Allergies: Alternative Solutions if Medications Don’t Work for You

It’s that time of year again: Pine pollen, grass pollen, molds and many other potent allergens are signaling the start of spring in Atlanta. Whether you live or work inside or outside of the perimeter, you have likely noticed the decline in cold days and flu symptoms as we welcome warmer weather and clearer skies.  We are all eager to get outdoors, work in the garden, and play on the ball fields.

Combine these allergens with increasing time outdoors and you have a recipe for a consistent chorus of “achoo”s, drippy noses, scratchy throats and red, itchy eyes. Severe seasonal allergies can cause significant discomfort and disruption. Some suffer so badly that missing work or avoiding activities they otherwise enjoy isn’t outside the norm. Despite the prevalence of allergies and the well-established medical interventions shown to treat or prevent them, patients are often misinformed or misunderstand their treatment options. While many just suffer through the season, there’s no need! There are several effective treatment options that can be explored.

What causes my allergies to make me feel so miserable in the first place?

The primary chemical involved in the allergic response is Histamine. Histamine causes blood vessels to dilate and to become leaky. These leaky vessels cause many of the classic symptoms of allergies: congestion, runny nose and red, watery eyes. Histamine also stimulates the nervous system, which is the primary cause of itching, sneezing and even pain.

What can I do about it?

The “first-line”, and most commonly used allergy medications are intranasal steroids and “second-generation antihistamines”.

Intranasal steroids, like Nasonex® and Flonase®, are by far the most effective way to treat and prevent allergic symptoms due to environmental allergens like pollens and mold. They should be used every day and preferably started at the beginning of the allergy season – even before developing symptoms. Intranasal corticosteroids are available both over the counter and by prescription.

Newer, long-acting antihistamines are less sedating than the older generation of antihistamines such as Benadryl®. Brand names like Zyrtec®, Claritin® and Allegra® are examples of these newer, second-generation antihistamines. Each is also available in generic form. They are all available over the counter and are useful adjuncts to intranasal corticosteroid sprays. They are rarely effective on their own for treating all symptoms, and they do not prevent the allergic response like steroid nasal sprays do. Some allergy sufferers not responding to a combination of steroid sprays and antihistamines can try adding antihistamine nasal sprays and/or immunomodulators like Singulair®, though studies show that their impact is marginal.

What can I do if my allergies don’t respond to the usual treatments?

If allergies are severe enough and not relieved by conventional means such as corticosteroid sprays and antihistamines, consideration of steroid shots or a desensitization program is warranted.

While desensitization is usually done by an allergist, a steroid shot is something that can be given in an urgent care setting if a provider assesses the patient and deems it necessary. A long-acting steroid such as Kenalog® is typically used and can be effective for preventing allergic symptoms for up to 3 months. Steroid shots should only be considered when conventional therapy fails and should not be used more than once a year. Risks and benefits of all medications, including potential side effects, should be discussed with your doctor.

If you’re tired of all the sneezing, dripping, itching and congestion, come into Piedmont Urgent Care for an allergy assessment by one of our Piedmont Health network providers and to learn about appropriate treatment options. We are Georgia’s source for prompt and attentive allergy care in the greater Atlanta and Macon metro areas. We have board-certified providers available in very convenient locations – come find the one nearest you!