What is a pollen allergy?
Have you ever noticed that you develop a stuffy nose at certain times of year? Maybe it’s so hard to breathe you can barely hold a conversation. Or maybe your nose is running like a faucet and you can’t stop rubbing your itchy eyes.
It sounds like it could be a pollen allergy.
Pollen is one of the major offenders in seasonal allergic rhinitis (also called hay fever).
It isn’t the fluffy seed pods you see blowing in the wind. The pollen that sneaks inside your nose as you breathe is barely visible to the naked eye, but if you’re allergic to it, it sure can make life miserable.
The word “rhinitis” means inflammation of the nose, and that’s where a lot of symptoms show up—think congestion and a runny nose. But it can cause other miserable symptoms, too, like itchy, watery eyes.
What kind of pollen triggers allergy symptoms?
The large and waxy pollen that bees and other pollinators carry from brightly colored flowers usually don’t trigger allergies.
So when it comes to cut flowers, you’re generally in the clear if the florist trims and removes pollen-containing stamens or you choose insect-pollinated or low-pollen flowers, like unscented tea roses, tulips, hydrangeas, or orchids.
The pollen that triggers sneezing and watery eyes is mainly from trees, grasses, and low-growing weeds. These types of plants are referred to as wind-pollinated species.
And their pollen is much smaller, lighter, and more-easily spread via wind.
“Ragweed is probably one of the worst. Grasses and trees are pretty bad as well,” says Daniel Sullivan, MD, an otolaryngologist and surgeon specializing in allergies at the Health First Medical Group in Melbourne, Florida.
Pollen typically leads to spring, summer, and/or fall allergies.
When is pollen season?
Like the real estate expression “location, location, location,” pollen-producing plants can be tolerable or horrible depending on the season, where they grow, and how close you are to them.
Ragweed, for example, grows mainly in the Eastern and Midwestern United States, so you might not have to deal with dreaded ragweed allergy symptoms as much if you live in California. But the olive trees might do you in during pollination.
Generally speaking, tree pollen shows up from March to April or May. Grass pollen typically pops up in late spring. Ragweed pollen peaks in the fall, around September, and lingers till October, Dr. Sullivan says.
On top of varying by location, however, the timing and severity of pollen seasons can also vary from year to year based on the weather—and the threat seems to be worsening over time in some places because of climate change.
If you want some warning before pollen season gears up, sign up for free email alerts from the National Allergy Bureau. They provide accurate pollen (and mold) levels in your area.
How pollen causes allergic reactions
Our immune systems decide how they will defend us against foreign substances. For example, some people may have little reaction to a foreign substance such as pollen, bee venom, or pet dander, while other people’s immune systems might see one of these things as a threat.
So your body overreacts to these invaders by producing histamines to fight off the allergens. That may sound like a good battle plan, but it could induce an allergic reaction.
You’ll feel the effect of that internal war on allergens in your nose, lungs, throat, sinuses, ears, skin, or stomach lining.
The variability of pollen allergies remains a mystery, but if you have asthma or a family history of allergies, you’re more likely to have some allergies. Children have a stronger possibility of developing allergies, although allergies can happen at any age.
Pollen allergy symptoms
Pollen allergy symptoms can vary widely, and people may have their own personal collection of symptoms, Dr. Sullivan says.
Pollen allergy symptoms begin in the nose. When the nose becomes irritated and inflamed with pollen, mucus production increases, and it may become thicker and start flowing from the front of the nose and the back.
Inflammation is just the beginning. Pollen also elicits one or a combination of these symptoms:
Redness and swelling around the eyes
Can allergies cause other illnesses?
Yes. If allergy symptoms aren’t miserable enough on their own, nasal inflammation can lead to pressure, headaches, sinus infections, or worse.
That pesky lingering inflammation in the sinuses makes it very hospitable for organisms, Dr. Sullivan says.
“If you have an allergy flare and you happen to get exposed to a virus or bacteria at work, you’re much more likely to get sick than if your allergies were under good control and you didn’t have inflammation already there,” he explains.
A recent study published in the journal Allergy attests to that, suggesting pollen exposure could weaken the immune system’s ability to fight against respiratory illnesses.
In addition, pollen allergies are a major contributor to asthma for some people and pollen can trigger asthma attacks.
People who have pollen allergies can also cross-react to thin-skinned fruits and veggies, a condition known as oral allergy syndrome. This can cause you to have itchy or tingling lips, tongue, or throat when eating certain kinds of fruits and vegetables, like apples or carrots.
Should you get a pollen allergy test?
You might not need an official pollen allergy diagnosis, especially if you remain aware of the pollen season, take precautions to limit your exposure, and manage your symptoms well.
On the other hand, if you can’t pinpoint what’s causing your symptoms, you might want to get tested by an allergist. Some medical conditions are easily mistaken for allergies.
“Some testing may help some folks understand what their triggers are. For instance, the olive tree in California is a major allergenic source of pollen, but so is the oak tree,” says Tina Sindher, MD, an allergist with Stanford Health Care in San Jose, California.
Both trees are likely to be treated the same way, but pinpointing the specific pollen can help in terms of new landscaping, offering clues about which plants to omit.
It is possible to develop new allergies at any time, Dr. Sindher points out, so even if new landscaping does relieve your allergy symptoms, keep in mind they could still become an issue in the future.
How are pollen allergies diagnosed?
