Ask the Pharmacist – Allergies

Q. With the trees budding and the spring flowers in full bloom, I think my allergies have returned with a vengeance. Can you review the allergy signs and symptoms and what options there are?

A. Allergies can be a nuisance, disrupting daily life with symptoms such as sneezing, runny nose, nasal congestion, itchy nose, itchy eyes, post nasal drainage and possibly facial pressure, itchy throat/palate and ear fullness and popping. More severe reactions may result in hives or even anaphylaxis. Some people may also experience allergic conjunctivitis (eye infection). Allergies can affect your quality of sleep and concentration which may impact your productivity at school or work.

Sometimes, there are associated physical signs which make it clear to others that you are indeed suffering from allergies. These physical signs could be an open mouth due to chronic mouth breathing, frequent sniffling or throat clearing, frequent grimacing and twitching of face due to itchy mucus membranes, allergic shiners (red or dark circles under eyes), allergic salute (wiping hand up face against the nose) to name a few.

There are a few factors that increase your risk of developing allergies. Some factors which you have no control over are having a family history of allergies to common triggers, born as the male sex, born during pollen season, maternal exposure to cigarette smoke in first year of life and the presence of allergen specific IgE in your body. Some factors you may have some control over are being overweight and your exposure to indoor allergens.

Allergies can be classified based on their frequency and their severity.

Frequency:

  • Intermittent allergic rhinitis is described as symptoms <4 days per week OR < 4 consecutive weeks
  • Persistent allergic rhinitis is described as symptoms >4 days per week AND > 4 consecutive weeks.

Severity:

  • Mild allergic rhinitis symptoms are usually not too bothersome with sleep not affected and no impairment of daily activities, sports or leisure. Work/school continue as normal
  • Moderate/Severe allergic rhinitis consist of abnormal sleep OR bothersome symptoms OR impairment of daily activities, sports, leisure OR impairing work/school productivity.

If you seek help for your allergies, you may first be asked to define the severity of your symptoms over the last 24 hours on a scale of 1-10.

<2 = very well controlled
2 to <5 = portly controlled
5 or more = uncontrolled

Of course, the ultimate goal would be to decrease your symptoms to be <2 on the scale with minimal treatment side effects. Fortunately, there are various methods to manage allergies effectively, from non-pharmacological approaches to over-the-counter and prescription treatments. As is the case with many ailments, prevention is key. Let’s first discuss some non-medicated methods to reduce or better yet prevent the allergies.

Non-Pharmacological Methods:

Allergen Avoidance: The most straightforward approach to managing allergies is to avoid triggers whenever possible. These helpful tips for specific allergy triggers can take weeks to months to show an improvement.

  • Pets: Remove pets from the home or at least keep pets outside of the bedrooms and main living areas. Brush pets outside and wash cats weekly and dogs once or twice weekly
  • Dust Mites: Wash bedding at least once weekly in hot water. Encase mattresses and pillows with impermeable covers. Replace carpets with hard flooring
  • Insects: Avoiding infested areas and wearing clothing that covers as much skin as possible. Limit time spent outdoors at dawn and dusk
  • Tobacco: Avoid smoking in the car or inside the home
  • Pollen: Stay indoors during high pollen seasons. Change your clothes and bathe/shower after being outdoors. Do not dry your clothing outdoors. Use air conditioning to allow for closed windows/doors
  • Moulds: Remove houseplants. Keep indoor humidity between 40-45%. Promptly fix any water leaks and use a fungicide on sinks, showers, garbage pails etc.

Air Filtration: Investing in a high-quality air purifier with a HEPA (High-Efficiency Particulate Air) filter can significantly reduce airborne allergens indoors. Place the purifier in commonly used rooms, such as the bedroom or living room, to maximize its effectiveness.

Saline Nasal Irrigation: Saline nasal sprays or neti pots can help rinse away allergens and mucus from the nasal passages, providing relief from congestion and reducing the frequency of allergic reactions. This simple yet effective method can be used daily for ongoing symptom management.

  • Lubricant Eye Drops: These drops can help dilute and flush out allergens
  • Nasal gels: Drug free nasal gels lubricate and moisturize the nasal mucosa helping to reduce irritation, crusting and soreness
  • Cold Compress: Using a cold compress can help reduce ocular itching
  • Sunglasses: The use of sunglasses helps to reduce contact with allergens and reduces photophobia (eye discomfort in bright light)

Allergy-Proofing Your Home: Regular cleaning, especially vacuuming with a HEPA filter-equipped vacuum cleaner, can minimize indoor allergens such as dust mites and pet dander.

If, despite taking action on the above suggestions, your allergies have managed to be burdensome, it might be time to try one of the many medicated options. There are effective treatments available over the counter as well as by a prescription.

As a reminder, allergies are one of the minor ailments that pharmacists can assist with and prescribe a treatment for you. Stay tuned for methods to treat your allergy symptoms. For more information on this or any other topic, contact your pharmacist.