Look Out, Allergy Sufferers

Spring is officially here, and with the extra hours of daylight and sunshine many enjoy, others are already in the throes of their seasonal allergies. Even on the prettiest days, they can be miserable with symptoms like a runny nose and sneezing, watery eyes, and a scratchy throat.

Dr. John Kulin, urgent care medicine physician and director of Shore Urgent Care in Northfield, said it is tree pollen that has allergy sufferers sneezing and sniffling this time of year. “Tree pollens can really trigger the body’s allergic response, and this is the time of year when trees are getting ready to bloom. We walk outside in the morning and see that fine coating on top of the car, that is pollen, and some people can have a very strong reaction to it. March to June is peak tree pollen season,” said Dr. Kulin. “In June through early September, grass pollens will cause most of the allergic reactions. Molds and dust mites can be present throughout the year and are worse on hot, damp days.”

What is an allergic reaction?
When the sniffles and the itchy eyes start, we think the allergic reaction is in the nose or eyes, but as Dr. Kulin explains, those are the symptoms of the allergic reaction. The allergic reaction really stems from the immune system going overboard. “Our immune system has a very important job and that is to defend our body against an invader such as bacteria or virus that might harm it. But when a person has an allergic reaction, the immune system releases antibodies, and the cells send out histamines and other chemicals, which causes blood vessels to expand and trigger the allergy symptoms. Allergies occur when the body’s immune system recognizes a harmless substance as a threat, causing the body to produce an over-the-top response to it.”

Antibodies are quite specific, according to Dr. Kulin. Each antibody will target only one type of allergen, which is why a person can have a strong allergic reaction to ragweed but not to tree pollen. He added that people’s individual immune system, stress, and even family history may factor into the body’s allergic response.

Managing allergic reactions
According to Dr. Kulin, when the pollen is heavy in the spring, most of us may have a mild reaction to it. An allergic reaction to pollen would be nasal congestion, often accompanied by a chronic mild cough as well as red, irritated, and watery eyes.

Dr. Kulin said many seasonal allergies can be managed using over-the-counter products. Nasal sprays such as Nasonex or Flonase will help to reduce the swelling in nasal passages. Antihistamines such as Zyrtec are helpful for allergy sufferers. Zyrtec and Claritin block the histamine that causes the itchy eyes, runny nose, and hives the body makes during an allergic reaction.

Dr. Kulin did not recommend the common antihistamine Benadryl to relieve allergy symptoms. “Although Benadryl is a strong antihistamine, it will likely make the person drowsy, so I do not advise it for relieving milder allergy symptoms. Both Zyrtec and Claritin are better for managing mild to moderate allergy symptoms,” said Dr. Kulin.

Patients who use over-the-counter medications like Zyrtec and Claritin should use them daily and not rely on them on an ‘as-needed basis.’ “These medications are much more effective when taken daily for allergy symptoms,” said Dr. Kulin.

Seeking help for allergies
“If any pain or pressure in the cheeks or the head accompanies nasal congestion, or if they develop a fever, they may be at risk of developing a sinus infection. If so, it is time to seek medical attention,” said Dr. Kulin. “They can go to their primary care provider, or if they cannot get into their primary care quickly, they can easily go to their local urgent care center.”

Dr. Kulin suggests they meet with an allergist for bad allergies or those not well controlled by over-the-counter medications. They will be able to do testing to see specifically what the patient has the strongest reaction to and may be able to desensitize the person over time.

Patients who have the potential for a severe reaction may need to carry an epi-pen with them at all times. “Food and nut allergies can be severe. They can have swelling of the lips and tongue. They might start wheezing and need an Epi-pen to shut down the symptoms quickly. But people need to understand that the Epi-pen is merely a bridge until the person gets emergency help. If they need to use the Epi-pen, they need to also seek immediate medical help,” Dr. Kulin said emphatically.

He went on to explain, “People’s reactions can escalate. A food allergy or a bee sting may have caused a mild reaction the first time they were exposed. It can be a month later or years later before that reaction is triggered again, and while the hope is that it is mild, it can be much more severe. For that reason, people who carry an Epi-pen need to make sure it is not expired. They last about a year before they need to be replaced,” said Dr. Kulin.

Poison Ivy and other outdoor allergens
When we are outside, there are a number of plants innocently growing in the yard that can cause strong allergic responses, like poison ivy or poison oak. The oil from these plants is the culprit. Dr. Kulin advised using over-the-counter products like TechNu Skin cleaner to get the plant oil off the skin. “People also need to take off the clothes they have been wearing and wash them in a strong soap. Likewise, they need to wash whatever kind of shop rag they have been using in the garden,” said Dr. Kulin.

Topical products may work for mild reactions. According to Dr. Kulin, more severe poison ivy reactions may require oral steroids to control. He added that you should not use hydrocortisone products on the face as they may cause damage to the skin.

Primary Care or Urgent Care
When patients are having allergic reactions, they need to decide what is best for them. “If they can get in to see their primary care provider quickly, that is a great option. If they choose to visit their urgent care center, they can get the same treatment and have the same medications prescribed to solve their problem. At Shore Urgent Care, we have made it as easy as possible to ‘get in line and save time.’ Patients are seen quickly. They can register from home on our website, know how many people are in front of them and get a call to head in when they are third in line,” said Dr. Kulin. “We know how important our patients’ time is.”

To register online in advance at Shore Urgent Care, located at 2605 Shore Road in Northfield, NJ, visit https://shorephysiciansgroup.com/shore-urgent-care/ or 609-365-5333.