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Springtime allergies: Nip them in the bud

Clean up your act

Spring cleaning is a great way to reduce allergens in your home. In addition to your regular spring cleaning routine, these few added steps can help if you're allergic to dust mites:

  • Encase mattresses, box springs and pillows in allergy-proof covers.
  • Wash sheets and blankets in water heated to at least 130 F (54 C).
  • Vacuum carpets weekly.
  • Replace carpeting with laminate flooring or another hard material that won't collect dust mites and other allergens, especially in your bedroom.

When to see a doctor

For many people, avoiding allergens and using over-the-counter medications are enough to relieve symptoms. But if your seasonal allergies are particularly bothersome, you may need skin tests or blood tests to find out exactly what allergens trigger your symptoms. That can help you determine what steps you need to take to avoid your specific triggers, and it can help your doctor determine which treatments are likely to work best for you.

Medications

A number of over-the-counter and prescription allergy medications can help control seasonal allergy symptoms:

  • Nasal corticosteroids. Available by prescription, corticosteroid nasal sprays are an effective medication for seasonal allergies and are often prescribed for troublesome symptoms. Examples include fluticasone (Flonase), budesonide (Rhinocort), mometasone (Nasonex) and triamcinolone (Nasacort). You may not notice full improvement until after you've used these medications for a week or so.
  • Antihistamines. Antihistamines help relieve itching, sneezing and runny nose for many people who have allergies, though they have less effect on allergy-related congestion. Over-the-counter oral antihistamines — such as loratadine (Claritin, Alavert) and cetirizine (Zyrtec) — are less likely to cause sedation. Other over-the-counter oral antihistamines include diphenhydramine (Benadryl) and chlorpheniramine (Chlor-Trimeton), but these and similar products can cause drowsiness. Prescription antihistamines, such as fexofenadine (Allegra) and the nasal spray azelastine (Astelin), can be helpful if over-the-counter medications don't do the trick.
  • Decongestants. These short-term medications are available in both over-the-counter and prescription liquids, tablets and nasal sprays. Oral decongestants include medications containing pseudoephedrine (Sudafed, Actifed, others). Nasal decongestants include phenylephrine (Neo-Synephrine) and oxymetazoline (Afrin). Oral decongestants can elevate blood pressure, so avoid them if you have high blood pressure. They can also worsen prostate problems. Decongestant nasal sprays should only be used for a few days. Prolonged use can make nasal congestion worse.
  • Leukotriene modifier. Montelukast (Singulair) is a prescription tablet taken to block the action of leukotrienes — immune system chemicals that cause allergy symptoms such as excess mucus production.
  • Cromolyn sodium. This medication, available as an over-the-counter nasal spray (NasalCrom, others), helps relieve hay fever symptoms by preventing the release of histamine. It's most effective when started before signs and symptoms develop and sometimes must be used three or four times a day.

Other treatments

Other treatments for seasonal allergies include:

  • Allergen immunotherapy. Also known as desensitization or allergy shots, this treatment may be right for you if medications don't control allergy symptoms or they cause significant side effects.
  • Nasal irrigation. To alleviate nasal allergy symptoms, your doctor may recommend nasal irrigation (nasal lavage). This involves flushing out mucus and irritants from your nose with a squeeze bottle or a neti pot, a small container with a spout designed for nose rinsing.
  • Herbal remedies and supplements. Extracts of the shrub butterbur may have some effectiveness in preventing seasonal allergy symptoms. If you do try butterbur, be sure to use a product that's labeled "PA free," which indicates it's had potentially toxic substances removed. Though their benefits are unclear, other alternative therapies for seasonal allergies include cat's claw, choline, goldenseal, stinging nettle, belladonna and bromelain. Some people also claim locally produced honey helps reduce allergic reactions.
  • Alternative therapies. Some people claim that probiotics, acupuncture and hypnosis may help with seasonal allergy symptoms. However, there's no solid evidence supporting the effectiveness of these treatments.
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AA00060

May 3, 2008

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