As spring arrives, many trees, weeds and grasses flower and release their pollen to fertilise their species. If you are one of the 20-30% of South Africans estimated by the Allergy Foundation South Africa to have allergic rhinitis (hay fever), this can trigger sneezing, an itchy nose, red, watery and itchy eyes, even an itchy mouth or inner ear.
“Other symptoms include dark circles under the eyes from congested nasal passages, and headaches from the pressure of congested sinuses,” says Cape Town-based allergologist Dr Pieter de Waal.
Take steps to protect yourself and find relief
• Understand how allergy works: It’s the result of an over-active immune system, explains Dr de Waal. While most people are unaffected by pollen and other potential allergens, such as dust mites, moulds and pet dander, when you have an allergy, your immune system identifies normally harmless particles as a threat and releases histamines. These chemical agents cause your nasal membranes to become inflamed, leading to itching and the production of watery nasal secretions to wash away the particles, leaving you sneezing and with a dripping nose.
• Distinguish between an allergy and a cold: While both can cause a runny or stuffy nose and sneezing, if the discharge is thick and discoloured and you have a low-grade fever and fatigue, it indicates a cold, not an allergy. This will usually resolve itself in a week or 10 days , while an allergy can persist for weeks, even months. To avoid allergy misdiagnosis, it’s crucial to consult a qualified healthcare professional for a thorough evaluation, including a detailed history and physical exam. If you are diagnosed with an allergy, ask an allergologist about testing to narrow down pollen culprits and discuss the most appropriate treatment. Accurate diagnosis requires considering factors beyond self-reported symptoms, as other conditions, such as sinusitis, can mimic allergy symptoms.
• Avoid pollen exposure: Follow the pollen counts in your area at www.pollencount.co.za, and schedule outdoor activities around them (walks, sports, gardening, braais). When counts are high, keep the windows of your home and car closed, and stay indoors at peak times: mid-morning and early evening. You can also apply a little petroleum jelly in the entrance of your nostrils to help trap pollen, suggests Dr De Waal. If you must go out, wear a COVID-type mask and wraparound shades, and shower and change your clothes when you get home.
• Relieve symptoms: The go-to treatment for allergic rhinitis is antihistamines. Older generation antihistamines were known to cause drowsiness and poor concentration, says Dr de Waal, but new generation ones are available in non-drowsy formulations, such as loratadine and desloratadine. For severe hay fever, starting regular antihistamine medication up to 4 weeks before the start of pollen season has been shown to improve symptom control, reports Allergy Clinic. Your healthcare provider may prescribe stronger varieties of antihistamines or corticosteroid nasal sprays to be taken regularly and continuously during the pollen season, and nasal douches to flush allergens from your nasal mucosa to allow the spray to work better. Ask before using nasal or oral decongestants, which provide temporary relief of congestion by constricting blood vessels in the nasal passages – some have side effects and can cause ‘rebound congestion’ if used longer than five days, cautions Dr De Waal. A simple saline nasal spray may help flush out the nose and clear it of allergens.
• Explore allergen immunotherapy: If symptoms are not controlled by these measures and persist, ask an allergologist if you qualify for this. It involves introducing a small amount of allergen into your system through an injection or sprays under the tongue. A course is typically undertaken for three years, says Dr De Waal. “It gradually ‘tricks’ the immune system to see the allergen in small quantities as acceptable, and over time teaches the immune system to develop tolerance to allergens.”
Always ask your healthcare provider before trying alternative remedies: Herbal and other complimentary treatments for hay fever are popular, but these are generally not subject to the same testing and manufacturing standards as prescription or traditional over-the-counter medications, and some may not be safe.
For more information, contact the Allergy Foundation South Africa, 081 405 8442, email [email protected] or visit www.allergyfoundation.co.za.
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