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 which 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 to these particles and releases a number of chemicals, including histamine
and leukotrienes, resulting in what is called an allergic reaction.

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.

Individuals with environmental allergies also can develop frequent ear or sinus infections (especially in the Spring and
Fall), difficulties sleeping, snoring, fatigue, depression, and decreased attention span.  They are also at increased risk of
asthma and atopic dermatitis (eczema).

What is the treatment of allergic rhinitis?
The treatment of allergies is a three step process:

  1. 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.
  2. 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.
  3. 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).   Visit the respective pages on allergy shots and allergy drops for
    more information.  Your board certified allergist/immunologist can also 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.
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Diagnosis of environmental allergies

Allergy Shots (immunotherapy)

Allergy Drops

Cat Allergy

Dog Allergy

Dust Mite Allergy

Seasonal Allergies

The Pollen-Food Syndrome