Environmental Allergies (Allergic Rhinitis)
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Allergies occur when the body's immune system over-reacts to particles that are normally harmless. In environmental
allergies, the body's immune system over-reacts to allergens from animals, dust mites, or pollens from grasses, weeds,
trees, and molds that are present in the air that you breathe in. When these allergens enter the nose, sinuses, and
lungs, the body's immune system over-reacts and releases a number of chemicals, including histamine and leukotrienes,
resulting in what is called an allergic reaction.
Allergic rhinitis is not a life threatening disease, but it seriously affects one's quality of life. Environmental allergies can
result in frequent ear or sinus infections, difficulties sleeping, snoring, fatigue, depression, and decreased attention
span. Individuals suffering from allergic rhinitis are at increased risk of developing asthma and atopic dermatitis
(eczema).
What are the symptoms of environmental allergies (allergic rhinitis) ?
Individuals suffering from environmental allergies may have one or more of the following symptoms:
- Sneezing
- Runny nose - usually the drainage is clear and watery
- Stuffy nose
- Itchy nose
- Post nasal drip
- Itchy or scratchy throat
- Sinus pain or pressure
- Itchy eyes
- Watery eyes
- Red puffy eyes
Symptoms can occur within a few minutes of exposure to allergens. Individuals allergic to pollens from plants
typically have symptoms during the Spring, Summer and/or Fall, while individuals allergic to animals and dust mites
often have symptoms all year long.
What is the treatment of allergic rhinitis?
The treatment of allergies is a three step process:
- Environmental control : avoiding the cause of allergies is a crucial step in improving allergies. This may include
removal of animals from the house for individuals with dog or cat allergies, or the use of dust mite covers for
dust mite allergies.
- Medications : there are a number of medications that can help minimize allergy symptoms. These include
antihistamines such as Benadryl, Atarax, Claritin, Allegra, Zyrtec, and Xyzal or antihistamine nose sprays such
as Astelin / Astepro, or Patanase. It also includes steroid nasal sprays such as Flonase, Nasonex, Nasacort,
Rhinocort, and Veramyst. Other medications used for allergies include decongestants (Sudafed) and
Leukotriene Inhibitors (Singulair, Zafirlukast,...) and eye drops. Speak with your doctor about which
medications are right for you.
- Allergen immunotherapy: this treatment is aimed at reducing your sensitivity to allergens and is the only
treatment that directly targets the cause of allergies. This can be done with shots (allergy shots) or with drops
under the tongue (sublingual immunotherapy). Allergy shots have been shown to be effective in up to 90% of
individuals suffering from allergic rhinitis. Allergy shots have also been demonstrated to be effective for
allergic asthma and insect allergy. Your board certified allergist/immunologist can provide you with more
information on allergen immunotherapy.
Sources include:
Allergen Immunotherapy practice in the United States: guidelines, measures, and outcomes. Ann Allergy Asthma
Immunol. 2011;107:289-300.
Updated 5 Feb 2013
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