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Relief from springtime allergies

Last updated: March 2010

Allergies are hard to treat—60 percent of the springtime allergy sufferers we surveyed had limited success managing their itchy eyes, sinus pain, sneezing, and other symptoms. But if you are miserable every time the trees bloom, don't give up. Our nationally representative online survey, conducted by the Consumer Reports National Research Center, polled 1,814 adults in April 2009 during the spring allergy season. Here's what allergy sufferers said might help:

Avoidance. It's not easy to steer clear of pollen and other allergens. Only one in five respondents said they were "highly satisfied" with the avoidance measures they tried, such as staying indoors with the windows shut and the air-conditioner on, having someone else mow the lawn, or doing outdoor activities on low-pollen days. But when these tactics worked, they were even more effective than taking over-the-counter medicine for allergies.

Staying indoors and taking other avoidance measures may be most important between 5 a.m. and 10 a.m., when allergen levels are typically highest. If you try this approach, set your air conditioner to recirculate the air so you reduce the amount of pollen and other outdoor allergens from flowing into your home.

Check the pollen count in your area before going out. When you return home, take a shower to wash the pollen off your skin, and wash your clothes.

Prescription medicine. Only about one in four said they were highly satisfied with prescription allergy drugs. But most who were felt they had successfully managed their symptoms. Common medications included fexofenadine (Allegra and generic), a "second-generation" antihistamine that's less likely to cause drowsiness than older antihistamines; fluticasone (Flonase and generic) and mometasone (Nasonex), corticosteroid nasal sprays; and montelukast (Singulair), which blocks molecules that can cause inflammation and allergies.

Overall, 8 percent of respondents received allergy shots, which can provide relief by gradually increasing the tolerance to specific allergens.

Over-the-counter medicine. More than two-thirds of our respondents relied on nonprescription drugs, including: diphenhydramine (Benadryl Allergy and generic), an older antihistamine that can cause drowsiness; loratadine (Claritin and generic) or cetirizine (Zyrtec and generic), second-generation antihistamines; and pseudoephedrine (Sudafed and generic), a nasal decongestant. Overall, nonprescription drugs were less likely to help manage symptoms than either avoidance or prescription medications, but they were better than doing nothing at all.

What you can do. Consider discussing your symptoms with a doctor. Most people who saw a doctor said the visit helped a lot, and 59 percent of those people said they had managed to rein in their symptoms.

Part of that benefit may be that the people who saw a doctor were more likely to take prescription drugs. And those medications, notably the steroid nasal sprays, often do work well, research suggests. Seeing a doctor also helped respondents pinpoint the OTC drugs and allergy-avoidance strategies that worked best for them. That may be because choosing from all the options can be confusing, and some are clearly better than others.

Finally, explore our allergy trouble tracker, which allows you to compare your symptoms to those of our survey respondents to help you find a remedy that may work for you.

Are you sure it's an allergy?

Proper allergy treatment starts with an accurate diagnosis. But distinguishing between allergies and other ailments can be hard. For example, all the conditions below can cause sneezing, congestion, and a runny nose. To identify your ailment, focus on the hallmark symptoms of each as well as the other characteristics that can help differentiate the diseases.

  Hallmark symptoms Other possible symptoms Duration
Allergies
  • Itchy eyes or nose
  • Scratchy or ticklish
  • throat
  • Watery nasal discharge
  • Watery eyes
  • Cough
  • Headache
  • Fatigue
Usually weeks to months. Symptoms worsen when exposed to offending substances or at certain times of the year.
Cold
  • Sore throat
  • Hacking cough
  • Watery to thick cloudy
  • or white nasal discharge
  • Low-grade fever
  • Mild fatigue and body
  • aches
3 days to 2 weeks
Flu
  • Fever of 102º F
  • (39º C) or higher
  • Headache
  • Exhaustion
  • Extreme body aches
  • Sore throat
  • Dry, hacking cough
2 to 5 days for initial severe symptoms; cough and fatigue can linger 2 to 3 weeks longer
Sinusitis
  • Pain or pressure in the face, eyes, or upper teeth
  • Thick, discolored nasal discharge
  • Cold symptoms that last 10 days or more
  • Headache
  • Sore throat
  • Fever
  • Cough, especially at night
  • Fatigue
Up to 12 weeks; less-common chronic form can linger much longer
Bronchitis Cold-like symptoms that develop into a deep, painful cough that produces yellow or green phlegm. Often worse at night.
  • Fever up to 102º F
  • Wheezing
  • "Rattling" in chest
  • Chest is sore or constricted
3 to 5 days for fever and most other symptoms; cough may continue for several weeks

Source: Consumer Reports On Health, September 2007

Allergy relief: Stories from two patients

Alioto recalls being told as a child that she'd outgrow her seasonal allergies. At age 52, she hasn't outgrown them yet. But with the help of her allergist, her symptoms are under better control. Her allergist performed skin tests that identified her allergy triggers. He then explained what was going on physiologically, and he taught her how to use medications and avoid allergens. Her advice: Get educated, and work with your doctor. "I'm a success story because I have an active life," she says. "Allergies are not going to go away, and I'm not expecting them to, but I'm on top of them."

