SNIFFLING, ITCHY EYES, GENERALLY feeling like a disembodied head—you swear your allergies haven’t ever been this bad. And you’re probably right. “I’ve been an allergist for more than a decade now, and every year seems to be the worst allergy year ever,” says Caroline Sokol, M.D., Ph.D., a physician in Massachusetts General Hospital’s Allergy & Clinical Immunology Unit.
Blame climate change, which is taking allergens to a whole new level: Pollen season now starts 20 days earlier, lasts ten days longer, and brings 21 percent more pollen than it did in 1990, according to a 2021 study. On top of that, “your body naturally boosts its response to the same allergens every year, making symptoms worse,” says Dr. Sokol. And over time, “allergy creep” can happen, too, meaning different allergens set you off. You can shut your windows, shower off pollen and change after you’ve been outdoors, and wear a mask when you go out. But those are all defensive maneuvers. You can—and should—go on the offensive with these moves.
Check that it’s an allergy
It’s hard to tell the difference between the symptoms of a viral illness like Covid and allergies. While a cough coming from your chest is more likely to be Covid and a tickle in your throat could be allergies, the only real way to know what you’re dealing with is to test for Covid, says Dr. Sokol.
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Beat pollen to the punch
“Allergies are easier to prevent than to treat once they’re flaring,” says Dr. Sokol. After the reaction starts, more cells come to the scene to fight the invader, and your symptoms get worse. So begin taking your allergy med about two weeks before allergy season (check pollen.aaaai.org), and continue taking it every day. Good rule of thumb: Start dosing up around St. Patrick’s Day if you live in the Northeast or around Valentine’s Day if you live in the South or Midwest. (In other words, right around now.)
Use a nasal steroid spray first
A task force of top allergy doctors found that OTC steroid sprays are the best starter med to try. These sprays—like Flonase (fluticasone propionate), Nasacort (triamcinolone acetonide), and Rhinocort (budesonide)—attack allergies at their core, says H. James Wedner, M.D., an allergist and a professor of medicine at Washington University School of Medicine in St. Louis.
When your body becomes allergic to pollen, it misidentifies it as a pathogen. (Same with pet dander, dust mites, and whatever else you’re allergic to.) To fight back, your body rallies chemicals, including histamine, and a host of immune-system cells. These end up causing inflammation in your nasal passages, which nasal sprays help counteract. It takes a few days for any spray to work. Which to choose is up to you—they’re equally effective, says Eddie Shields, M.D., a board certified allergist at Arkansas Allergy and Asthma Clinic.
Consider an Antihistamine
If you need relief now, before a nasal spray takes effect, you can layer on an oral nonsedating antihistamine pill, such as Claritin (loratadine), Allegra (fexofenadine), Zyrtec (cetirizine), or Xyzal (levocetirizine). Or try an antihistamine nasal spray like Astepro (azelastine).
Antihistamines target only one chemical (histamine) in an allergic reaction, which is why docs see them as a second-tier approach. There’s no magic formula for how long to be on both; try weaning off after a week. If symptoms flare up again, you might benefit from being on both meds full-time. (Nothing wrong with that, docs say.)
Allegra tends to be the least sedating; some patients say Zyrtec causes drowsiness; and Claritin is less effective, says Dr. Shields. “Anecdotally,” says Dr. Sokol, “some people find that one works for them for a while and then just seems to lose a little bit of efficacy. They find if they switch to another one, they do better.”
Head to an Allergist
If none of the above helps, see an allergist. You can find out exactly what you’re allergic to and, if appropriate, opt for allergy shots—the only treatment that offers long-term allergy relief. Over time, the weekly shots, which can eventually be reduced to monthly, help you build tolerance to what makes you sneeze. One thing: It can take up to five years to see the full benefit. If you’re allergic only to grass, dust mites, or ragweed, you may be eligible for sublingual immunotherapy. This still takes three to five years, but all you have to do is dissolve a tablet under your tongue at home.
How Not to Treat Seasonal Allergies
Decongestants
If you take a basic decongestant for seasonal allergies, you might feel better initially, but Dr. Sokol says it doesn’t actually manage the underlying cause of your issues. It can also have side effects, like raising blood pressure. Decongestant nasal sprays containing oxymetazoline, like Afrin and Mucinex, aren’t a good long-term strategy, either. They can trigger rebound congestion: When the med wears off, the symptoms may come back even stronger, forcing a cycle of using more and more. If you use medicated nose drops, stop after three days.
Redness-relief eye drops
Stay away from redness-relief products containing tetrahydrozoline, such as Visine. These shrink blood vessels in your eyes and can even damage tissue if you use them too often. If nasal sprays or antihistamines don’t take care of red, itchy eyes—or if itchy eyes are your only symptom—you can try antihistamine eye drops, like Pataday (olopatadine) or Zaditor (ketotifen). These block the release of histamine in cells in your eyes and reduce irritation, Dr. Shields says.
Benadryl
Considered a first-generation antihistamine, Benadryl is known to cause drowsiness, and its ability to relieve allergy symptoms wears off after a few hours.
Erica Sweeney is a writer who mostly covers health, wellness and careers. She has written for The New York Times, HuffPost, Teen Vogue, Parade, Money, Business Insider and many more.
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