Achoo! How To Survive Fall Allergy Season

For many people with allergies, spring is the worst season of the year. But here at Westchester Health, we’ve observed that for a large number of our patients, fall is right behind it in severity. People with nasal and eye allergies, as well as asthma, often suffer throughout the fall, from late August thru November.

2 ways fall allergies differ from spring allergies

1. Ragweed pollen

James Pollowitz, MD, FAAAAI, FACAAI

Ragweed is the best known fall allergen, pollinating between August 15th and the first frost (usually late September‒early October), usually hitting its peak around Labor Day. Ragweed pollen is very small and light and amazingly, can travel up to 200 miles.

Symptoms of ragweed allergy include:

  • nasal congestion
  • sneezing
  • watery, runny nose
  • eye itching, tearing and redness
  • itchy throat
  • post nasal drainage

Asthmatic patients who are allergic to ragweed often experience an increase of symptoms (coughing, wheezing, shortness of breath, chest tightness). In addition to ragweed, other weed pollens can cause allergies too, including lambs quarters, pigweed and cocklebur.

2. Molds

Molds are another very common fall allergen. The mold season is somewhat later than weeds, usually October and November. Molds grow on dead vegetation (especially fall leaves) and its spores (the mold equivalent of pollen) are then carried by the wind, causing the same type of allergy symptoms as pollens. Molds grow well in low light and in areas of high moisture, both of which often occur in the fall.

Being indoors more in the fall also triggers allergies and asthma

In the fall, most of us spend more time indoors (home, school, office) and are thus more exposed to indoor allergens such as pets (especially dogs and cats), mold and dust mites. Allergic reactions usually increase during this season and trigger asthma attacks and sinus and ear infections. Cold air, cigarette smoke and climatic changes are other important triggers. Typical asthma symptoms include cough, chest tightness, wheezing and shortness of breath.

Best ways to treat fall allergies

Treatment of fall allergies (or any allergies) involves taking three important actions:

1) Avoid or eliminate triggers

To reduce the irritants that are triggering allergic reactions:

  • use allergen encasings on all pillows and mattresses
  • remove and control mold in your home by frequently cleaning and repairing any water leaks or dampness
  • remove pets or restrict them to certain areas in the house
2) OTC medications

Many medications used to treat allergies are now available without a prescription. These include long acting, less sedating antihistamine OTC medications such as Claritin, Zyrtec Allegra (also available as generic brands) and most recently Xyzal. There are now several OTC nasal steroids: including: Nasacort AQ, Flonase, Flonase Sensimist and Rhinocort. They have also become available without a prescription over the past few years. These medications are more effective than antihistamines, especially for relief of nasal congestion.

3) Rescue medications

Rescue medications such as albuterol are important in managing acute symptoms but should not be used regularly. Using them more than twice a week indicates that you need asthma controller medication such as inhaled steroids (Flovent, Asmanex or Qvar) or a non-steroid such as Singulair (montelukast).

More severe asthma is often treated with combined steroid/long-acting bronchodilator inhaled medications such as Advair, Symbicort, Dulera or Breo Ellipta. Persistent asthma requires a treatment action plan and ongoing follow-up, similar to other chronic diseases such as diabetes, hypertension or arthritis.

4) Immunotherapy (allergy shots)

Allergy shots (immunotherapy) are a very beneficial therapy and have been used for more than 100 years for millions of patients. People with pollen, cat and dust mite allergies can experience as much as 90% improvement compared to medical therapy alone. A usual course of therapy is 3-5 years of treatment. When the shots are stopped, most patients do not relapse for at least 5-10 years.

5) Immunotherapy (tablets)

A new type of allergy immunotherapy involves tablets placed in the mouth under the tongue, where they dissolve. Currently, there are now four available products: Grastek and Oralair to treat grass pollen allergies, and Ragwitek for ragweed allergy. A product to treat dust mite allergies (Odactra) was recently approved for treatment of patients age 18 to 65. This product will be on the market soon (by early 2018).

Even with allergies, you can still enjoy the fall

If you dread the fall because of allergies, you’re not alone. But neither should you suffer unnecessarily. The correct diagnosis and treatment for your allergies can actually help you enjoy this beautiful time of the year.

Suffering from fall allergies? Come see us.

If you’re experiencing any of the allergic reactions discussed above, or want to know how to better manage your allergies, please call (914) 232-1919 to make an appointment with one of our Westchester Health allergy/immunology specialists. Along with you, he/she will determine the best course of treatment and/or medication, and order any necessary tests so that hopefully, you’ll soon be able to enjoy the fall season, every year. Whenever, wherever you need us, we’re here for you.

By James Pollowitz, MD, FAAAAI, FACAAI, an allergy and immunology specialist with Westchester Health, member of Westchester Health Physician Partners

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