Seasonal allergies are underway: how can allergy sufferers overcome them?

Measures to prevent and treat allergic reactions

Since allergies are still incurable, this article offers some helpful tips on how to alleviate ailments associated with allergic reactions to tree, grass and weed pollen, whose blooming season usually starts in spring.

1. Avoiding or eliminating allergens from the immediate environment

Symptoms of an allergic reaction usually occur within minutes or hours of being exposed to an allergen, so it is generally recommended to avoid allergens whenever possible. However, this is sometimes difficult and impractical – if avoiding contact altogether isn’t possible, it should at least be minimised.

In the case of pollen, it is recommended to check the pollen calendar and pollen forecast for information on monthly or daily pollen counts in order to take appropriate preventive actions. For example, if a high concentration of allergic pollen in the air is forecast, it is recommended to stay indoors, if possible.

Additional protective measures in the form of allergen control and elimination from the immediate environment include the following:

• Avoid airing your home during peak pollen count (usually between 5 a.m. and 10 a.m.); airing should be as short as possible and done in the afternoon.
• Keep car and room windows closed during peak flowering times of allergenic plants, and humidify the living and sleeping areas in your home.
• Use an air conditioner to help filter out pollen; regularly clean and replace the filter before the start of flowering season.
• Dry clothes indoors or in a tumble dryer to avoid unnecessary introduction of unwanted pollen into the living space.
• Take off clothes and shoes after spending time in nature, which should be reduced to a minimum (preferably in the late afternoon or evening).
• Wear protective sunglasses and hats, including a face mask if necessary, especially during windy and dry days when being outside is unavoidable.
• Take daily showers and regularly wash your hair, especially before going to bed.
• Frequently change and wash your sheets and other bedding at 60 ⁰C or above.
• Avoid smoking, aerosols and similar irritants because they can aggravate allergy symptoms.

2. Symptomatic treatment with pharmaceuticals

Antihistamines, nasal decongestants and corticosteroids are the most commonly prescribed medications for relieving allergy symptoms. Since these medicines produce different effects in the body, it is necessary to describe in more detail how each one is used, how long the therapy lasts and what its expected benefit is. Moreover, it is also possible to undergo hyposensitization (immunotherapy) as recommended by an allergy/immunology subspecialist.

a. Antihistamines

Antihistamines or antiallergics are the main anti-inflammatory drugs prescribed for the symptomatic treatment of allergies, and they work by preventing histamine activity that is responsible for the onset of allergic reaction symptoms. They are most useful in treating mild-to-moderate hay fever, and are most often taken in the form of tablets, capsules and solutions for topical application. They are used for keeping allergies under control as:

• Preventive treatment to suppress allergy symptoms (prophylactic effect), whereby therapy should be started several weeks (at least two) before the expected blooming season of plants whose pollen causes allergies, with continuous administration throughout the season.
• Curative treatment to alleviate/treat allergy symptoms (immediate effect), whereby therapy is taken as needed after allergic reactions have already occurred.

b. Nasal decongestants

Nasal decongestants are used as therapy for short-term treatment of nasal congestion, and are taken in the form of sprays or nasal drops. They act by narrowing the blood vessels inside the nose, thereby reducing mucous membrane swelling and improving airway patency.

It is important to note that decongestants should not be used for more than a week at a time because they can lead to damage of the nasal mucosa as an important factor of allergen resistance, resulting in rebound congestion due to medication overuse.

c. Corticosteroids

Corticosteroids have the most prominent anti-inflammatory effect of the drugs mentioned so far. They are used in more severe cases of an allergic disease where symptoms cannot be successfully managed by antihistamines. They act by inhibiting the release of inflammatory mediators or by stimulating anti-inflammatory activity.

Corticosteroid therapy should be started at least two to three weeks before the expected onset of symptoms as long-term prophylaxis and continued throughout the pollen season. Due to possible side effects, strict adherence to prescribed therapy under medical supervision is required.

d. Hyposensitization or immunotherapy

Allergen-specific hyposensitization or immunotherapy is a form of long-term treatment of an allergic disease using low and increasing doses of the allergen to which the patient is primarily sensitive in order to stimulate the development of tolerance to the allergen responsible for the allergic response.

This therapeutic method is recommended to younger patients with long-term and severe seasonal allergic rhinitis caused by only one pollen allergen or one group of pollen (monosensitization), especially in cases where allergen avoidance measures are not possible or have not led to a satisfactory result, or when drugs have not been fully effective.

It is performed by administering subcutaneous injections or sublingual solutions regularly over a period of several years, but not more than three to four. Most patients notice milder allergic reactions or reduced symptom occurrence, with decreased use of allergy medications.

3. Maintaining good nasal hygiene

As an extremely simple but nonetheless very useful measure, it is recommended to use isotonic saline (NaCl 0.9%), salt water and hypertonic saline (NaCl > 0.9%) for maintaining good nasal hygiene. The aforementioned preparations are neutral (i.e. they do not contain drugs), and are used to moisten the nasal mucosa and rinse allergens from its surface.

Depending on their composition, it is possible to use them several times a day as needed and for an indefinite period, making sure to always check the shelf life of the preparation before application. They are administered by either dropping or spraying the solution into the nose, whereby proper application of the dropper or pump is important to avoid mechanical damage to the mucosa.

In addition to rinsing out allergens from the nasal passage and decongesting the nose, hypertonic saline also contributes to reduced virus replication in the respiratory mucosa due to increased salt concentration that directly prevents the growth and reproduction of pathogens. Respiratory pathogens, including SARS-CoV-2, have difficulty surviving in such an environment; therefore, their number and virulence is effectively reduced.

Conclusion

Pollen allergies are considered modern-age “diseases” because of their significant prevalence across the world, especially in developed countries where almost a quarter of the population is affected. Precisely because of their increasing prevalence, as well as clinical and economic importance, it is necessary to recognize allergy symptoms early on and properly address them, either by preventive methods of symptom suppression or through the use of medicines to alleviate/treat symptoms.

However, it is important to keep in mind that, like all medicines, allergy medications can cause side effects. Pharmacovigilance measures aim to ensure patient protection and safe drug use, and Marti Farm has many years of experience and know-how precisely in this area: connect with us to learn how our team of experts can assist you in the performance of pharmacovigilance activities via an individualized and comprehensive approach to finding solutions that will successfully meet all your business needs.

Zorana Stanko, MA / Professional Medical Translator