How to tackle seasonal allergies, a telltale sign of spring

ROCHESTER — April is approaching, and that also means seasonal pollen allergies are on their way, too, for Southeast Minnesota.

"There have been a lot of different studies that have tracked pollen counts, and it's almost always (that) you start seeing tree pollens detected right around April 1," said Dr. David Lowe, an allergist at Olmsted Medical Center. "It's still that first week of April is where we really start thinking about getting busy with spring allergy symptoms."

The combination of oaks, maples, elms, walnuts and birches entering their pollination season, and mold spores re-entering the air as the snow melts can cause symptoms such as sneezing, itchy eyes, runny nose and coughing.

Dr. Dayne Voelker, a Mayo Clinic Health System allergist who sees patients in Rochester and Austin, said he predicts this spring's allergy season could be stronger because of the higher-than-average snowfall Minnesota received this winter.

"I suspect that our trees and grasses are going to have a good start to the spring," Voelker said. "So I suspect that we'll probably have higher pollen counts because the pollen count is kind of reflective of the precipitation we had in the season before."

Climate change has also extended Minnesota's allergy seasons, Voelker said. A 2016 EPA study found that the ragweed pollen season increased between 1995 and 2015 by 18 days in the Minneapolis area and by 15 days in the La Crosse, Wisconsin, area.

"As the climate is warmer and staying kind of more advantageous for growth of trees, grasses and weeds, we're starting now to have a longer pollen season," Voelker said. "And it starts earlier."

Contributed / Mayo Clinic

There are several treatment options for seasonal allergy symptoms, and most are available over the counter. Lowe said some of the strongest options include nasal steroid sprays like triamcinolone acetonide (Nasacort) and fluticasone propionate (Flonase) if they are used daily, not just as needed.

"There's some evidence that if you start a nasal steroid spray, like you started March 1 in Minnesota and you use it for 30 days prior to the development of allergy season, using it a month ahead of time will help decrease the severity of allergy symptoms," Lowe said.

Other OTC options include antihistamine pills such as loratadine (Claritin), cetirizine (Zyrtec) and fexofenadine (Allegra) and antihistamine eye drops.

"Those medications, they can be used daily, but they can also be used as needed," Voelker said. "They usually work in about an hour or so."

There's also a fairly new option on the market: a nasal antihistimine spray called axelastine (Astepro).

"It's basically like spraying Zyrtec or Allegra, Claritin in your nose," Voelker said. "The benefits of that one is that it works quicker than the oral antihistamines; it works in about 15 to 20 minutes, and it seems to be a little bit more effective."

One thing to avoid, Lowe said, is the daily use of decongestants like pseudoephedrine (Sudafed) to treat allergy symptoms.

"We don't necessarily like to have people on decongestants day in and day out," Lowe said. "I would say they're fine if you're younger and healthier, but they can raise your blood pressure, they can make you shaky, jittery, interfere with your sleep. ... If you're really desperate, you got to have something to make it through some big event, then take a decongestant for a day or two."

Those suffering from seasonal allergies can also receive allergy shots, in which a small amount of a patients allergens are injected in order to make their immune system more tolerant of those allergens. Lowe said some patients prefer this once-a-month shot over taking a nasal or oral medication.

"And sometimes people come in and say, 'Well, do I have to try all the medicines before I try shots?' No," Lowe said. "There isn't a hard-and-fast rule that says you have to fail all the medicines before you can start shots."

Another way to reduce symptoms is finding out what you're allergic to and take actions to avoid those allergens. For pollen, Lowe said running the air conditioner can reduce pollen in your home, and if you've been outside a lot during the day, showering before bed can wash that pollen away so it doesn't get onto your sheets.

Allergy testing to see what particular allergens trigger symptoms can be helpful, Voelker said, especially if people want to try avoiding contact with their allergens.

"We look at perennial allergens ... dust mite, cat, dog," Voelker said. "And then we test for seasonal things as well, so that's going to be our tree pollen, our grass pollen, our weed pollen and then molds as well."

The upcoming tree pollen season typically lasts through April and May. Grass pollen season picks up in late May to early June, and the weed pollen and mold allergy season arrives in August and September.