Maeve O’Connor, MD
It seems hard to believe that the schools were recently closed due to a snow storm and that tree pollen was already flying around in the air!! Charlotte is ranked 3rd worst U.S. city for allergies this year, so I guess we should expect the trees to be ready to pollinate early!!! Last year was one of the worst Spring allergy seasons for the East with the amount of pollen in the air four times higher than what allergists typically consider to be high. It makes me wonder what we are going to experience this year! Yes, Spring has sprung in Charlotte, North Carolina. Spring is one of the most beautiful times to live here, but with Spring comes tree pollen which causes many Charlotteans to suffer terribly with allergy symptoms.
What is pollen?? Pollen is the male fertilizing agent of flowering trees, grasses, weeds, and other plants and is composed of powdery granules. Pines and oaks produce the large pollen molecules that you can actually see. As for tiny pollen, its small size and light weight allow it to be carried by the wind. Though high pollen counts affects numerous types of allergies, from eye and skin reactions, the most common spring allergy is allergic rhinitis. This is the term for allergies in the nose- itching, sneezing, runny nose and congestion. Allergy symptoms are annoying, and for many people they interfere with the ability to work, perform at school, or even sleep.
Seasonal allergic rhinitis is often called “hay fever” and affects 35 million people in the United States. It is triggered by "allergens," substances that initiate an allergic response, such as pollen. When people who have allergies inhale these allergens, they combine with an allergic antibody called immunolglobulin E (IgE). Normally present at very low levels in the body, IgE is found in larger quantities in people who have allergies. When the allergen and the IgE combine in the lining of the nose or eyes, the result is the release of chemicals, including histamine. These chemicals cause the allergic symptoms of sneezing, itching, watery eyes, nasal congestion or headaches as the body tries to fight off the foreign allergen. Seasonal allergies have a large impact on quality of life, but fortunately, medical treatment is usually very effective.
Spring allergies can manifest in many different forms other than allergies in the nose, including:
Allergic Rhinitis
This is irritation of the nose where the inside of the nose becomes inflamed after being exposed to an allergic trigger. It often is associated with asthma and sinusitis.
Common symptoms include:
- Watery eyes
- Sneezing
- A runny nose
- Itchy eyes and nose
- Children who have allergic rhinitis may have dark circles under their eyes
- Children may use the palm of their hand to push the nose up in an attempt to relieve itching (which is known as the "allergic salute.")
Asthma
Asthma is an ongoing disease that inflames the airways, making it difficult to breathe. It can be tricky to diagnose because it often is mistaken for other respiratory disorders, such as bronchitis or pneumonia.
Up to 80% of children with asthma develop symptoms before the age of five. A child's physician must rely heavily on the parents' observations to determine the signs of asthma and make a proper diagnosis.
Key symptoms of asthma are:
- Coughing
- Shortness of breath
- Wheezing
- Chest tightness
- Young children may complain that their chests "hurt" or "feel funny," or they may slow down when playing and become easily irritated.
Asthma also may be triggered by a family history of allergy.
Atopic Dermatitis (Eczema)
Many parents do not realize that atopic dermatitis is part of the allergic profile. In fact, it is often one of the very first signs of allergic diseases in infants and young children. Sometimes called the "itch that rashes," atopic dermatitis is a red, inflamed rash most often seen on the arms, legs, ankles or necks of children.
Atopic dermatitis often will start in the first year of life. It affects 9 to 12% of the population, most of whom are children. Between 80 and 90% of children who have atopic dermatitis show signs before the age of seven.
Scratching that gets worse in the early evening and at night, sometimes to the point of interrupting normal sleep patterns, is a symptom of allergic dermatitis.
The good news is that the rash will often improve with age; unfortunately the symptoms of allergic rhinitis or asthma may start appearing.
Conjunctivitis (Inflammation of the eyes)
An inflammation of the whites of the eyes is the main sign of allergic conjunctivitis. It also is indicated by redness, tearing, stinging, or pus discharging from the eyes.
Many children with allergic rhinitis develop the symptoms of allergic conjunctivitis and are sent home from school, even though allergic conjunctivitis is not contagious. Bacterial and viral forms of conjunctivitis are contagious, and often are preceded by an upper respiratory infection.
Itchy eyes are the key distinguishing feature of allergic conjunctivitis. Symptoms that indicate non-allergic conjunctivitis are burning and scratchy eyes.
Otitis media (Ear infection)
Earaches are common among children, however sometimes they can be a symptom of something much more serious like otitis media. Otitis media is an ear infection that occurs when viruses and/or bacteria get inside the ear.
When the ears are infected, the inner ears become inflamed and swollen. If fluids plug the openings of the ears, air and fluid get trapped inside the ear. These ear tubes are smaller and straighter in children than they are in adults. This makes it harder for fluid to drain out of the ear.
The earliest signs of otitis media are usually ear pain and discomfort. The earliest sign can be irritability and pulling on the infected ear and diarrhea.
Sinusitis
Pain in the forehead, teeth or face, coughing and dark yellow or green nasal discharge are the main symptoms of sinusitis. With allergic sinusitis, itchy eyes and sneezing may also occur. Sinusitis usually happens with rhinitis, and more than 50% of moderate to severe asthmatics have chronic sinusitis.
Tips to help with your Allergies:
- Stay inside during peak pollen times, usually between 10 a.m. and 4 p.m.
- Keep your car windows closed when traveling.
- Stay indoors when humidity is high and on days with high wind, when dust and pollen are more likely to be in the air.
- Wear a mask when outside to limit inhaling pollen granules.
- Shower after spending time outside to wash away pollen that collects on the skin and in the hair.
If you or someone you love suffers from allergy symptoms as described above, consult an allergist board certified by the American Board of Allergy and Immunology (www.abai.org). An allergist can get you diagnosed and feeling better!!
