Spring is the season for many of us to get excited about the end of winter and start of warmer weather. However, for many of us, allergies can lead to significant discomfort. In fact, allergies affect between 20 to 40 million Americans per year. So what are allergies? Allergies are where the body reacts to little substances called allergens. The body believes these allergens are attacking the body and mounts an immune response, releasing histamine. The substance histamine causes the nasal passageway to swell up and secrete clear drainage, and makes eyes become red and itchy. This can cause the nose to feel stuffy, congested and make it difficult to breathe.
Treating allergies has been a long evolving science. Initially, the treatment of allergies involved oral medication, called antihistamines. The issue many of us have with pills is that your whole body must absorb the medication, even though only one part of it is affected. The first antihistamine pills, such as Benadryl, worked well, but caused patients to become sleepy or tired. For almost any patient, the pill was worse than the allergy symptoms themselves. Newer antihistamine pills work on a different mechanism, by having little circulation into the brain, which was supposed to cause little or no drowsiness. While this marked a significant improvement, many patients still complained of being less alert than ideal. Physicians, later tried to isolate the main source of allergy discomfort, which is nasal stuffiness, sneezing, and red itchy eyes by using nasal sprays and eye drops. Afrin nasal spray was one of the first sprays to be used for fighting allergies. These sprays worked right away and worked well, but had a serious drawback– they were addictive and could lead to disruption of the lining of the nose.
More recently, nasal steroid sprays were utilized. These sprays deposit a small amount of steroid (an anti-swelling steroid, not the steroids made popular by beefed up athletes) which would counteract the allergic process. These sprays work by gradually decreasing swelling of the nose over a period of 2 to 6 weeks and can be used fairly safely for extended periods of time. The advantage of steroid sprays are that they do not cause drowsiness and can be used indefinitely. The disadvantage of steroid sprays are that they can cause irritation in some individuals and must be used properly to be effective.
Within the last several years, antihistamine sprays have become more popular. These sprays work to immediately decrease the allergic response and can be used safely over a long period of time. These sprays have the advantage of avoiding drowsiness and an excellent track record of safety.
What can patients do if they have year round allergies, or do not want to constantly take pills or use sprays? The best method is to find the allergic culprit by getting tested. This lets the patient know what to avoid. Avoidance is not possible for all allergies, such as dust, mold, etc. Allergy shots have been a mainstay of the allergy treatments for patients with severe allergies. Patients are given shots of a low dose of what they are allergic to over a period of weeks to months so that they no longer need any more medication. Sublingual therapy, which is the placement of an allergen in the mouth rather than via shots, has began to play an increasingly larger role.
Overall, allergies are a common way in which many of us react with the environment. However, identifying allergies and treating them in the least invasive fashion can make spring time a season to look forward to.