Taking the Itch Out of Fall Allergies

Last Editorial Review: 1/31/2005

Don't let seasonal allergy symptoms spoil your fun.

By Jennifer Warner
WebMD Feature

Reviewed By Cynthia Haines

Autumn may conjure rustic images of falling leaves and hay rides for outdoor enthusiasts, but for many seasonal allergy sufferers, it's often just another reason to stock up on tissue and stay inside.

But by learning what triggers your seasonal allergy symptoms, also known as hay fever, experts say you can work with your doctor to come up with a treatment plan that not only treats your symptoms but prevents them from coming back.

Fall Allergy Triggers

Seasonal allergy symptoms are caused by an allergic response to mold, pollen, or other tiny microscopic substances.

Common triggers of fall seasonal allergies include:

  • Ragweed. Found along roadsides and in vacant lots, fields, and other sunny spots, this common weed with finely divided leaves and tiny, greenish-white, down-turned blossoms is the leading cause of fall allergy symptoms.
  • Mold. Indoor and outdoor mold counts peak in the humid months of late summer and early autumn and are especially problematic for people with asthma and allergies. Outdoor molds are found in falling leaves, soil, vegetation, and rotting wood. Indoor molds flourish in damp household areas such as basements, shower stalls, and near washing machines and dryers.
  • Dust mites. Although present year round, dust mites thrive in humidity and can cause problems during the fall months when they're stirred up by dirty ventilation systems.

"When you turn on your furnace, you distribute a lot of mold and mites that have been sitting there all summer," says Christopher Randolph, MD, associate clinical professor of allergy, immunology, and pediatrics at Yale University. "That's a very common problem for indoor allergies in the fall."

But outdoors, experts say ragweed is king when it comes to triggering fall allergy symptoms.

"Ragweed is the No. 1 fall and late summer weed in most areas of the U.S. that causes fall allergies," says Clifford Bassett, MD, medical director of Allergy and Asthma Care of New York. "One ragweed plant can produce one billion pollen grains that can travel from 300 to 700 miles in the air."

Bassett says research suggests that ragweed pollen production is also on the rise due to global warming, so more and more people are becoming affected by this common allergy trigger.

To find current pollen and mold spore counts in your area, contact the National Allergy Bureau (www.aaaai.org/nab), which provides reports to the public three times a week. Many regional weather reports also include information on pollen and mold spore counts.

Treat Symptoms Before They Start

Experts say many people mistakenly think that you should wait and treat seasonal allergy symptoms after they start. But in fact, the best way to get relief from runny noses and itchy, watery eyes is to prevent them before they start.

"If you know that the fall season is the season that sets you off, then you need to start your medicines now because the fall weed pollens start increasing in the month of August and into September and then last until the first frost," says Dan Atkins, MD, director of ambulatory pediatrics at National Jewish Medical & Research Center in Denver.

Even though fall allergies are triggered by different types of allergy triggers, the symptoms they produce are the same as those caused by other types of hay fever, and each type of symptom requires targeted treatment:

  • Runny nose, sneezing, congestion. For nasal symptoms, experts say the first line of treatment is a prescription nasal corticosteroid. There are several different ones to choose from. Daily use of these nasal sprays before and during allergy season provides more effective relief than using them only when allergy symptoms flare up. To avoid side effects, such as nosebleeds and stinging, users should direct the spray out toward the ear and away from the nasal septum (the partition between the right and left sides of the nose). Nonsedating antihistamines, including over-the-counter Claritin and prescription medications, may also be used in children or others who have trouble using nasal sprays.
  • Itchy, watery eyes. Prescription eye drops work by stabilizing the cells in the eyes that react to allergens and can be used in combination with other treatments.
  • Sinus headache. Congestion in the sinuses may also cause sinus pressure headaches in some people. Relieving the pressure by easing congestion with an antihistamine or decongestant can prevent sinus headaches.

If one treatment doesn't provide relief, a combination of medications may be needed.

Experts say many people take an antihistamine drug for a month or two and then come in and say it's no longer working. But antihistamines do not lose their effect with time. "That's a popular misconception," Bassett tells WebMD.

Instead, people's seasonal allergy symptoms may be getting worse because their disease is progressing, they may need multiple medications, or they may be exposed to different allergy triggers that are causing additional symptoms, says Bassett.

Beware of the Rebound

Randolph says another common mistake people make when trying to self-treat their allergies is using nonprescription medications that may provide temporary relief but will eventually make their symptoms worse.

We certainly urge people not to use over-the-counter nasal decongestant sprays, which cause rebound in the nose, or eye drops that have blood vessel constrictors in them to treat their allergies, says Randolph.

He says these medications contain agents that work on one part of the nervous system, and then another part of the nervous system comes back and whacks you, creating a rebound effect.

For example, if you put these types of eye drops in the eye, it shrinks the blood vessels and constricts them, Randolph tells WebMD. "After a period of time, the other part of the nervous system comes back and swells the blood vessels up again, and the person actually looks worse."

Watch What You Eat

Researchers say another little known fact about fall seasonal allergies is that certain foods can trigger allergy symptoms in people who suffer from ragweed allergies.

Up to 50% of people who are allergic to ragweed may also experience a tingling, burning, or itching in the mouth when they eat certain foods due to a similar allergy trigger in ragweed and those foods, including melons, banana, zucchini, cucumber, sunflower seeds, and chamomile teas.

The person with ragweed allergy becomes particularly sensitive to other allergy triggers when they are bombarded with ragweed pollen in the fall, says Atkins.

That means that even if someone ate a little bit of watermelon at the beginning of the summer and experienced only mild tingling and burning, they might have a more powerful response in the fall after exposure to ragweed.

When All Else Fails

Experts say treating and preventing seasonal allergies sometimes takes a lot of trial and error. But if one medication or approach doesn't work, talk to a doctor about testing to determine if year-round allergy triggers may be causing your symptoms, such as pet dander.

For people with allergies that last for more than six months a year and have tried antihistamines, decongestants, and corticosteroid nasal sprays, allergy shots may also be another option. Allergy shots require a regular series of shots that contain small amounts of the allergy trigger to eventually desensitize the person to the allergy trigger.

But for the majority of people who suffer from brief bouts of seasonal allergy symptoms, Randolph says the goal is to use nonsedating prescription antihistamines and avoid the sedating over-the-counter medications that might interact with other medications, particularly drugs used to treat high blood pressure.

Originally published Aug. 22, 2003.

Updated Aug. 20, 2004.

Reviewed by Cynthia Haines, MD.

SOURCES: Clifford Bassett, MD, medical director, Allergy and Asthma Care of New York. Christopher Randolph, MD, associate clinical professor of allergy, immunology, and pediatrics, Yale University; spokesman, American Academy of Allergy, Asthma & Immunology. Dan Atkins, MD, director of ambulatory pediatrics, National Jewish Medical & Research Center. American Academy of Allergy, Asthma & Immunology.

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