Patient education: Environmental allergies in adults (The Basics)

What are environmental allergies? — Environmental allergies are a group of conditions that can cause sneezing, stuffy or runny nose, and itchy eyes. They are caused by allergies to things in our surroundings, such as in the home and outdoors. Normally, people breathe in these substances without a problem. But when a person has an environmental allergy, their immune system acts as if the substance is harmful to the body. This causes symptoms.

Some people have allergy symptoms all year long. Year-round symptoms are usually caused by allergies to:

●Insects, such as dust mites and cockroaches

●Animals, such as cats and dogs

●Mold spores

Other people have symptoms only during certain times of the year, when the thing that they are allergic to is around. These allergies might be called "seasonal allergies." Some people also use the term "hay fever." Seasonal allergy symptoms are caused by:

●Pollens from trees, grasses, or weeds (figure 1)

●Mold spores, which are in the air when the weather is humid, or after rain

Many people first get environmental allergies when they are children or young adults. Environmental allergies are lifelong, but symptoms can get better or worse over time. Environmental allergies sometimes run in families.

What are the symptoms of environmental allergies? — Symptoms of environmental allergies can include:

●Stuffy nose, runny nose, or sneezing a lot

●Itchy or red eyes

●Sore throat, or itching of the throat or ears

●Waking up at night or trouble sleeping, which can lead to feeling tired during the day

Is there a test for environmental allergies? — Yes. Your doctor will ask about your symptoms and do an exam. They might order other tests, such as allergy skin testing, which can help the doctor figure out what you are allergic to. During a skin test, a doctor will put a drop of the substance that you might be allergic to on your skin, and make a tiny prick in the skin. Then, they will watch your skin to see if it turns red and bumpy.

How are environmental allergies treated? — People with environmental allergies might use 1 or more of the following treatments to help reduce their symptoms:

●Nose rinses – Rinsing out the nose with salt water cleans the inside of the nose and gets rid of pollen in the nose. Different devices can be used to rinse the nose.

●Steroid nose sprays – Doctors often recommend these sprays first, because they are the best treatment for stuffy nose. Many of these sprays are available without a prescription. Steroid nose sprays work best if you use them every day, and it can take a few days for them to work fully. Steroid nose sprays are more effective than other allergy medicines for stuffy nose and post-nasal drip. (Post-nasal drip is when mucus runs down the back of your throat.)

●Antihistamines – These medicines help stop itching, sneezing, and runny nose symptoms. They don't treat stuffy nose as well as steroid nose sprays. Some antihistamines can make people feel tired.

●Antihistamine eye drops – These medicines are available without a prescription. They can help with eyes that feel itchy or gritty.

●Decongestants – These medicines can reduce stuffy nose symptoms. People with certain health problems, such as high blood pressure, should not take decongestants. Also, people should not use decongestant nose sprays for more than 3 days in a row. Using decongestant nose sprays for more than 3 days in a row can make symptoms worse.

●Allergy shots – Some people with environmental allergies choose to get allergy shots. Usually, allergy shots are given every week or month by an allergy doctor. They contain tiny amounts of allergens, such as pollen. Many people find that this treatment reduces their symptoms, but it can take months to work.

●Allergy pills (under the tongue) – For some types of pollen allergies, there are pills that work much like allergy shots. These pills need to be prescribed by a doctor. They are made to dissolve under the tongue. They are taken every day for several months of the year.

Talk with your doctor or nurse about the benefits and downsides of the different treatments. The right treatment for you will depend a lot on your symptoms and other health problems. It is also important to talk with your doctor or nurse about when and how to use your medicines.

Can environmental allergy symptoms be prevented? — Yes. If you get symptoms at the same time every year, talk with your doctor or nurse. Some people can prevent symptoms by starting their medicine a week or 2 before that time of the year.

You can also help prevent symptoms by avoiding the things that you are allergic to. For example, if you are allergic to pollen, you can:

●Stay inside during the times of the year when you have symptoms.

●Keep car and house windows closed, and use air conditioning instead.

●Take a shower before bed to rinse pollen off of your hair and skin.

●Wear a dust mask if you need to be outside.

If you are allergic to dust, dust mites, mold, or pets, you can:

●Wash bedding every week in hot water with detergent, or dry it in a dryer on the hot setting. If possible, use a comforter or blanket that can be washed.

●Cover pillows and mattresses with vinyl covers to protect yourself from dust mites.

●Use fewer items that collect dust, especially in the bedroom – These include curtains, bed skirts, carpet or rugs, and stuffed animals.

●Clean air conditioner and furnace filters regularly.

●Vacuum every week using a vacuum with a high-efficiency particulate air ("HEPA") filter.

●Keep pets out of the home, if you can – Keeping pets only out of certain rooms might help a bit, but usually does not remove animal allergens from your home.

●Bathe dogs each week – This might help reduce your symptoms. Bathing cats will probably not reduce your symptoms.

What if I want to get pregnant? — If you want to get pregnant, talk with your doctor about which medicines are safe to take during pregnancy. Environmental allergy symptoms can get worse, get better, or stay the same during pregnancy.

When should I call the doctor? — Call your doctor or nurse for advice if you:

●Have a fever of 100.4°F (38°C) or higher, or chills

●Have green or yellow mucus

These symptoms could mean that you have an infection and not just allergies.

More on this topic

Patient education: Environmental allergies in children (The Basics)
Patient education: Giving your child over-the-counter medicines (The Basics)
Patient education: Allergy skin testing (The Basics)
Patient education: How to rinse out your nose with salt water (The Basics)
Patient education: How to use nasal medicines (The Basics)
Patient education: How to use eye medicines (The Basics)
Patient education: Allergy shots (The Basics)

Patient education: Allergic rhinitis (Beyond the Basics)
Patient education: Trigger avoidance in allergic rhinitis (Beyond the Basics)
Patient education: Allergic conjunctivitis (Beyond the Basics)