Hayfever and Allergies

Hayfever

Hayfever is not caused by hay, nor does it produce a fever! It is a reaction (e.g., stuffy, runny nose, itchy, watery eyes, or a blocked feeling in your ears) caused by an allergy to airborne particles that are inhaled.

Allergy

When a plant or animal substance, which is foreign to humans, invades the body through the membranes of the eyes, nose, and throat, it causes an immune reaction. Your body is fighting the invader. Under ordinary circumstances this is a helpful process – natural protection. However, some individuals exhibit an exaggerated allergic response to certain substances. Those substances are called allergens, and these people are allergic. Being allergic is a trait that tends to run in families.

The allergens stimulate the body to form sensitizing antibodies, which combine with the allergens. This combination causes the body to release a number of chemicals that produce allergic symptoms. Histamine is the best known chemical produced by the body; it causes itching, irritation, swelling of the nasal membranes, and excess mucous production.

What is Allergic Rhinitis?

Particles of plant or animal proteins that are small enough and lightweight enough to be carried through the air can be deposited onto membranes of the eyes, nose, and throat. Common sources are pollens, mold spores, animal danders, and house dust. Allergic rhinitis is the stuffy, runny nose and itchy eyes that result from an inflamed nasal passage.

More than 14 million Americans suffer from allergic rhinitis. For some it is a mere nuisance. But, for others it can be debilitating.

What Are the Inhalant Allergies?

Pollens
Early springtime hayfever is most often caused by tree pollens. Late springtime pollens come from the grasses and weeds. Colorful or fragrant flowers such as roses rarely cause allergies because their pollens are too heavy to be airborne. They rely on insects to carry their pollen from one plant to another.

The most significant hayfever producing pollen in the United States comes from ragweed. It begins in late August and continues until October or the first frost in most parts of the U.S.

Molds
Molds are fungi, which spoil bread, rot fruit, and mildew clothing. They also grow on dead leaves, grass, hay, straw, and in the soil. Because they are not killed by frost, the mold allergy season is long, and mold spores may be outside all year, except when snow covers the ground.

Indoors, molds grow on houseplants and in their soil. They also grow in damp places such as basements, bathrooms, and laundry rooms. Molds can be found in cheeses and fermented alcoholic beverages.

Year-Round (Perennials)
Other allergens that are present through all seasons include animal danders (cats, dogs, horses, and other pets, wool, and feathers), cosmetics, foods, and house dust. House dust is a complex mixture of disintegrating cellulose (furniture stuffing), molds, danders (pets and other animals), and insects and small mites. If your allergies become worse in the winter, when hot air surfaces are turned on, they are probably due to house dust.

What Can You Do?

The first line of defense is avoidance of allergens. Ideally, you would live away from where your allergies occur – on a beach where you only breathe sea breezes or in the desert where nothing can grow. Unfortunately this is not practical. You could try the following:

• Rid your home of indoor plants, mildew, and animals that produce dander.
• Change air filters monthly in the heating and air conditioning systems in your home. Or, install an air purifier.
• Change feather pillows, woolen blankets, and woolen clothing to cotton or synthetic materials, such as Dacron.
• Use antihistamines and decongestants as necessary and as directed by your physician.
• Observe general good health practices
  • Stop smoking and avoid air pollutants
  • Exercise regularly
  • Eat a balanced diet
  • Supplement your diet with vitamins, especially vitamin C

Diagnosis

Careful evaluation of the nose and sinuses will enable your ENT specialist to determine if infection or structural abnormalities (deviated septum, polyps) are contributing to your symptoms. Blood or skin testing may be recommended.

Treatment

A number of medications are useful in the treatment of allergy. Your physician will choose those best suited to you. They may include antihistamines, decongestants, cromolyns, and cortisone- type preparations. The medical management of suspected allergy also includes counseling in proper environmental control. Finally, based on a detailed history and thorough examination, your doctor may advise testing to determine the specific substances to which you are allergic.

What About Allergy Shots?

Desensitization for inhalant allergens is the administration of injections, which build up protective antibodies to specific allergens (pollens, molds, animal danders, dust). Testing can be done to identify the specific causes of your allergy using either skin or blood tests. Once your doctor knows what you are allergic to and the degree of your sensitivity, you may begin treatment with allergy shots. The allergy injection, if necessary, will be started at the highest safe dosage, shortening the time required for the benefits to become apparent.

Allergy injections may produce visible improvements within a few weeks of starting therapy. The shots must be continued for three-to-five years to give more permanent relief. Your ear, nose, and throat specialist will give you more specific details of an expected treatment schedule based on your history. Although allergy injections produce improvement in allergic symptoms, the use of various medications may continue to be necessary, especially if you are exposed to large amounts of the allergen or if there are complicating factors. Your physician will monitor your progress throughout the course of your treatment, as well as care for any other nasal and sinus disorders that may contribute to your symptoms.

Copyright American Academy of Otolaryngology – Head and Neck Surgery