Question:

My allergies are bothering me. Can I get relief from an over-the-counter medication? What type of product should I try?

Answer:

Fall allergy season has arrived, affecting more than 36 million Americans with bothersome symptoms, which can include itchy, watery eyes, sneezing, congestion, a runny nose, coughing, drowsiness, and headache.

Allergic rhinitis, also called hay fever, is usually triggered by outdoor allergens ─ ordinary substances such as weeds and pollen. In the fall, ragweed is the number one allergy trigger. Ragweed grows wild in many parts of United States, and its pollen can drift up to 400 miles, so you may be affected even if the plant isn’t prevalent in your area. Ragweed season ends with the first frost. Other causes of fall hay fever are indoor allergens such as mold and dust mites, which can accumulate in heating systems. Turning on your furnace for the first time can stir up mites and mold and cause allergic symptoms in allergy sufferers.

Minimizing exposure to allergens is one way to help control symptoms. The American Academy of Allergy, Asthma, and Immunology’s (AAAAI) National Allergy Bureau compiles ragweed pollen and mold counts from certified stations across the nation and reports concentrations as low, moderate, or high. Click here to check counts in your area. AAAAI also offers these tips for minimizing allergen exposure:

Ø Do a thorough cleaning that includes curtains, rugs, windows, book shelves, and heating vents ─ this helps remove accumulated dust and mold.

Ø Keep home and car windows closed. Cooler weather makes it tempting to open windows, but people with allergies need to prevent outdoor allergens from drifting inside.

Ø Remove piles of leaves, clippings, and compost from around your house; this will reduce your exposure to mold, as will cutting back trees and brush around your home.

Ø Take a shower and wash your clothes in hot water after working in your yard or other outdoor activities to remove outdoor allergens.

Ø Try wearing a filter mask when raking leaves or mowing the yard to stave off pollen and mold stirred up by these activities.

Ø Avoid outdoor activities between 5 AM and 10 AM – this is the prime time for pollen emission.

If cutting back on allergen exposure doesn’t provide sufficient relief, over-the-counter (OTC) and prescription medications can help. OTC medications for allergies fall into two categories. Antihistamines, formulated as tablets, capsules, or liquids, ease mild-to-moderate symptoms, such as sneezing, a runny nose, itchy, watery eyes, and a itchy nose and throat. Older, or first-generation, formulations of OTC antihistamines, such as Actifed and Benadryl, may make you drowsy. Second-generation antihistamines, including Claritin and Alavert, are designed to provide 24-hour relief without drowsiness.

Decongestants can help clear a stuffy nose and sinus, which can cause pressure and headache. Decongestants act by reducing blood flow to the affected area, which helps shrink congested tissue. Decongestants, which are produced as eye and nose drops, sprays, tablets, and liquid, come with some caveats. OTC nasal decongestant sprays and drops can provide temporary relief, but using them longer than 3 days can cause your nose to swell, which increases rather than relieves congestion. Some medical conditions and prescription drugs don’t mix well with decongestants. If you have another health problem or are taking prescription medications, talk to your doctor to make sure OTC decongestants are safe for you to use.

A new federal law also may impact OTC decongestant use. On September 30, 2006, new government restrictions require that all products containing pseudoephedrine ─ the active ingredient in many OTC decongestants ─ be kept behind your pharmacist’s counter or in a locked case. Customers in all states are now required to show ID when buying these products; purchases are recorded and consumers can only buy a limited amount of product each month. This regulation is an attempt to curb illegal production of methamphetamine (crystal meth), which can be made with pseudoephedrine.

To help consumers avoid the hassle of going through the new process (and protect sales of their popular products), some drug companies are replacing pseudoephedrine with another ingredient, phenylephrine. Phenylephrine is an older drug, and some recent research suggests that the 10 mg-dose found in OTC products doesn’t work as well as pseudoephedrine. The makers of Sudafed have introduced Sudafed PE (PE indicates the active ingredient is phenylephrine). Vick’s DayQuil also has been reformulated with phenylephrine. If you have used one of these products with good results in the past, be aware that the reformulated version might not produce the same effects.

If OTC products aren’t adequately controlling your symptoms, you may want to consult an allergist or immunologist. These specialists can pinpoint the allergens causing your symptoms and develop a management plan that may include environmental adjustments in your work or living space and prescription medications, which are more effective and better tolerated than OTC remedies.

Prescription drugs for allergies include anti-inflammatory medications, such as steroid nasals sprays (Nasonex and Flonase, for example), which many people find effective for itchy eyes and stuffy noses. Prescription antihistamines are longer acting than OTC drugs and cause less drowsiness.

Allergy shots also are an option for people with severe allergies that don’t respond to OTC products or prescription drugs. Called immunotherapy, a series of shots deliver increasing doses of the allergens your physician has determined affect you. Over time, the shots desensitize you to these triggers and can provide long-term relief from stubborn allergies.

To find a specialist in your area and learn more about seasonal allergies and treatment options, visit AAAAI’s site.