Friday, November 28, 2014
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Dealing with seasonal allergies: Know your options

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Spring is in the air — literally! Your runny nose, itchy eyes and sneezing fits are all products of the pollen, weeds and dust mites that have gone airborne now that the snow has melted.

After our winter of discontent, we’re hearing that this allergy season could be the worst yet. Fortunately, Dr. John Cohn, an allergist in the Department of Critical Care and Pulmonary Medicine at Thomas Jefferson University Hospital doesn’t see it that way.

“I’ve been doing this for over 30 years and I can’t remember the last time I had a newspaper call me and say, ‘I heard this is going to be a good allergy season’,” joked Dr. Cohn.

Dr. Cohn explained that the only factor that truly makes a difference in allergy season outcomes is rain — and lots of it.  

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  • “It’s only when we get a couple of weeks of consistent rain, like true April showers, that it washes away enough of the pollen to make a difference,” Dr. Cohn said. “Other than that, nothing else will drastically change the pollen count.”

    So unless the rain starts pouring down (and quick!) what can you do to take control of your allergies? Luckily, our endless options of over-the-counter remedies are nothing to sneeze at. But it can be hard to make sense of it all, especially when your eyes are in a ragweed haze.

    Antihistamines, decongestants, mast cell stabilizers, combinations drugs — which options are best? We had local experts weigh in on the most effective OTC remedies for allergy sufferers.

    The two most common allergy relief options are antihistamines and decongestants. Antihistamines work to block the affect of histamine, a substance that the body makes during an allergic reaction. While, decongestants reduce blood flow in the affected area, which helps clear congestion and improve breathing.

    When pitted against each other, Dr. Cohn recommends antihistamines are the way to go.

    “The best OTC remedies are non-sedating long-acting antihistamines, of which, there are three kinds: certirizine (Zyterc), fexofenadine (Allegra) and loratadine (Claritin),” explains Dr. Cohn.

    But Dr. Cohn is quick to stress that the concept of “best” will always vary from patient to patient.

    “When you ask me what’s the best drug, I’m thinking, if I give Drug 1 to 100 patients in Group A where 80 percent have a favorable reaction and I give Drug 2 to 100 patients in Group B where only 40 percent have a favorable reaction then I know Drug 1 has greater odds of reacting well with patients — in this case, Drug 1 is antihistamines.”

    When it comes to easing allergy symptoms in children, Dr. Jonathan Spergel, Chief of the Allergy Section, at The Children's Hospital of Philadelphia agrees wholeheartedly. 

    “The three OTC antihistamines all come in liquid form making them safe for children and they each have very slight pluses and minuses so I tell my patients to take whichever one they prefer,” said Dr. Spergel.

    Decongestants don’t block the histamines that are the main cause behind your itchy, runny nose and eyes. Dr. Cohn finds that decongestants also have the most side effects in terms of blood pressure, prostate issues, tremors and trouble sleeping.

    Dr. Spergel warns that allergy sufferers will definitely want to steer clear of topical nasal decongestants, such as Afrin. “That’s the OTC medication that we worry about most.”

    “These decongestants are addictive and cause rebound, so if you use them [repeatedly for more than three to five consecutive days] they’ll cause nasal damage and you’ll experience worse symptoms than you did before,” Dr. Cohn explained. 

    For allergy relief with the least possible side effects, Dr. Spergel recommends a nasal saline spray. “Good old-fashioned salt water up your nose works really well to flush out all of that pollen,” said Dr. Spergel.

    If OTC medications just aren’t cutting it, when do you know it’s time to see a specialist?

    “If the recommended doses are not working and you’re going beyond them; if you experience a fever or coughing and breathing problems beyond the usual runny nose and sneezing, then you should consult with your doctor,” Dr. Spergel suggested.

    To nip your seasonal allergies in the bud, Dr. Spergel shares the advice he offers to help parents take control of their children’s allergies.

    “When kids come in from playing outside, they should change their clothes and take shower,” said Dr. Spergel. “They are likely covered in pollen and then they sleep in their bed and they’re just breathing it in all night long.”

    At the very least, Dr. Spergel recommends washing your hands and face to rid you of some of the pollen you likely picked up while outside.

    For more information on allergies, visit AAFA.org.

    Kelly O'Shea Senior Health Producer, Philly.com
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