of the sneezing, running nose, nasal stuffiness, congestion, and other symptoms that accompany allergies. 

General Guidance

Here are some helpful tips to lessen the symptoms of your springtime allergies:

• Stay indoors on days that are dry and windy to lower the exposure to allergens (substances that cause allergic symptoms such as pollen).
• The best time to go outside is right after a spring rain. Rain helps to remove some of the allergens from the air. But keep the outdoor excursion relatively short, because pollen levels sometimes soar after a rainfall.
•  Avoid doing yard work, such as raking old leaves (which could stir up mold) pulling weeds or mowing the lawn. 
• Use a NIOSH-approved N95 mask if outdoor work cannot be avoided.
• Wear sunglasses and a hat when outdoors, to reduce the exposure of allergens to the hair and eyes.
• If you must be outdoors in the spring, remove outer clothing (such as jackets or sweatshirts) before re-entering the home, and leave them in the garage or somewhere outside, to keep allergens from accumulating inside the home.
• Shower to rinse off any pollen or other allergens from the skin or hair after being outside.
• Wash bedding in hot soapy water at least once each week to reduce the accumulation of pollen and other allergens in your bed.
• Limit contact with outdoor pets during allergy season.
• Avoid hanging laundry outside to dry. Pollen can stick to clothing, sheets, and towels and expose those with allergies after the laundry is taken into the house.

Reduce Exposure

As the pollen count goes up, so too does the severity of allergic symptoms. To alleviate the severity of symptoms, the Academy of Asthma Allergy & Immunology suggests several interventions.

Keep tabs on the daily pollen count via the local media (internet, radio, newspaper, or television). When the pollen count is reported to be high:

• Start taking allergy medication before symptoms occur; waiting until symptoms have started will reduce the effectiveness of the drugs. For example, in pollen-allergic patients, starting intranasal corticosteroids at least a couple of weeks before pollen season commences can help patients better control their symptoms. Antihistamines can be taken concurrently, but patients do not necessarily need to start these early to insure optimal efficacy during their peak allergy seasons.
• Close the doors and windows of the house.
• Stay indoors whenever possible (particularly in the early morning hours when the pollen counts are usually the highest).

Air Filters and Ventilation

For people coping with allergies, it’s important to keep the indoor air as clean as possible to lower exposure to pollen, this includes:

• Ventilating indoor areas well
• Turning on the air conditioning in the car while driving and in the house, to help circulate and clean stagnant air
• Using a CERTIFIED asthma & allergy friendly filter attachment for forced air heating or air conditioning systems.
• Using an air purification system with a high-efficiency particulate air (HEPA) filter. A HEPA filter removes very small particles from the air.
• Using a dehumidifier to keep the air as dry as possible.
• Cleaning with a vacuum cleaner that has HEPA filter as often as possible. The Asthma and Allergy Foundation of America suggests using CERTIFIED asthma & allergy friendly vacuums.

Over-the-Counter Medications

There are various over-the-counter allergy medications available without a prescription. The two main options are:

• Oral antihistamines: A type of medication that helps to relieve symptoms such as sneezing, runny nose, watery eyes and itching. Examples include, Claritan or Alavert (Ioratadine), Zyrtec Allergy (cetirizine), and Allegra Allergy (fexofenadine).
• Intranasal corticosteroids: The most efficacious treatment for allergic rhinitis available over the counter. Intranasal fluticasone (e.g. brand name Flonase, also available generic form) is one of the most common used, but Rhinocort and Nasocort are just as effective.

Both oral antihistamines and intranasal corticosteroids serve as the cornerstone of allergic rhinitis therapy and can be used long-term without difficulty in almost all patients.

Other Options

These medications should not be used long-term, but can be helpful for a few days.

• Decongestants: Oral (by mouth) or nasal medication that works to alleviate nasal congestion—temporarily. Examples of decongestants taken by mouth include Sudafed, Afrinal, and more. Nasal decongestants (available as a nose spray) includes Afrin (oxymetazoline) and Neo-Synephrine (phenylephrine). Note, nasal decongestants should only be used temporarily, as long-term use can cause symptoms to worsen (called rebound congestion). Additionally, decongestants are notorious for increasing blood pressure in susceptible patients and most patients are not aware of the risk.
• Nasal sprays: Cromolyn sodium is a commonly used nasal spray for allergy symptoms that is sold under the brand name Nasalcrom. This medication works best when started before symptoms occur. Another option, Astepro Allergy, will become available in early 2022 as the first and only over-the-counter antihistamine nasal spray for allergies available in the United States. It's approved for adults and children 6 years of age and older.
• Combination medications: Some allergy medications have antihistamines and decongestants, examples are Claritin-D (loratadine-pseudoephedrine) and Allegra-D (fexofenadine-pseudoephedrine).

Natural Remedies

Other recommendations for coping with allergies in the spring include:

• Use a saline solution to irrigate (rinse) the sinuses and remove allergens (and mucus) from the nose. There are several inexpensive commercial systems available, including the Neti pot (a container with a spout for pouring saline solution), or plastic dispensers. Note, if a plastic nasal irrigation bottle is used, be sure to replace it every three months, or before it gets moldy or dirty (which could cause additional sinus problems)—be sure to read the package insert for further instructions. Only use distilled water or water that has been boiled for at least five minutes to remove any contamination.
• Consider acupuncture. Several studies show that acupuncture may be effective for allergies, and more studies are being conducted to back up this hypothesis.

Medical Intervention

When over-the-counter medications do not alleviate symptoms, it may be a good time to consult with a healthcare provider. Medical treatment for severe allergy symptoms may include:

• Corticosteroid (long-lasting steroid) injections to lower inflammation. Corticosteroids are sometimes used to treat severe flare-ups of allergies or asthma but not as a long-term treatment, as they can cause complications such as an increased risk of infection, thinning bones (osteoporosis), muscle weakness, and weight gain.
• Allergy (skin) testing to confirm what is triggering the allergies, aimed at alleviating the source if possible, and at identifying a specific treatment that may work best on an individual basis.
• Allergy shots to help reduce the immune system reaction for a person coping with allergies—helpful for developing a tolerance.
• Sublingual immunotherapy (under the tongue) tablets.

Skin testing is a necessary first step to determine if a patient would benefit from allergy shots or sublingual immunotherapy tablets.

A Word From Verywell

Although it may be impossible to completely alleviate allergy symptoms by simply changing the environment, there are many effective over-the-counter and prescription medical treatments available to help a person more comfortably cope with allergies during the spring season.