immune disorders
Seasonal Allergies
Treatment of Seasonal Allergies
Corticosteroid nasal sprays Antihistamines Decongestants Eye drops Allergen immunotherapy People with severe seasonal allergies that remain troublesome after trying standard treatments may consider moving to an area that does not have the allergen. Acorticosteroid nasal sprayis usually very effective and is used first. Most of these sprays have few side effects, although they can cause nosebleeds and a sore nose. Anantihistamine,taken by mouth or used as a nasal spray, can be used instead of or in addition to a corticosteroid nasal spray. Antihistamines are often used with a decongestant, such aspseudoephedrine, taken by mouth. Manyantihistamine-decongestant combinationsare available over the counter as a single tablet. However, people with high blood pressure should not take a decongestant unless a doctor recommends it and monitors its use. Also, people who take a monoamine oxidase inhibitors (a type of antidepressant) cannot take a product that combines an antihistamine and a decongestant. These combination drugs should not be used in young children. Antihistamines may have side effects, particularly Anticholinergic: What Does It Mean? . They include sleepiness, dry mouth, blurred vision, constipation, difficulty with urination, confusion, and light-headedness. Decongestantsare also available over the counter as nose drops or sprays. They should not be used for more than a few days at a time because using them continually for a week or more may worsen or prolong nasal congestion—called a rebound effect—and may eventually result in chronic congestion. Side effects tend to be fewer and less severe with nasal sprays than with drugs taken by mouth. Other drugsare sometimes useful. Cromolyn is available by prescription as a nasal spray and may help relieve a runny nose. To be effective, it must be used regularly.Azelastine(which is an antihistamine and a mast cell stabilizer) andipratropium, both available by prescription as nasal sprays, may be effective. But these drugs can have anticholinergic effects similar to those of antihistamines taken by mouth, especially drowsiness. Montelukast, a leukotriene inhibitor available by prescription, reduces inflammation and helps relieve a runny nose. It is best used only when other drugs are ineffective. Possible side effects include confusion, anxiety, depression, and abnormal muscle movements. Regularly flushing out the sinuseswith a warm water and salt (saline) solution may help loosen and wash out mucus and hydrate the nasal lining. This technique is called sinus irrigation. When these treatments are ineffective, a corticosteroid may be taken by mouth or by injection for a short time (usually for fewer than 10 days). If taken by mouth or injection for a long time, Corticosteroids: Uses and Side Effects can have serious side effects. Bathing the eyes with plain eyewashes (such as artificial tears) can help reduce irritation. Any substance that may be causing the allergic reaction should be avoided. Contact lenses should not be worn during episodes of conjunctivitis. Diagnosis containing antihistamines and a drug that causes blood vessels to narrow (a vasoconstrictor) are often effective. These eye drops are available without a prescription. However, they may be less effective and have more side effects than prescription eye drops. Eye drops containing cromolyn, available by prescription, are used to prevent rather than relieve allergic conjunctivitis. They can be used when exposure to the allergen is anticipated. If symptoms are very severe, eye drops containing corticosteroids, available by prescription, may be used. During treatment with corticosteroid eye drops, the eyes should be checked regularly for increased pressure and infection by an ophthalmologist. Antihistamines taken by mouth (such asfexofenadine) may also be helpful, especially when other areas of the body (such as the ears, nose, or throat) are also affected by the allergies. If other treatments are ineffective, Allergen immunotherapy (desensitization) helps some people. Desensitization is a process that tries to teach the person's immune system not to react to an allergen. The person is given progressively larger doses of the allergen. The first dose is so small that even an allergic person will not react to it. However, the small dose starts to get the person's immune system used to the allergen. Then the dose is gradually increased. Each increase is so small that the immune system still does not react. The dose is increased until the person is not reacting to the same amount of allergen that once caused symptoms. Immunotherapy for seasonal allergies is needed in the following situations: When symptoms are severe When the allergen cannot be avoided When the drugs usually used to treat allergic rhinitis or conjunctivitis cannot control symptoms Immunotherapy for seasonal allergies involves gradually increasing doses of allergen placed under the tongue (sublingual) or injected into the skin. Because even small doses occasionally cause dangerous allergic reactions, people remain in the doctor’s office for at least 30 minutes afterward. If they do not have a reaction after first dose, they can take subsequent doses at home. Allergen immunotherapy for hay fever should be started after the pollen season to prepare for the next season. Immunotherapy has more side effects when started during pollen season because the pollen allergens have already stimulated the immune system. Immunotherapy is most effective when continued year-round. People taking allergen immunotherapy for allergic rhinitis should carry a prefilled, self-injectingepinephrinesyringe in case an anaphylactic reaction occurs before their immunotherapy treatment in the doctor's office takes effect. 