As a child, I used to have a mild pollen allergy, which then disappeared during my teen years. A few years ago it reappeared. At first, only my nose was affected. Later, my eyes started developing puss to the point of fusing together during the night (the dried puss was turning my eyes red). Also, it became harder to breathe during allergy season (you can monitor pollen levels at http://www.pollen.com).
Heavy breathing can eventually lead to asthma, which is really serious. My doctor prescribed me loratadine (antihistamine) pills, antibiotic eyedrops (chloramphenicol) and some over the counter allergy drops (CVS eye allergy relief drops). I think that the allergy drops work the best for my eyes, and I can sleep again at night. My eyes are still itchy occasionally (not nearly as much as they used to), but at least they don’t stick together during sleep. Another thing that helps is to put some paper towels in my windows. They let fresh air in, but block the pollen. Thanks to this method of filtering the air in my room, I don’t have breathing problems any more. Of course, I have to minimize the time I spend outdoors. Wearing a mask outside is also an option. Some immediate relief can be achieved using the “neti potty“, a device used for removing allergens and dirt from the nasal cavity (see figure below). It flushes the nasal cavities using salty water. You have to make sure the water is sterile (by boiling it for instance) to avoid getting an infection.
Neti Pot
The permanent solution to seasonal allergies is called immunotherapy. The first step is allergy testing, when the doctor applies to your skin a few dozen drops containing various allergens (e. g. ragweed pollen, poplar pollen etc.). Then he slightly stings your skin to help absorb the drops better into your skin. About 10 minutes later he looks at the bumps developing on your skin and determines what exactly you are allergic to: pollen, dust mites, insects, cats etc. The second phase involves getting weekly shots in your arm for a whole year ! At least they don’t hurt.
If immunotherapy is not available or too inconvenient for the patient, nasal sprays and antihistamine pills can offer significant relief. These forms of treatment should be started two weeks before the allergy season. Starting the treatment during allergy season will be far less effective.
As part of an immune response to what the body perceives correctly or incorrectly as foreign pathogens (pollen in case of a pollen allergy), histamines are released. They increase the permeability of the capillaries to white blood cells and some proteins, to allow them to engage pathogens in the infected tissues. This causes fluid to escape from capillaries into the tissues, leading to the classic symptoms of an allergic reaction: a runny, itchy nose and watery, itchy eyes. Concomitantly, leukotrienes are also produced, creating even more inflammation. They can lead to heavy breathing and even asthma. Leukotriene antagonists block their action. Neither antihistamines nor leukotriene antagonists compromise the normal function of the immune system.
Fluticasone, flunisolide or nasonex nasal sprays (they contain antihistamines) can be used every 12 hours, applying 1 to 2 sprays on each side. Do not insert the tip of the bottle too deeply or else you will miss the lower turbinate area of your nose. Aim the jet straight up (as shown in the picture below) and not towards the nasal septum, or you can thin the septum to the point that it develops a hole. This is so with any cortisone containing spray (cortisone reduces the itching and discomfort). If the nose becomes congested and it’s getting harder to breathe through the nose, combine these sprays with nasal relief drops. They will shrink the tissue in the nose and clear up the airways.
Antihistamine pills usually contain one of two active ingredients: loratadine (e.g. Claritine) and citirizine (e. g. Zyrtec). They will also make you slightly drowsy, which makes falling asleep at night easier (so take them best before going to sleep). If you have difficulty breathing, including if you have asthma, you can optionally choose Predisone, a corticosteroid prescription drug. This latter drug will however lower your immune system, and should be used with caution. Singulair, a leukotriene antagonist, is often prescribed (particularly in asthma), being extremely efficient in eliminating allergy symptoms. Among its side effects are unfortunately depression and high irritability.
For eye allergy you can choose over the counter allergy relief drops. They contain antihistamines to reduce the allergic reaction, and other astringent ingredients that clean out the puss and reduce the redness. The astringent will unfortunately also lead to dry eyes. If these drops don’t work, one can try Patanol prescription eye drops.
If the eyes develop puss during the night, they can get infected, in which case the doctor can prescribe eye drops containing an antibiotic, like tobramycin and chloramphenicol. At the same time use nose drops to decongest the nose, or else the tear ducts, which are connected to the nose, will clog and lead to infection of the eyes over the night (since you don’t blink during sleep and the tears cannot drain properly if the tear ducts are clogged).
Fun Fact:
Internet searches for "pollen allergy"
Explanation: The main peak of each year correlates with the Spring allergy season which peaks in April. The smaller peak to the right corresponds to the Fall allergy season which peaks in September.
