Most of the time, diagnosing seasonal allergies is possible just from knowing a good history, the timing of the symptoms, and the typical signs on a physical exam. More involved allergy tests—either blood tests, or skin tests, which are reactions to certain molecules placed just under the skin—are possible if the diagnosis needs to be confirmed.
What are allergy 'seasons'?
There are actually three allergy "seasons," each involving different types of pollens.
- Early in the spring, trees release pollens even before beginning to show their buds. This early release hits the eastern half of the United States hardest.
- As the grasses come onto the scene later in the spring, their pollens create a middle season.
- The late phase is from summer until the first frost in most of the United States and involves the most widely known culprit, ragweed.
How can I treat my allergies?
So, what can be done to minimize the suffering of seasonal allergies? The answer is prevention and medication.
Prevention involves knowing when the risk of pollen exposure is high and avoiding that exposure as much as possible. Pollen counts begin to rise after the sun does and peak by noon, making the morning the worst for large pollen exposure. Many local newspapers and news broadcasts include daily pollen counts to help with day-to-day variations. Driving with car windows up, drying clothes indoors instead of on a clothesline, and keeping home windows closed all help to minimize pollen exposure. Keeping lawns mowed and raking and disposing of old leaves reduces the exposure to molds that grow in shady, moist areas. Sunglasses protect the eyes from direct pollen hits, and washing up before bedtime removes pollen from children's hair and faces and cuts down on nighttime exposures. Keeping a clean air-conditioning filter system is also recommended.
For the exposure that can't be avoided and the symptoms it brings, medications can help. Since histamine is one of the molecules the immune system releases in allergic reactions, antihistamines work by blocking its effects.
Products such as diphenhydramine (Benedryl) can be bought over-the-counter and have been around for years. Unfortunately, a common side effect is drowsiness, and a small percentage of children paradoxically become agitated. Oral decongestants counteract the drowsiness but don't counteract allergy symptoms directly. An over-the-counter nasal spray called Cromylyn will provide about four hours of relief but requires a few weeks of use before becoming fully effective. Despite the availability of over-the-counter products, you should always consult with your doctor before medicating your child.
What about prescription medications?
Several medications are available with a doctor's prescription. These include newer antihistamines that can be given once a day and are less sedating. Inhaled nasal steroids are very effective and can be used in children as young as three (although many small children rebel at the idea of a nasal medicine). Immunotherapy, also known as allergy shots, involves multiple shots and isn't usually necessary or advised for children.
Although we can't yet cure allergies, knowledge, preventive measures, and the judicious use of medication can alleviate one of the few downsides to spring.