Pollen Counts

Pollen is here and now’s the time to start thinking about allergies. Depending on the winter rain and temperature, trees in Northern California start pollenating in January and February. Grass will follow in March and go through June. Starting now may decrease how bad pollen allergy symptoms get.

Watch for the beginning of allergy season and start medications accordingly. I look for the flowering trees with their beautiful pink and white blossoms. Locally, Scotch broom is an early pollinator, so watch for clumps of yellow on the hillsides. You’ll find another yellow warning dusting the car windshield in the morning: that film you have to wipe away is pollen. Another way to be in the know is by monitoring your local weather report or linking here to the National Oceanic and Atmospheric Administration (NOAA) pollen count.

The first line of defense with pollen allergies is avoidance.

Keep bedroom windows closed during high pollen counts (usually the early morning).

Use nasal saline (make at home or purchase) to flush allergens from nose.

Wash hair to remove pollen at night so your child isn’t sleeping on a pillow full of pollen.

The second line of defense is oral antihistamines. These are available over the counter as cetirizine (Zyrtec) or loratadine (Claritin) taken once a day. Fexofenadine (Allegra) is dosed twice a day, and diphenhydramine (Benedryl) is given every 6 to 8 hours but can cause sedation and sometimes excitability.

When pollen links to the allergy receptors on our mast cells, the cells basically explode releasing histamine. In turn, histamine causes the swelling, itching, and redness. We take antihistamines to counteract the effect of histamine. Think of them as a sponge trying to mop up all that spilled histamine.

The next line of therapy against seasonal allergies is the preventive nasal allergy sprays. Some of these, like cromolyn (NasalCrom), are over the counter. Others like prescription fluticasone (Flonase and Veramyst), mometasone (Nasonex), and budesonide (Rhinocort) are inhaled steroids. These are sprayed into the nose to block the pollen from reaching the receptors. These don’t work immediately, but over days they can reduce swelling, itching, and runny nose and sometimes reduce the need for antihistamines. Think of the preventive nasal sprays as putting a lock on the door to keep someone from getting in and spilling histamine that will need mopping up.

When it comes to stuffy noses, you’ll find no end to the pharmaceutical options. These include azelastine (Astelin), an antihistamine sprayed into the nose and montelukast (Singulair), an oral anti-inflammatory medication taken as a preventive. Decongestants like pseudoephedrine may dry up the nose, but they don’t do anything to counteract histamine.

For itchy, watery eyes from pollen allergies, oral antihistamines can be combined with antihistamine drops for the eye. Look for eye drops that say they work for allergies and don’t just treat redness. Any eye symptoms that don’t promptly improve with home care should be discussed with your doctor.

Keeping an eye on mother nature and starting preventive measures against pollen allergies sooner rather than later can help control symptoms and prevent compilations.

 

About Lisa M. Asta, MD

Lisa M. Asta, M.D. is board-certified by the American Board of Pediatrics and is a Fellow of the American Academy of Pediatrics, for which she is also a Media Representative (she has been interviewed for “Kids Health” on Health Radio, and quoted in Parenting Magazine, USA Today, and the New York Times, among other publications). She is a Clinical Professor of Pediatrics at the University of California at San Francisco and past pediatric chair at John Muir Medical Center in Walnut Creek. She graduated from Temple University School of Medicine and the Johns Hopkins University. Dr. Asta is also a writer whose fiction has appeared in Inkwell, Philadelphia Stories, Schuylkill, and Zeniada. Her essays have appeared in the Journal of the American Medical Association, Hippocrates, the San Jose Mercury News, and The New Physician Magazine. She is an occasional contributor to KQED public radio’s Perspectives series, and has written articles for Bay Area Parent, Valley Parent, Parents’ Press, and Parents Express, as well as online at WebMD.com, Rx.com, and MyLifePath.com. She wrote a chapter in The Field Guide to the Normal Newborn, ed. Gary Emmet, M.D. BabyCenter.com currently has two how-to videos for parents in production which feature Dr. Asta. For more on Dr. Asta’s writing, visit www.LMAsta.com
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