What to do about Seasonal Allergies

| Posted On Apr 29, 2014 | By:

allergy season.shutterstock_175072418The month of April marks the beginning of seasonal allergies and the telltale sneezing, watery eyes, nasal congestion or pressure, and general malaise that start for millions of Americans.  Many people do not know what they’re allergic to and wonder if they should get tested to find out.  My general answer is that it depends on how severe your allergy symptoms are and what has or has not helped you to manage them in the past.  Getting tested for allergies should only be done if immunotherapy, aka “allergy shots”, is your last resort in the battle to manage your allergies.

Before contemplating allergy testing and shots, here’s what you should do first to see if you can make allergy season suffering more a thing of the past:

Although you don’t need to know what you’re allergic to, there are ways to find out.

Certain pollens and molds consistently come out at certain times of the year.  If April is when you can’t stop sneezing, for example, you’re probably allergic to maple tree pollen.  It gets harder to discern what might be setting you off if it’s Memorial Day, however, as many trees and grasses are peaking then.  Here’s a chart showing the pollinating seasons of some common allergens:

Pollinating Seasons Table 2If you want to figure out what sets off your allergies, you can be a pretty good “allergy sleuth” these days with the technology available.  There are websites that list the pollen counts of different plants day by day, so if you’re sneezing on Tuesday, you can see what might be causing it.  If you only develop symptoms on rainy days, you might have a mold allergy (and some sites list mold counts, too!)  By tracking symptoms and allergens over a week or two, you may pinpoint the offending plant(s) or mold(s).

Try allergy medicines first – they’re available over-the-counter (OTC) and through a doctor’s prescription.

Twenty years or so ago, with the introduction of the 24-hour antihistamine, the practice of treating seasonal allergies significantly changed for the better.  OTC antihistamines like Zyrtec, Allegra, and Claritin work by preventing your reaction to an allergen, and as they are long-lasting, people can get around-the-clock relief with them.

If you do know what you’re allergic to or know the time of year when symptoms usually materialize, I would recommend you begin taking an antihistamine about a week before the start of that pollinating season and the onset of symptoms.  Many people also ask me which product is better, and the reality is that it can be very individualized.  I find Zyrtec (generic name cetirizine) seems to be the most effective for most people, but if after a few weeks you still find your symptoms bothersome, try another product. For your convenience, most of our on-site pharmacies carry over-the-counter allergy medication.

Recently, the nasal steroid Nasacort became available as an OTC medication, too.  It’s an anti-inflammatory nasal spray and very comparable to the prescription product Flonase, but as an OTC medication, it’s more convenient and less expensive.

And then there are many OTC eye drop medicines, which are antihistamines to prevent itchy, watery eyes.

Astelin is a prescription nasal antihistamine spray and prescription antihistamine eye drops include Patanol, Elestat and Optivar. 

Try allergen prevention, too!

Even if you know what you’re allergic to, the reality is that it can be very hard to avoid it entirely, but there are several things you can do to mitigate your exposure to allergens:

  1. Keep your car windows up and use the air conditioner in the car.
  2. Dust windowsills daily with a damp cloth.
  3. Keep your bedroom windows closed to cut down on allergens entering where you sleep.  Use an air conditioner in the warmer months.
  4. Shower and rinse your hair before bedtime.
  5. Put clothes into a covered hamper versus on the floor to contain allergens (and even consider changing into clean clothes before walking too far into your home).
  6. Avoid outdoor activities or dawn or dusk, which are peak times for pollen.

 When everything else isn’t enough: Allergy Testing and Immunotherapy

Allergy shots are a form of treatment called immunotherapy and work like vaccines do.  Each allergy shot contains a tiny amount of the specific substance or substances – called “allergens” – that trigger your allergic reaction.  Allergy shots contain just enough of the allergen to stimulate your immune system to develop a tolerance to the allergen, but not enough to cause a full-blown allergic reaction.  Over time, we increase the amount of the allergen in the shot so your body can get used to the allergens and therefore becomes further desensitized to them, and your allergy symptoms diminish over time.

Before starting immunotherapy, you will first need to have an allergy test.  Not only does this confirm what you are allergic to, but it can also show how severe your allergy is.  Both of these pieces of information guide us in developing the most effective immunotherapy dosage and schedule possible.

At Atrius Health, each time you receive an allergy shot, you stay in the office for about 30 minutes to make sure you do not have a reaction to the allergen in the shot.  Once you start a regimen of allergy shots, you will usually stay on it for 3-5 annual cycles.  After that, we often recommend that people stop the immunotherapy and reevaluate whether the shots are still necessary, as people’s tolerances can change dramatically.  If allergies again become worse, people usually need to continue allergy shots indefinitely.

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About Dr. Lynda Kabbash

Dr Lynda Kabbash joined Harvard Vanguard in 1999. She received her medical degree from McGill University and residency training in Internal Medicine and Allergy and Immunology at the Montreal General Hospital and Royal Victoria Hospital. She is a Fellow of the Royal College of Physicians and Surgeons of Canada, certified in Internal Medicine and Allergy and Clinical Immunology. She is also a Fellow of the American Academy of Asthma, Allergy and Immunology. Dr Kabbash is involved in the Norfolk District Medical Society, Massachusetts Medical Society and the American Medical Association. She has served on the Board of Trustees at Cotting School in Lexington until one year ago.


  1. Hello;

    Thank you for the insightful article,even though I no longer suffer from allergies, I have two members of my
    family that do suffer terribly. I will make copies of this article and give it to them.

    Thank you, Lourdes.

    Comment by Lourdes Deserpa on May 1, 2014 at 10:38 am
  2. Thank you for this insightful article. I wanted to suggest that preventative care could include acupuncture one month before the allergy season kicks in. I have found that my clients have been very pleased with the fact they have eliminated or minimized the need for allergy medication when they have committed to a full round of acupuncture treatments. How do you feel about nasal irrigation?
    Thanks for your response,
    Lynda Danzig

    Comment by Lynda Danzig, Lic. Ac., L. M.T. on June 18, 2014 at 12:30 am
  3. Really helpful post on seasonal allergies.Its really excellent information…

    Comment by Alexa on December 4, 2014 at 7:54 am

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