Stuffy nose, itchy and or watery eyes, runny nose, all this sounds like a winter cold but there is a chance that it is actually allergies. All too often people only associate allergies with summer because of the obvious flowers and trees blooming and the constant media coverage of pollen in the air. As winter falls upon us we are faced with a different set of irritants…
With the cold, people tend to spend more time inside and with the furnace on. As that furnace fires up it can blanket your home in dust, mold spores and parts of any little bugs that may have been trapped in there (think crickets, cockroach, ants and flying bugs, etc ). As you spend more time inside you are also exposed to more of your environmental factors as well such as dust mites, animals and possibly mold. If you have perennial (year round) allergies these symptoms may worsen in the winter with more time spent indoors.
Allergies may present themselves as recurrent ear infections in adults, coughing, recurrent sore throats, runny nose, sneezing, watery and or itchy eyes. All symptoms that are common to a cold or flu.
So how do you determine if your symptoms are from allergies? Well the most common way people determine if they have allergies is by the time of year they develop symptoms. Typically people will note their allergy symptoms in the Spring or Fall. In Southern Arizona we typically experience more allergies from weeds in the Fall and grasses and trees during the Spring. However this is not written in stone as the temperatures are conducive to longer pollination times in this part of the country. (This is a good website to look at pollen counts across the country). Other ways to tell if you have allergies is a positive response to medical therapies (which are described below) or by blood or skin testing.
Controlling your environment often is very beneficial. Remove carpeting in the bedroom, dusting often, wash sheets in hot water weekly, frequently grooming pets or removing pets in the setting of significant allergies.
This brings us to treatment of allergies. Besides environmental modifications, the most commonly used medications are over the counter antihistamines (Zyrtec (cetirizine), Claritin (loratadine) and Allegra (Fexofenadine)). These are all second generation antihistamines and have fewer side effects (ie drowsiness) than first generation antihistamines (ie Benadryl). But one of the most effective medications for nasal symptoms is a topical nasal steroid (ie Flonase or Fluticasone). Other simple, but yet effective, treatment options are nasal irrigations. These can be found over the counter and use a bottle with saline packets to make a large volume of salt water to rinses your nose with. This removes allergens and particulate matter from the inside of your nose and thins the mucous/secretions. Simple saline sprays are not very helpful with the exception of moisturizing a dry nose. There are prescription medications called leukotriene blockers ( ie Montelukast) and topical antihistamines (ie Azelastine) which are available from your physician and have some benefit as well.
“But doctor, I have tried all the above and my nose still runs”. There is another potential diagnosis and that is non-allergic rhinitis such as vasomotor rhinitis. Using a topical medication on as needed basis (by prescription only) may help. Some patients also find systemic decongestants (pseudoephedrine) beneficial. Another popular medication that is over the counter but has potential problems is a topical decongestant like Afrin and Neosynephrine. Chronically using these medications can result in “rebound” congestion and worsening of symptoms.
If you have the above symptoms and have not had relief using the common methods described, an evaluation by your physician may be called for. Your physician can evaluate other potential causes like chronic sinus disease, nasal polyps, turbinate hypertrophy, or deviated septum.