It's the Worst Pollen Season Ever!

It is true that millions of adults and children suffer from seasonal allergies. It is also true that the duration of spring pollen season appears to be getting longer in many parts of the world. But what is it about the spring that makes so many people miserable? Let's discuss.

Most plants follow a consistent and typical pattern of pollination. Trees usually start pollinating first each spring, followed by grass and weeds in the summer, then ragweed in the early autumn. The exact timing will vary year to year based upon weather patterns, and by the part of the world in which you live.

Spring allergy season is dominated by tree pollen. Trees release pollen into the air, which then gets carried by the wind to far off destinations, sometimes miles away. This is important for two main reasons: 1) you can't necessarily blame your neighbor's big oak tree for all your sniffles and 2) people can still suffer even if they don't live near highly wooded areas. Allergy testing can help determine exactly what someone is allergic to, which helps with management.

People with seasonal allergies typically experience intense itching, along with watery/swollen eyes, sneezing, runny nose, and nasal congestion. Symptoms often appear worse in the spring as many people get relief during the 3-6 months of winter. Pollen levels are highest between 5-10 a.m. on dry, windy days and lowest after a good rain.

There are many treatment options available:

Antihistamines - These are most effective for treatment of itching, but are not very good for stuffy noses. Caution with first generation antihistamines, which can cause sedation.

Nasal steroid sprays -- These are the best treatment for congestion but must be used daily and consistently to offer benefit. Ideally, they should be started at least 2 weeks before pollen season.

Eye drops -- There are many different types, but the ones that are "mast cell stabilizers" are best, often combined with antihistamines.

Decongestants - These should be avoided for the most part due to unfavorable side effects and availability of better options.

Immunotherapy (allergy shots) -- Can offer a way to desensitize and potential cure, while also preventing development of new allergies or asthma. Requires weekly build up injections at the doctor's office for 4-6 months, followed by monthly maintenance injections for 3-5 years. Immunotherapy is not a quick fix -- it often takes 6-12 months before symptoms improve. New sublingual forms are available only for grass and ragweed.

In addition to medications to help treat symptoms, there are avoidance measures that can help:

Close it up -- Ideally, windows at home and in the car should remain completely closed 24 hours a day during the entire pollen season. Air conditioning can help filter pollen and keep indoors cool.

Wash before bed -- It's important to remove pollen by washing face/hair and also changing clothing before bed each night.

Hidden exposures -- Pets can bring pollen inside the home after they spend time outdoors. Washing them regularly, or using a damp cloth after returning indoors can help lower exposure.

These are just a few tips to help reduce the misery you or your child may face this spring. Everyone with seasonal allergies should strive for the same goals: Sleep well at night, feel well during the day, and have limited restrictions on daily life. If you're not achieving these goals, then make sure you discuss with your primary doctor or allergist.