“Such a great reminder of how to combat allergies as we head into springtime. Coming from a home that struggles with asthma and hay fever, it’s great to be reminded that there practical solutions to this very annoying problem, thanks Dr Hassina Ebrahim!” – Guest editor – Jessica King
During springtime, exposure to pollen can trigger a range of symptoms in the nose, eyes, throat, lungs, or skin. These symptoms can be referred to as hay fever.
Seasonal allergies often run in families. If both your parents, or your siblings, have them, you’re more likely to suffer from them, too. Many people with seasonal allergies also have asthma.
The immune systems of people who are allergic to pollen as an example, treat these particles (called allergens) as invaders and release chemicals, including histamine, into the bloodstream to defend against them. It’s the release of these chemicals that causes allergy symptoms.
Worldwide, hay fever is estimated to affect between 10% and 30% of the population. Hay fever, or allergic rhinitis, is caused by an allergic reaction to irritants in the air. While some people suffer from the condition all year-round, many experience seasonal rhinitis, meaning that it occurs during specific seasons.
Hay fever is a very common condition affecting approximately one in five adults and one in three children. The condition can commence at any age, even from as young as one month.
What causes seasonal allergies?
Seasonal allergies, like other types of allergies, develop when the body’s immune system overreacts to something in the environment, usually during spring, summer or fall when certain plants and trees pollinate. Tree pollinating months vary throughout South Africa, starting in late July and peaking in September in the Western Cape. In Gauteng, the tree pollen season is a little longer.
In Kwa-Zulu Natal, the peak tree pollinating months are August to October.
The risk of developing hay fever is much higher in people with asthma or eczema, and in those with a family history of allergy.
What symptoms can one experience with seasonal allergies?
Common signs and symptoms of seasonal allergies can include:
- Watery nasal discharge, nasal itching, and sneezing
- Post-nasal drip: This is because of secretions from the nose that drain down into the throat, causing congestion and cough
- Sore throat
- Cough: Allergy coughs are typically caused by swelling or irritation of the airways and also as a result of post-nasal drip, when the mucous hanging out in your sinuses trickles down the back of your throat
- Itchy and swollen eyes because of allergic conjunctivitis
- Itchy ears
- Sleep disturbances: breathing through the mouth, night time cough and daytime fatigue can all cause sleep disturbances. Snoring can also be a sign as result of nasal congestion.
Diagnosing seasonal allergies
Seasonal allergies are easy to diagnose, because the pattern of symptoms returns from year to year following exposure to an allergen. If there is a family history, this can also make the diagnosis likely.
If you think your child has the above-mentioned symptoms, talk with your doctor. The doctor will ask about symptoms and when they appear and, based on the answers and a clinical exam, should be able to make a diagnosis. If not, the doctor may refer you to an allergy specialist for blood tests or allergy skin tests.
Treating seasonal allergies
The main part of treatment is to limit exposure to allergens, for example, decreasing or limiting outdoor activities at times of high pollen count.
It’s also a good idea for kids with seasonal allergies to wash their hands or shower and change clothing after playing outside.
Keep indoor air clean by:
- Use the air conditioning in your house and car.
- If you have forced air heating or air conditioning in your house, use high-efficiency filters and follow regular maintenance schedules.
- Keep indoor air dry with a dehumidifier.
- Use a portable high-efficiency particulate air (HEPA) filter in your bedroom.
- Clean floors often with a vacuum cleaner that has a HEPA filter.
If reducing exposure isn’t possible or is ineffective, medicines can help ease allergy symptoms.
The following medications can be taken:
- Anti-histamines: These help reduce itching, sneezing and runny nose.
- Decongestants: These work by causing blood vessels to constrict. This helps relieve congestion caused by the dilation of blood vessels in the nasal passages. These over-the-counter drugs can bring temporary relief from congestion, but they are not a long-term solution
- Steroid nasal sprays: These have few side effects and dramatically relieve symptoms in most people. If the nose is crusted or contains mucus, you can first clean it with saline (salt water) before using the steroid nasal spray. These will be prescribed by your doctor
- 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. It’s especially effective in treating allergy-induced asthma. It’s often used when nasal sprays can’t be tolerated or for mild asthma.
- For some people, allergy shots (allergen immunotherapy) can be a good option. Also known as desensitisation, this treatment involves regular injections containing tiny amounts of the substances that cause your allergies. Over time, these injections reduce the immune system reaction that causes symptoms.
Take home message
Avoiding allergen exposure will help to reduce symptoms. Over the counter medication can be used for symptom relief, however it is best to see your doctor to get started on a treatment plan.
by – Dr Hassina Ebrahim
Specialist paediatrician
MBCHB; FCPAED; MMED (UKZN)
