Managing seasonal allergies

 

Managing seasonal allergies

Seasonal allergies I know of so many friends and patients who are struggling with allergies this spring. I reached out to my favorite pediatric Allergist Katherine Fast to pick her brain on the topic. This post includes What are seasonal allergies? How can you tell the difference between allergies and a cold? What can you do to minimize exposure? What are basic symptomatic treatments? The value of seeing an allergist Seasonal allergies are hitting a lot of folks hard this season. With the climate in upheaval, pollen seasons are starting earlier and lasting longer. Allergy symptoms occur when airborne irritants, or allergens, enter the eyes, nose and throat, setting off an allergic reaction. Since children need to be exposed to an allergen before developing a reaction to it, kids under two years of age are less likely to have issues with pollen. It typically takes at least a season or two before they react, so if a newborns has congestion, we are not going to blame that on seasonal allergies. The tendency to be allergic runs in families, but doesn’t mean you will always be allergic to the same thing. If your little one has eczema they are more likely to be reactive to various triggers. It can be a challenge trying to figure out if you are dealing with allergies, a virus or some kind of infection. There are some clues: With allergies: the mucus from the runny nose is clear there is usually NO fever Many people complain of Itchy faces, nose and eyes. Both eyes are usually equally itchy, and sometimes are a little red Some kids actually get a telltale crease at the top of their nose from pushing at it! There will often be dark circles under the eyes. These allergic shiners occur when congestion in your sinuses leads to congestion in the small veins under your eyes. The blood pools under your eyes and these swollen veins dilate and darken, creating dark circles and puffiness. (These can happen from any type of nasal allergy) It lingers The symptoms come along seasonally How do I know it’s not a virus or infection?  Viral nasal secretions are typically thicker and can be discolored, like green, yellow, or thick white The worst of the symptoms usually clear within 7-10 days If the pinkeye is involved, it can start in just one eye. May have muscle aches, fever, productive cough Dr. Ted’s approach involves immediately figuring out if congestion is due to allergies by doing a strict 7-14 day trial with an antihistamine in any patient age 2 years or older. If congestion clears up quickly with daily Claritin or Zyrtec, and comes back 2-3 days after stopping, you know you’re dealing with allergies. Here are some common sense things you can do to help minimize exposure, which in turn can diminish symptoms Have your child wash their hands and face as soon as they come in from playing outside so they don’t rub pollen in their eyes and nose.  Do a rinse off in the shower or bath before going to bed Check the forecast for pollen levels, and limit outdoor activities when pollen counts are at their highest. Mornings are often the time of day when pollens are worse Avoid hanging laundry outside on a clothesline during high pollen season Put on a new pillow case every night. Hepa filters can be really helpful, but make sure you have a good one.  Your heating, ventilation, and air conditioning (HVAC) system can make a big difference. They have something called a MERV rating, which stands for minimum efficiency reporting value. This tells you how big the pores are and what they will allow through. Old filters will allow almost anything to pass through. If possible, upgrade the filters to a MERV rating of nine or higher. Symptomatic Treatment. Sometimes you just can’t avoid the pollen and need to use some treatments to get relief.  Clearing the Nose Sinus irrigation/Neil Med: For adults and older kids, sinus irrigation/neti pot can be a valuable tool. It is worth a try, but don’t be too hard on your kids if they refuse. Xlear nose spray is a great product and is safe for all ages Nasal steroids now have multiple brands that are over the counter. The nose sprays can actually bring relief to the eyes as well Allergist Katie Fast starts with Budesonide, because it is water based so might be more easily tolerated but Flonase and Nasonex are other good brands. It is important to use them properly. Aim the spray to the outside rather than the middle of the nose. For example, if spraying in the right side, aim to the outer corner of the right eye, and vice versa EYE DROPS If your eyes are really bugging you, start with some natural eye drops such as artificial tears or Similassin. Do NOT get the ones that are focused on getting the red out. If those don’t do the trick. Zaditor or Patanol are good options. Keep the drops in the fridge. The cold adds an extra level of soothing. Oral Antihistamines Zyrtec and Claritin are less likely to make you sleepy and can give full day relief. If you are looking for a list of natural ways to approach allergy treatments, check out this post by holistic Pediatrician Elisa Song The Big Picture My conversation with Dr. Fast left me with an impression that wasn't the initial focus of this post, but after we spoke, seemed blindingly obvious. If you suspect any type of allergy, please take the time to see an allergist. A few years of allergy shots or sublingual tablets may take away or minimize a life sentence of seasonal allergies. If it becomes clear that you or your little one are impacted by grasses/ pollens etc. Reach out before the next season suffering begins again.  Think of it as a gift to your child.