Drew, 34, had been allergy-free until about four years ago when he moved to the U.S. from Hong Kong. "I'm originally from Australia. I never had allergies until I came here," he says. "It's really weird." Each spring he'd get what he thought was a cold: Runny nose, itchy, puffy eyes, and respiratory problems. One day he happened to see a flyer for an allergist who practiced in his building and realized his symptoms pointed to hay fever. Skin tests identified the allergens. A combination of prescription and over-the-counter drugs helped, but annoying symptoms remained. Drew decided to start allergy shots. "With immunotherapy I'd get up to five years without symptoms, which is kind of cool," he says. In just six months he improved. "The biggest change I noticed after starting treatment was being able to go outside and exercise and being able to breathe."

Should I see an allergist?

If you've tried medications and nondrug approaches and haven't found relief from your chronic allergies, consider talking with an allergist about immunotherapy. Expect to have a skin or blood test to identify what triggers your allergies. Then you'll receive shots of gradually increasing doses of those allergens. Research shows immunotherapy can effectively and safely reduce symptoms and the need for medication.

But the process takes time: After about four months of weekly or biweekly injections, you'll need monthly booster shots for up to five years. Patients receiving treatment for two different allergens can expect to pay, on average, $921 for the first year of shots and $345 for the subsequent two to five years, estimates Linda Cox, M.D., the chair of the Practice and Policy Division of the American Academy of Allergy, Asthma and Immunology, a professional medical organization. Patients who only require treatment for one allergen may pay, on average, $608 for the first year and $208 for subsequent years.

Tips for kids with allergies

If your child has hay fever, here are some steps you can take to help him or her avoid allergens:

Know your child's triggers. Keep a diary to help track when and where your child's allergy symptoms occur. Then take steps to limit your child's exposure.

Avoid the allergens.
When the pollen count is high, keep your child indoors, with the windows shut and air-conditioner on. Plan outdoor activities for low pollen days. Afterward, wash your child's clothes to remove any lingering allergens, and make sure he washes up as well.

Talk with your pediatrician.
Your doctor may recommend other avoidance strategies or allergy medicine to help relieve the runny nose, sneezing, and other symptoms.

Get a dog or cat. Research has suggested that kids who are exposed to animals early in life are more likely to develop allergies and asthma, but more recent evidence seems to show that early exposure to cats and dogs, in particular, may actually cut the risk of developing allergies and asthma, according to the American Academy of Allergy Asthma and Immunology.

Behind the survey

In April 2009, 1,814 adults with seasonal allergies took an online survey designed by the Consumer Reports National Research Center. The results provide a patient's perspective on the day-to-day management of the condition.

Can the survey results help me choose among allergy treatments? Allergies are hard to treat. Our survey found that none of the main strategies for coping with allergies was completely successful. Consumers may be moving from one medicine to the next for different reasons, such as lack of overall effect or difficulty tolerating side effects. Some people take more than one medication simultaneously to treat different symptoms. The survey findings don't provide an easy answer, but they can help you gauge the severity of your condition, benchmark your symptoms, and determine whether to pursue, change or discontinue treatment. Since only your doctor can provide a clinical exam and review your health status and history, it's always a good idea to involve him or her in health decisions. In the case of allergies, having a thorough discussion with a physician or allergist matters a lot. It doesn't always. For example, our survey work on back pain found that primary-care physicians weren't very helpful.

What did we ask? We wanted to know whether respondents had allergies to things in their environment, such as pollen, trees, grass, ragweed, molds, mites, or pets (dogs or cats) and then found out what exactly triggered their allergic response (many were unsure). We then narrowed the sample to 1,814 U.S. residents ages 18 or older who typically experience springtime reactions to outdoor allergens during one or more spring months (March, April, May, June). We asked respondents about symptoms, the number of days that allergies left them feeling miserable, experience with providers, and their use of treatments—including avoidance strategies—and overall success managing their condition.

Does the survery represent the general population? Results were collected from a nationally representative survey of the U.S. population that was designed by the Consumer Reports National Research Center in consultation with internal and external medical experts. The sample was drawn from Knowledge Network's nationally representative online panel, which was recruited through a combination of random-digit-dialing and address-based sampling. The survey was fielded between April 6 and April 20, 2009, and asked about experience with allergies in 2008. Sampling error at the 95 percent confidence level was 2.98 percent.

How do the survey results compare with those of clinical trials? In this allergy survey, we ask patients to report and recall the extent of their symptoms at one point in time. Clinical studies, on the other hand, usually include physical exams to assess whether treatment is effective. Clinical studies may also follow people over time and compare the use of a single treatment against a placebo. Findings can help clarify what a medication can do to address specific symptoms and whether some drugs work better than others. We encourage you to make decisions based on clinical evidence.

In the case of allergies, however, clinical studies are a particularly poor match for understanding how allergy treatment works in the daily lives of millions of Americans. Most people are using multiple treatments. While we know from our survey and clinical trials that something works better than nothing (the placebo analogy), only a population-based survey like this one can show that when it comes to treating allergies as a condition, complete success is elusive for most allergy sufferers.

   

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