For millions of people in the U.S., spring means suffering allergic reactions to the pollens released by trees early in the season and grasses closer to summer.
But suffering is not inevitable, according to two Northeastern University professors of pharmacy. Mansoor Amiji and Brandon Dionne say there are a variety of treatments for runny, sneezy and stuffy noses as well as itchy and watery eyes, scratchy throats, fatigue and headaches.
Their five best tips include over-the-counter and prescription medications, as well as lifestyle adjustments that can make it safe to enjoy the outdoors this springtime.
Antihistamines work by stopping histamines released by the body’s contact with allergens from binding to receptors in cells and triggering allergic reactions, says Dionne, an associate clinical professor of pharmacy and health systems sciences.
“Usually my first step is systemic antihistamines, and I think fexofenadine (brand name Allegra) is the best one,” he says.
As a second-generation antihistamine, Allegra causes less drowsiness than Benadryl, which also goes by the generic name diphenhydramine, Dionne says.
“Fexofenadine is my favorite because it’s effective but causes less drowsiness. Cetirizine (brand name Zyrtec) is similarly effective, but it causes more drowsiness than fexofenadine,” Dionne says.
Amiji’s antihistamine of choice is Claritin, or loratadine, which he takes at night with no ill effects on his sleep.
Amiji, a Northeastern University Distinguished Professor of Pharmaceutical Sciences and Chemical Engineering, also takes prescription eye drops to arrest allergic reactions that cause his eyes to water and itch.
The product he uses is Cromostil, a mast cell stabilizer that prevents the release of histamine. Amiji advises people to find out which of several allergy-fighting eye drops on the market would work best for them.
People whose noses remain itchy, stuffy and runny despite oral over-the-counter antihistamines might want to talk to their doctors about adding a nasal corticosteroid such as Flonase to the treatment plan, Dionne says.
“If antihistamines alone aren’t working, or if you prefer not to take systemic antihistamines, that’s usually where I would recommend intranasal steroids,” he says. “It can be helpful for people with severe seasonal allergies.”
Amiji says adding a topical treatment to the oral antihistamine can have a synergistic effect, making the combined treatments more effective than their separate parts.
Allergies can feel like a bad cold when they cause stuffy noses, especially when the nasal congestion leads to headaches.
Relief can come in the form of decongestants containing pseudoephedrine such as Sudafed, which work by reducing swelling in the sinuses to improve mucus and air flow, Dionne says.
Since pseudoephedrine can also increase blood pressure throughout the body, “I would only use it if you have congestion,” he says.
“You can do both Allegra and Sudafed,” says Dionne, who says he would shy away from using combination drugs such as Zyrtec D, which contain both an antihistamine and decongestant.
“You don’t always need both,” he says. “Take whichever one you need.”
If allergies cause mucus build up in stuffed up noses, consider using a nasal wash such as a neti pot to clear the gunk out, Amiji says.
“It moisturizes and also cleans out the nose,” he says.
“It’s really important to use it correctly to make sure that the liquid goes in one nostril and comes out the other” rather than going into the mouth or throat, Amiji says. If you’re interested in using a nasal wash, check out videos and instructional sheets available online.
If you can, avoid exercising outdoors or doing yard work when pollen counts are high by checking daily pollen reports, Dionne says.
Close windows and use air conditioners if it gets hot, he says. Use HEPA filters in vacuums and HVAC systems and air purifiers when HEPA filters are not applicable.
Tips such as washing one’s hair before bed to wash off pollen may not have been scientifically studied but may be useful, Amiji says. He says stepping up the laundry schedule, especially by washing bed linens more often, may also help.