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Allergic Rhinitis (Hay Fever): FAQ

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This information was reviewed and approved by Rafeul Alam, Rafeul Alam, MD, PhD (2/29/2020).

While most people gratefully welcome the longer days and warmer weather of spring, people with hay fever often dread the itchy eyes, runny nose and sneezing that come with the season's pollens and mold spores. 

Learn answers to frequently asked questions about this common allergic condition known as hay fever (seasonal allergic rhinitis).


Allergic Rhinitis FAQ Topics

What causes hay fever?

Question: What causes my allergies to flare up in the spring?

Answer: Pollen is the most likely cause. Your immune system has mistakenly learned to remember the pollen released by various plants as potentially harmful, and responds with the familiar allergic symptoms. Each species of plant releases pollen at about the same time every year. Trees are usually the first plants to release pollen, usually in the early spring. Grasses come next in the spring and early summer. Weeds generally release their pollen in late summer and fall. The specific types of pollen and the time of their release depend upon the local climate and vary around the country. People with seasonal rhinitis are often allergic to more than one type of pollen.


Question: What can influence the severity of the allergy season?

Answer: Weather can influence the timing and severity of the allergy season. A mild winter often leads to a more severe pollen season. The grass season varies the most. If the spring is warmer and wetter than usual, then more grass grows, which leads to a more severe season during the late spring and summer. However, rain can have benefits, as well. For instance, rain can wash pollen that has already been released out of the air.


Question: My husband suffers from asthma and allergies but hasn't had trouble with either since we moved to Colorado. However, we want to go to a place to dance, and we have been warned that it will be smoky. Will he probably need an inhaler for this? What do you suggest?

Answer: Irritants such as cigarette smoke can trigger asthma and nasal symptoms. Therefore, if you are going to be exposed to irritants like smoke, dust or other air pollution, it is wise to take along your rescue inhaler and take it at the first symptoms.


Question: I have always had normal nasal (rhinitis) symptoms, but this year, I have also developed asthma and food allergies. Is this a typical allergic response?

Answer: Some people with a history of pollen allergy develop a condition called oral allergy syndrome. This occurs when cross-reactions between allergy pollen and fresh fruit cause itchiness and swelling in the mouth and throat after eating the food allergen. Although this is usually mild, you should be evaluated by your allergist, because sometimes the reaction can be severe. People with a history of nasal allergy are more likely to have asthma than individuals without allergy.


What are the complications of allergic rhinitis with other respiratory conditions?

Question: I have COPD and problems with my sinuses. I currently use Claritin-D®. Is there another medicine that will work better to clear up the drainage?

Answer: Medications like Claritin-D can help sinus drainage for people with allergy and sinus drainage problems. Other antihistamines and decongestants can work as well. When there are chronic sinus problems, especially with a history of allergy, nasal steroid sprays are often very helpful. Nasal saltwater rinses can also be very beneficial. You will need to talk to your doctor about these options, but most people's symptoms can be well controlled. Also be sure to talk about your other medications.


Question: I have emphysema and struggle with shortness of breath this time of the year due to allergies. What treatments and medications are recommended for those with COPD and heart problems (I had open heart surgery nine years ago)?

Answer: Standard treatment for allergies should help when they complicate COPD. The standard treatment for nasal allergies includes nasal steroid sprays, nasal saline (saltwater) washes and antihistamines.


Question: I have a mother-in-law who lives in Napa, California. She has bad asthma and wants to move out of California. Is there a list that shows the "best places to live for asthma sufferers"? If so, can you direct me to it?

Answer: There is no list of good or bad places to live with asthma, since asthma can be triggered by a variety of things such as allergies, air pollution and climate. There may be variations in these factors that can influence asthma control. For allergies caused by pollens there may be a short honeymoon from allergies when someone moves to a new place. However, within a few years people often become sensitized to new allergens.


Question: I recently moved to Denver from the West Coast, and my asthma is much better here. I travel a lot for business, usually to the West Coast, and my asthma is worse again. What is the difference?

Answer: Because of its dry air and high altitude, Denver has lower levels of the house dust mite. The house dust mite is a major allergen, causing asthma flare-ups on the West Coast and in other humid areas of the country. This might explain why you do well in Denver and suffer relapses of asthma when you travel. Evaluation by your allergist will likely be helpful.


Question: Why is it that some children only get sick with asthma in the wintertime? Should I always start my child on inhaled steroids in August? And leave him on them until March?

Answer: The most likely explanation is that your child's asthma flare-ups are caused by viral infections. These tend to be most common in the wintertime. A less likely explanation is that your child is allergic to indoor allergens such as molds, animal dander and house dust mites. Because people often spend more time indoors during the winter, this may increase exposure to indoor allergens. It is very reasonable for your doctor to put your child on preventive therapy such as inhaled corticosteroids in the winter if you know from past experience that he is likely to have increased symptoms at that time.


Question: Can people with COPD take Allegra®? I know Sudafed and others are not recommended for COPD patients.

Answer: People who have allergies as well as COPD can take antihistamines, such as Allegra, for their allergies.

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