What are seasonal allergies? They are also known as “hay fever” or seasonal allergic rhinitis. 36 million Americans suffer from seasonal allergies every year. They are, by definition, “seasonal” or during one part of the year. Pollen (or allergens) are tiny, egg shaped, powdery grains released from flowering plants/trees/weeds/grasses. They are carried in the wind and enter into our nasal/oral passages and eyes. Allergy symptoms include: watery/itchy eyes, sneezing, clear nasal mucus and coughing. Allergies can be confused with the common cold but keep in mind, allergies do NOT cause a fever or thick, colorful nasal mucus. Allergies can lead to sinus infections/headaches and fatigue. Asthma sufferers can have more severe symptoms during allergy season.
In Colorado, tree allergens are present from Feb until June (right now for us here in Fort Collins), grass allergens are from early May until August and weed allergens are from August until September. Pollen counts increase on warm sunny days and are worse if it’s windy. Pollen counts are lower if it’s rainy or cool. If both parents have seasonal allergies then there is a 66% chance a child will also have them, it drops to 60% if only one parent has them. Seasonal allergies can start at any age, but are most often noticed by age 10years. It takes 2 years of exposure to allergens before developing symptoms; so we rarely see allergies in children under the age of 2 years.
Here’s a link to our local pol en counts at the weather channel:
Allergens can cause an itchy rash if touched to the skin (esp. grass). They can also cross react with food allergy proteins: grass allergens cross react with food allergy proteins in vegetables: onion, lettuce, carrots, celery and corn. Tree pollens can cross react with foods: apples, grapes, peaches, celery and apricots.
Testing: an Allergist can test for allergies using a skin test or a blood test. Testing may be indicated if you need to know specifically what you are allergic too, or if you desire allergy shots to lessen severe allergies. Most of our patients benefit from simply treating allergies through modifying/safeguarding their environment or through medications.
Here are some tips on how to lessen symptoms of seasonal allergies by control of your child’s environment.
Reduce or eliminate your exposure to allergens (pollen):
During high pollen counts, keep windows shut and your air conditioning on. This
includes your car (and put it on re-circulate and not fresh intake for your vent settings).
If your child is outside and may have pollen on their clothing or hair then have them
bathe/shower once they come indoors. At a minimum, leave shoes at the door so you don’t track allergens in, change clothes, use a wet washcloth to wipe down your child’s arms/legs/hair. Bathing before bed wil help reduce contaminating your child’s bedding with allergens.
If your teen has allergies to grass, have them choose another chore instead of mowing. Minimize being outside from 5-10am, this is when most pollen is released. Use impermeable bedding covers for pillows and mattress. Consider a HEPA filter. Ones attached to your AC may be expensive and have had
mixed results in research studies. Having a HEPA filter on your vacuum container has been shown effective.
Many children that have allergies are sensitive to strong smells. Avoiding strong
smelling chemicals/detergents or scented items (candles/perfumes). Use natural unscented products if possible.
Rinsing your child’s nose with a saline irrigation can go a long way in rinsing away
Here are some tips on how to lessen symptoms of seasonal allergies, by control of your child’s allergies through medications.
There are many safe and effective medications you may use:
1. OTC (over the counter) Antihistamines. First generation medications include
diphenhydramne (Benadryl), bropheniramine (Dimetapp Allergy), chlorpheniramine (Chlor-Trimeton). These are often sedating and need to be taken more often. Second generation and less sedating antihistamines: loratadine (Claratin or Alavert), cetirizine (Zyrtec), fexofenadine (Allegra). These are often less sedating and are 1-2 times daily depending on age. We love these longer acting forms!
2. Prescription steroid nasal sprays. Nasal sprays have the highest effectiveness for nasal
symptoms and are considered a first line treatment. There are a number of prescriptions options: fluticasone (Flonase), mometasone (Nasonex), budesonide (Rhinocort Aqua), triamcinolone (Nasacort AQ), these options are for children 2 yrs of age and up. Often children will benefit from combining an oral antihistamine and a nasal steroid spray. It is
important to use these sprays properly. Use saline first to rinse the nasal passages. Direct the spray away from the nasal septum, a slight sniff helps in dispersing the medication. Rinsing the mouth out after is a good idea to prevent an overgrowth of yeast. These can be used safely for years if needed. If nasal bleeding occurs, then take a break.
3. Prescription antihistamine nasal sprays. Azelastine (Astelin) and olopatadine
4. Prescription Leukotreine modifiers (montelukast or Singulair). This medication can be
very helpful, in addition to antihistamines and nasal steroids. They are also indicated for allergy induced asthma and exercise induced asthma. They are dispensed as a chewable medication for the younger children, or as granules placed in applesauce.
5. Antihistamine eye drops: OTC varieties: Alocril and Zaditor (3 yr and up), Naphcon A
and Opcon A (6 yrs and up). Prescription: Pataday (3yr and up). These can be very helpful when oral antihistamines don’t quite help with itching. Children can rub their eyes with so much force that they blister and the white part of the eye can swell and look jelly-like. Try a cool compress and a lubricating eye drop as well as the antihistamine drops!
6. Allergy shots: This is also known as immunotherapy. It is done at an Allergist’s office. It
involves weekly (initially) injections to reduce the person’s sensitivity to allergens. These are often continued for 3-5 years. This can be costly and tough for children. But if allergies are severe, induce asthma or are not effectively treated by medications then this may be a good option. Please check with us and we can discuss a possible referral if this is the best option for your child.
Please call us for an appointment to discuss your child’s allergies. There are many options we can discuss. We want your child to be comfortable during allergy season! “Ah-choo”, we’re here for you!
Information taken from multiple sources: National Jewish, Amer Academy of Allergy and Immunology, healthychildren.org, Up-To-Date.
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