How to treat and manage allergies at home, and when to see an allergist

Woman sitting in the meadow

Whether they hit you in the spring or fall — or worse, both — allergies can range from a minor annoyance to a serious asthma attack. Here’s what you need to know to manage seasonal allergies.

The science behind allergies

Allergies are the result of our body’s immune system recognizing microscopic substances we breathe in as a danger signal. In the case of seasonal allergies, those foreign substances are pollens, which come from trees, grasses and weeds and can travel hundreds of miles in the air searching for other plants to reproduce with.

Not everyone’s immune system reacts to pollen, but for those suffering from seasonal allergies, pollen triggers allergy cells to release substances like histamine that create the allergy symptoms. This is an immune response that isn’t supposed to happen.

Those allergy symptoms can include…

  • itchy, stuffy nose
  • sneezing
  • swollen, watery and itchy red eyes
  • sore throat, congestion or earaches from nasal drainage
  • flare-ups in eczema (an itchy skin rash)

And with climate change, pollen counts continue to rise, particularly with ragweed in the fall, causing more people to have more, and more severe, allergy symptoms.

The first line of defense against allergies

Allergists typically recommend two initial strategies to tamp down these symptoms:

Avoid the allergens in the first place

On days when pollen counts are especially high (check your weather channel or app), try to spend time indoors and keep windows closed in your car and house. Of course, we don’t want you to live in a bubble, so when you do spend time outside, taking a shower and rinsing off the pollens when you come inside can drastically reduce your body’s immune response. We also recommend saline solutions or a neti pot to flush pollen out of the nose. And for those with outdoor pets, wiping them down with a damp towel when they come inside can keep pollen from getting into the house.

Try over-the-counter (OTC) medications

OTC medications can be extremely effective at preventing our allergy cells from triggering, keeping symptoms under control before they even start. For oral medications, allergists recommend those with long-acting, less-sedating active ingredients, such as:

  • loratadine (Claritin)
  • cetirizine (Zyrtec)
  • fexofenadine (Allegra)

These are recommended over the shorter-acting diphenhydramine found in Benadryl, which can cause drowsiness.

OTC corticosteroid nasal sprays can also be very effective at reducing symptoms, especially stuffy noses. These include name-brands Flonase, Rhinocort and Nasacort, for example. Topical nasal decongestants such as Afrin (active ingredient: oxymetazoline hydrochloride) aren’t as effective and patients can get addicted to them, so they aren’t recommended.

It’s also important to use the proper technique. Here’s how to use a nasal spray effectively:

  • Point your nose down to your toes.
  • Put the nozzle up your nose and aimed toward the eye.
  • When spraying, don’t snort or try to breathe in the spray, but let it coat the inner nostril and dab excess medicine that drips out of your nose with a tissue.

For more explanation, watch me demonstrate proper nasal spray technique in a TikTok video.

While oral medications for some patients can give almost immediate relief, nasal sprays often require two to four weeks of regular use to get the full effect. And not all of these medications will work for every allergy sufferer, so it’s important to experiment with different options to see what works for you.

There’s also a misconception that medications will lose their effectiveness, but in reality, allergies can get worse over time, so a medicine that worked one year may not work the next. And to save money on these medications, generic versions typically work just as well as the brand name versions.

What if allergies persist or get worse?

If symptoms continue even after avoiding allergens and taking OTC medications, if they interrupt your daily activities, or they’re severe — difficulty breathing, coughing, tightness in the chest and recurring sinus infections — make an appointment to see an allergist. Allergists specialize in diagnosing, treating and preventing allergies and other immune system problems.

Allergists will utilize immunotherapy to help the body develop a tolerance to the pollens that cause those allergic reactions, inducing long-term immune system change. Starting small, allergists gradually increase the amount of allergens the body is exposed to via allergy shots or tablets and liquid placed under a patient’s tongue to build natural immunity to the allergens. With regular administration, the body slowly begins ignoring these triggering allergens. Patients can expect to see symptom improvement within a few months, but long-term change to the immune system requires 3 to 5 years of treatment.

Seasonal allergies can be annoying, or even debilitating for some. But with the right defenses, including the patience to find the best OTC medications for your symptoms or an allergist to help in the fight, you can start to breathe easier during allergy seasons.

Are your allergies getting worse or interrupting your life?

Schedule an appointment with one of our experts here.

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