April showers bring May flowers — and for many people, congestion, sneezing and itchy, runny eyes. But sometimes those symptoms, even in the spring, don’t stem from plant and tree pollen but from dust mites and pet dander. And at least a third of people who think they have allergies actually have a condition known as nonallergic rhinitis, a reaction that can be triggered by an infection, a sensitivity to chemicals or drugs, or changes in weather patterns. ¶ Effective treatment starts with identifying the cause. But that doesn’t always mean allergy tests, especially the ones now offered by some pharmacies or those you can buy to test yourself. Instead, learn about your symptoms, what brings relief and when to see a doctor.
If you suspect that your symptoms are caused by an allergy, you can often get confirmation — and relief — by taking some simple steps.
But if you’re uncertain or the measures don’t help, talk with a doctor. A physical exam and a few questions about your symptoms, environmental and occupational exposure, hobbies, overall health and other factors should help narrow it down. If necessary, an allergy skin test, which involves pricking the skin with a tiny amount of the suspected allergens, can confirm a diagnosis. A little redness shows that you have an allergy; no reaction suggests nonallergic rhinitis.
Be wary of any allergy test that’s not guided by symptoms, a doctor’s exam and your medical history. The free tests offered in pharmacies or home tests often check for common allergens, including cat dander, cedar, dust mites, egg and grass. But such tests are often misleading and can cause you to make unnecessary lifestyle changes.
If you do have an allergy, the following recommendations often help.
●Avoid allergens. For outdoor allergies, check pollen and mold spore levels with the National Allergy Bureau at www.aaaai.org. When counts are high, stay indoors with the windows shut and air conditioner on. For indoor allergies, use an air conditioner or dehumidifier, remove carpeting from bedrooms, wash rugs, curtains and bedding often, and vacuum regularly. To control dust mites, encase your mattress, box spring and pillows in allergen-proof covers. Keep pets out of your bedroom. Fix leaks and ventilate rooms, and clean up mold promptly.
●Use the right drug. The best first choice is often a generic version of the over-the-counter antihistamines cetirizine, fexofenadine or loratadine. All cost less then their brand-name counterparts (Zyrtec, Allegra and Claritin, respectively). Prescription steroid nasal sprays such as fluticasone (Flonase and generic) are effective. Stop using them if they cause irritation or nosebleeds.
Nonallergenic rhinitis typically does not include the itchy eyes or sore throat caused by allergies. Its triggers include respiratory infections, changes in weather and temperature, cold or dry air, certain food (especially spicy items), alcohol, strong odors or fumes, cigarette smoke, perfume, air pollution and certain medications.
To get relief, start by trying to avoid known triggers. If a drug is the culprit, ask your doctor about trying an alternative. If you can’t avoid the trigger, consider using prescription steroid nasal sprays for treating serious allergies beforehand, or with the prescription nasal antihistamine azelastine (Astelin, Astepro and generic). Steroid sprays also work well for persistent symptoms.