By Lawrence Larson
Every year, when the buds begin to sprout on the flowering pear tree outside my office, people soon show up inside my office with runny noses and itchy eyes. That’s how I know allergy season has arrived in the South Sound.
With our mild winter this year, the pollen season arrived earlier than usual, which likely means we’ll have a long and difficult allergy season ahead.
The tree pollen counts are going to be high, and they’ve already started. Our area has some of the highest pollen counts in the United States, especially for alder trees and grasses.
In the Pacific Northwest’s temperate climate, tree pollen is most prevalent from February to April, grass pollen from May to July, then weed pollen in August and September.
With pollen allergies, every microclimate can be different, so symptoms can vary depending on where you live in the Pacific Northwest. Within a city, like Tacoma, pollen counts are generally lower because there’s less vegetation. In rural areas of east Pierce County, pollen counts can be as much as 100 times higher than in the cities, due to the increased vegetation.
With allergy season well under way, here are some of the common questions I hear at Mary Bridge Children’s Hospital and Health Center:
Can children outgrow allergies?
We believe that most people don’t grow out of allergies, but rather, they grow into them. Over the past few years, I’ve noticed that allergies tend to be increasing in both children and adults. Children usually start having problems with pollen allergies between ages of 5 to 10, and then their symptoms escalate every year with re-exposure to the pollen until they plateau in their late-teen years or early adulthood.
What can I do to help my child who has seasonal allergies?
Avoiding pollen is the best way to avoid pollen allergies, but staying indoors all the time is not practical as part of a normal childhood. Before your child goes outside, consider these tips to minimize exposure:
• Allergies tend to be worse in theh middle of the day, so play outside during the morning or evening to provide less exposure to pollen.
• Wear glasses and a hat to keep pollen off the face and eyes.
• If a child starts to experience a reaction while playing at a park, find a water fountain and wash their hands and face. It also helps to wash after play time outdoors.
• Don’t dry their sheets outdoors in the pollen season, as they’ll accumulate pollen.
• When they sleep at night, keep their head away from any open windows.
What are some treatments?
Taking a simple antihistamine before outdoor activity can help. Generic, over-the-counter antihistamines are very good and can cost a penny or less per dose. Don’t be afraid to avoid the expensive name brands.
A saltwater nasal wash or a neti pot can be effective at reducing nasal secretions and congestion, and saline doesn’t have any side effects.
Eye symptoms are primarily related to congestion. Any decongestant for the nose can also reduce eye symptoms, without the need for eye drops, which can sting and be hard to put in your child’s eyes.
If those steps don’t work, a whole host of other medications are available by prescription. They include intranasal steroid sprays, antihistamine (as a nasal spray or taken by mouth), eye drops and Cromolyn, which is available by prescription or as over-the-counter nasal spray or drops.
What are allergy shots, and what do they involve?
Subcutaneous immunotherapy, known as allergy shots, is quite useful for children and adults, and has a high incidence of control or cure for allergies. Treatment, however, requires multiple injections over a long period of time, usually five years.
On the horizon is oral allergy immunotherapy, which can be taken by mouth and is widely used in Europe, but not yet approved or available in the United States. This is not to be confused with the currently available sublingual drops, which are unreliable.
How do I know whether I should try simple over-the-counter medication, or do I need allergy shots?
Generally, allergies can be managed with simple medications and avoidance if:
• Symptoms are mild and don’t limit attendance at school or work.
• They don’t interfere with your ability to sleep at night.
• They don’t interfere with your daytime activities.
If your life is impaired by allergies, it may be time to consider allergy immunotherapy. Visit a board-certified allergy/immunology specialist for an evaluation and appropriate treatment.
Dr. Lawrence Larson is a board-certified allergy/immunology specialist at MultiCare Mary Bridge Children’s Hospital and Health Center and Pediatrics Northwest.