Achoo! It’s the all-too-familiar sound that arrives at spring’s first bloom. With it comes the dreaded stuffy and runny nose and itchy eyes – allergy season has sprung.
“Things seem to really crescendo in March, April, May, and that’s the worst time of year for most people who live in Northern California,” said Dr. Steven Rubinstein, chairman of the allergy department at Palo Alto Medical Foundation’s Mountain View location.
According to Rubinstein, one-third of the world’s population suffers from allergies, an overreaction of the immune system.
“The immune system will see biologic things like pollen or mold or dust or animals and instead of ignoring it like most people, the immune system will overreact to those things and (it) can’t kill a pollen grain or dog hair and it gets frustrated,” he said.
That frustration releases a variety of substances, like histamines, which bring on the stuffy, runny, itchy and sneezy nose. Pollen, mold, animal hair and dust mites are the four major types of allergens that affect people, Rubinstein said. But in Northern California, the largest culprit is grass, which lives in the pollen family.
“There are pollens that are on flowers that are really sticky, and it requires birds and bees to make them pollinate,” Rubinstein said. “Those aren’t really in the air that much, so those aren’t really clinically relevant. It’s the pollens that are blown by the wind that really can cause a problem.”
The two other pollens, he added, are weeds and trees – like oak, which blooms in March and April.
Diagnosis and treatment
To discover what a patient is allergic to, Rubinstein said allergy doctors perform a scratch test, wherein they drop the allergen on the patient’s skin to see if he or she reacts. From there, they formulate a treatment plan that can consist of a few different options, including environmental manipulation or medication.
Environmental manipulation can be as simple as taking precautions to prevent bringing allergens from the outside world into your home. Rubinstein suggested special pillow wrappers that fit under the regular cover to safeguard people from breathing in allergens, like dust mites, that may have snuck through the stitching of the bedding. He also recommends that people change their clothes before sitting on or lying in their beds.
“People say, ‘Oh, my dog never comes in my bed,’ but they hug the dog right before they go to sleep and they’re bringing the dog proteins and the pollens that are on the dog into their bed,” he said.
For medication treatment, Rubinstein said there are two categories: rescue and preventive. Rescue medications include over-the-counter pills such as Claritin, Zyrtec and Allegra, which help control symptoms after allergy sufferers have already reacted to an allergen. Preventive medications include nasal sprays such as Flonase and Nasacort, which work as a shield to protect the immune system from reacting in the first place.
“These are sprays that have a cortisone base to them,” he said. “Cortisone (is) a type of steroid – not anabolic or weight-lifting steroids, but healing steroids. These sprays just work locally in the nose, but the drawback is they take generally days and weeks to work, so there’s no immediate response.”
Rubinstein suggested using a nasal spray when symptoms start or before the onset of allergy season because it takes some time to work.