Can’t Stop Sneezing?

Ah, the beautiful golden mist floats above our Austin trees…ACHOO! It’s cedar fever time in central Texas, and many of us are suffering. Itchy eyes, runny nose, sneezing, stuffy nose, ear pain and very sore throats are all part of the package. Often people are afraid they have the flu or strep throat, because their symptoms are so intense, but one clue with allergies is the LACK of a fever- while you might have an elevated temperature of 99-100*, allergies don’t cause the 101-104* fevers and chills that infections can trigger. That being said, some of the most PAINFUL sore throats can come from “just allergies”…so be sympathetic to your suffering friends and family.

What is the best treatment for seasonal allergies? 
First line treatment for seasonal allergies includes both oral non-sedating antihistamines (like brand names Allegra, Claritin & Zyrtec, now all over the counter) and nasal steroid sprays (such as Nasonex, Flonase, Veramyst, etc.- require a prescription.) My personal preference for someone who truly has daily symptoms during a given season, especially with significant nasal congestion, is to start with these nasal steroid sprays. These are not “pump you up” steroids, but anti-inflammatory steroids that only act locally in the nasal membranes, creating sort of a protective barrier in your nose; blocking irritating pollens from ever causing that release of histamine that triggers all the itchy, runny, drippy symptoms. When I see a patient who suffers from nasal congestion, drainage, etc., “every” winter or spring, my plan is to get them started on these nasal steroid sprays a week or so before that season the next year, in the hope of preventing symptoms from ever starting.

There are also prescription nasal antihistamine sprays, which are very effective in drying up dripping noses, but are limited in many people by a rather nasty aftertaste. (Leaning forward as you use this type of spray can greatly reduce this side effect).

Another oral medication that works very well for seasonal allergies (when taken daily throughout a particular season) works by targeting the immune response via a “leukotriene antagonist”- don’t worry about the specifics here, but know this pill effectively limits the body’s allergic inflammatory response. The trade name of this drug is Singulair, and it is used both for seasonal allergies and for asthma. Many physicians use this drug as a second line of defense when the daily nasal steroids are not enough, especially if people are having too much sedation or dryness as a result of oral antihistamines.

Allergy shots from an allergist may also be a very effective option, but because they require a significant time and financial investment, we reserve this treatment for patients more severely affected.

BOTTOM LINE: If you have had a stuffy nose for weeks or are having fits of sneezing or itchy eyes, ears or throat, talk to your family doctor about treatment options both NOW and in anticipation of your next allergy season.

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