The two most common types of allergy tests are the skin prick test and intradermal test.
Pollen is just one type of allergen that can be tested. Allergists also use these tests when they suspect other allergens, such as pet dander, mold, stinging insects, latex, or food, are triggering allergic reactions.
During a skin prick test, a tiny amount of allergen is placed on your skin. The allergist will then gently prick or scratch the area so the allergen can enter the skin.
The intradermal test is minimally invasive. It involves injecting a small amount of allergen under the skin. You might feel a slight prick when the allergen is injected. An allergist might opt for this method because it is more sensitive than the skin test, and several allergens can be tested at the same time.
With both tests, redness and swelling appear at the test site in no more than 15 minutes if you are allergic. You also might have a skin rash, stuffy nose, or red, watery eyes.
In rare cases, anaphylaxis (a whole-body allergic reaction that can be life-threatening) may occur. Rest assured, your allergist is already prepared to treat you quickly.
Pollen allergy prevention
The go-to tactic for treating people with allergies is usually an antihistamine pill or nasal spray. While those are effective for suppressing symptoms, Dr. Sindher says you don’t always have to rely on medicine if you know what’s coming.
“Once you know the allergen, the first line of defense is avoiding the allergens,” she says. But she knows that’s easier said than done, especially if you want to open your windows or enjoy the great outdoors.
One method is all too familiar. The same masks we’ve been wearing to protect ourselves and others against Covid-19 could help us avoid allergens too.
A recent study showed that surgical and N95 masks help filter allergens and prevent people from breathing them in, therefore cutting back on dreaded allergy symptoms.
Here are a few more suggestions to minimize your exposure, or at least get pollen off your body as soon as you can:
Don’t touch your nose.
Wash your hands with soap and water often.
Limit your outdoor time when pollen counts are high for plants to which you’re allergic.
If possible, keep house and car windows closed during high-pollen season and use central air conditioning.
Wear sunglasses and a hat to keep pollen out of your eyes and off your hair.
Take off your shoes and leave them by the door when entering the house.
Change out of clothes worn during outdoor time. Bathe and shampoo your hair.
Wash and dry clothes that were worn outside. Don’t hang clothes to dry outside.
Wash bedding in hot, soapy water once a week.
Restrict snuggle time with pets that spend a lot of time outdoors.
Pollen allergy treatments
We usually reach for medication after a headache or stomachache begins. But a preemptive strike is more effective than when it comes to halting the release of histamine, which prompts those nasty allergy symptoms you want to sidestep.
Allergists recommend taking allergy medication before pollen season begins, especially if your symptoms are so severe they interfere with daily activities or if you’re prone to getting a sinus infection because the nasal passages are blocked.
“I usually tell my patients to start taking medicine a week or two before the expected pollen season,” Dr. Sindher says. “The inflammation is so bad that it takes a lot more effort to get it back down versus if you start before the pollen season, [which is] easier to control.”
Allergy relief is available in many forms: oral tablets, liquid medications, eye drops, nasal sprays, and rinses.
For most people, taking a pill is the easiest solution, but according to Dr. Sindher, one of the most effective remedies for post-pollen exposure is a simple saline nasal rinse.
“Saline nasal rinses, or nasal sprays such as Flonase, are super helpful and can take care of a lot of symptoms without having to use pharmaceutical options,” she says.
They work by flushing out the allergens. Not everyone is crazy about bending over the sink and squirting water in one nostril (or pouring it in with a neti pot) and watching it run out the other nostril. It’s an odd feeling. And it might take a little practice to nail down the method.
If you can’t bring yourself to do a nasal rinse, a nasal spray might make you less squeamish. To kick those wretched symptoms to the curb, these best allergy nasal sprays are worth the effort.
Here are some other options to tame your symptoms:
Antihistamines: They’re available over the counter and by prescription. They work by blocking or reducing histamines to relieve allergy symptoms. Most are available in a nondrowsy formula, but some may make you drowsy. Know how they will affect you before using heavy machinery, driving, and performing other tasks you need to be alert to do safely.
Decongestants: These come in pill and nasal spray forms. They relieve stuffiness and pressure. A word of caution: you should only use decongestant nasal sprays for a few days. Otherwise, it may actually make your symptoms worse.
Immunotherapy may be the next step in fighting pollen allergies for people who can’t find relief with nasal sprays or allergy medications.
This type of preventative treatment works by exposing you to an allergen and gradually increasing the doses of the allergen to build up the body’s immune system. The intended result: you are less sensitive to the pollen.
“Allergy shots can be very helpful at reducing your immune response to allergies and decreasing your overall allergic burden,” Dr. Sullivan says.
Allergens are injected into the body over a period of time to build up the body’s tolerance to the specific allergen. This treatment has been a mainstay for more than 100 years and is typically recommended when allergy medications fail to mitigate symptoms.
Tablets containing the allergen are placed under the tongue daily before and during grass and ragweed seasons.
The type of immunotherapy you choose depends on various factors, including treatment goals and your lifestyle, Dr. Sindher says.
Allergy shots may not be well-suited for someone who has a needle phobia or travels a lot and can’t make weekly appointments in the initial stage of immunotherapy, she says.
Sublingual tablets are federally approved only for ragweed, pollen, and dust mites, so if you’re allergic to other things, like pet dander or mold, your doctor will likely steer you to something that covers all your allergens.
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