Patient education: Seasonal allergies in adults (The Basics)
Written by the doctors and editors at UpToDate
What are seasonal allergies?
— Seasonal allergies, also called “hay fever,” are a group of conditions that can cause sneezing, a stuffy nose, or a runny nose. Symptoms occur only at certain times of the year. Most seasonal allergies are caused by:
●Pollens from trees, grasses, or weeds (figure 1)
●Mold spores, which grow when the weather is humid, wet, or damp
Normally, people breathe in these substances without a problem. When a person has a seasonal allergy, his or her immune system acts as if the substance is harmful to the body. This causes symptoms.
Many people first get seasonal allergies when they are children or young adults. Seasonal allergies are lifelong, but symptoms can get better or worse over time. Seasonal allergies sometimes run in families.
Some people have symptoms like those of seasonal allergies, but their symptoms last all year. Year-round symptoms are usually caused by:
●Insects, such as dust mites and cockroaches
●Animals, such as cats and dogs
What are the symptoms of seasonal allergies?
— Symptoms of seasonal allergies can include:
●Stuffy nose, runny nose, or sneezing a lot
●Itchy or red eyes
●Sore throat, or itching of the throat or ears
●Waking up at night or trouble sleeping, which can lead to feeling tired during the day
Is there a test for seasonal allergies?
— Yes. Your doctor will ask about your symptoms and do an exam. He or she might order other tests, such as allergy skin testing, which can help the doctor figure out what you are allergic to. During a skin test, a doctor will put a drop of the substance you might be allergic to on your skin, and make a tiny prick in the skin. Then, he or she will watch your skin to see if it turns red and bumpy.
How are seasonal allergies treated?
— People with seasonal allergies might use one or more of the following treatments to help reduce their symptoms:
●Nose rinses – Rinsing out the nose with salt water cleans the inside of the nose and gets rid of pollen in the nose. Different devices can be used to rinse the nose.
●Steroid nose sprays – Doctors often prescribe these sprays first, but it can take days to weeks before they work. (Steroid nose sprays do not contain the same steroids that athletes take to build muscle). In the US, it’s also possible to get one steroid nose spray (triamcinolone) without a prescription. If you decide to try this medicine, you might need to take a nasal decongestant for a few days first. This will reduce swelling in the nose and make it easier for the steroid to get deep into your nose. Steroid nose sprays work best if you use them every day. Steroid nose sprays are more effective than other allergy medicines for congestion and post-nasal drip (which is when mucus runs down the back of your throat).
●Antihistamines – These medicines help stop itching, sneezing, and runny nose symptoms. Some antihistamines can make people feel tired.
●Decongestants – These medicines can reduce stuffy nose symptoms. People with certain health problems, such as high blood pressure, should not take decongestants. Also, people should not use decongestant nose sprays for more than 3 days in a row. Using these nose sprays for more than 3 days in a row can make symptoms worse.
●Allergy shots – Some people with seasonal allergies choose to get allergy shots. Usually, allergy shots are given every week or month by an allergy doctor. They contain tiny amounts of allergens, such as pollen. Many people find that this treatment reduces their symptoms, but it can take months to work.
●Allergy pills (under the tongue) – For some types of pollen allergies, there are pills that work much like allergy shots. The pills are made to dissolve under the tongue. They are taken every day for several months of the year.
Talk with your doctor about the benefits and downsides of the different treatments. The right treatment for you will depend a lot on your symptoms and other health problems. It is also important to talk with your doctor or nurse about when and how to use your medicines.
Can seasonal allergy symptoms be prevented?
— Yes. If you get symptoms at the same time every year, talk with your doctor or nurse. Some people can prevent symptoms by starting their medicine a week or 2 before that time of the year.
You can also help prevent symptoms by avoiding the things you are allergic to. For example, people who are allergic to pollen can:
●Stay inside during the times of the year when they have symptoms
●Keep car and house windows closed, and use air conditioning instead
●Take a shower before bed to rinse pollen off their hair and skin
●Wear a dust mask if they need to be outside
What if I want to get pregnant?
— If you want to get pregnant, talk with your doctor about which medicines are safe for pregnant women to take. Seasonal allergy symptoms can get worse, get better, or stay the same in pregnant women.