House Calls / Dr. Michael Schwartz

Spring is a beautiful season. Unfortunately, with the warmer weather and flowers blooming come seasonal allergies. Approximately 36 million Americans suffer from this condition. The most common trigger of seasonal allergies is pollen. Pollen is a small powder produced by trees and grasses.

Once produced, this substance is carried by the wind and enters the body through the nose and mouth. In some patients, pollen is perceived by the body's immune system as foreign, causing the immune system to react in an inappropriate fashion. The result is allergies.

Symptoms of allergies may be mild and include sneezing, itchy eyes, runny nose or fatigue. However, more serious symptoms can include wheezing, coughing and shortness of breath.

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Frequently, patients' daily lives are significantly impacted by allergy symptoms. Fortunately, there are many ways to identify and treat these annoying symptoms.

Allergy Testing

Skin Testing: There are several ways to determine if you have allergies. The most common type of testing is known as skin testing. An antigen (the allergic substance) is either applied directly to the skin (scratch or patch test) or delivered under the skin (intradermal test). If the patient develops a rash, bumps, inflammation or itching from the test, it suggests an allergy to that substance. This test is usually performed by an allergy specialist.

Blood testing: Testing in this manner is a fairly new way of testing for allergies. Your doctor will merely draw a small vial of blood and can then identify if you are allergic to certain foods, exposures or seasonal pollens. This test can be performed by most doctors including your primary care physician.

Allergy Medication

Antihistamines are the mainstay of allergy treatments. Many of the most common medications (e.g. Claritin, Allegra, Zyrtec) are now found over the counter. These "non-sedating" antihistamines can often alleviate many of the allergy symptoms.

Nasal sprays usually contain steroids which are directly absorbed into the lining of the nose. These convenient sprays can completely eliminate symptoms by preventing your body from reacting to the pollens. In general, these sprays are extremely safe; however, side effects may include nasal irritation, nasal bleeding and, in rare cases, glaucoma. A prescription is necessary to obtain these products.

Eye drops can be extremely effective in eliminating the tearing and itch of allergies. These medications may include several different components which all act synergistically to alleviate eye symptoms. Side effects of these medications include brief stinging or tearing and an occasional bitter taste in the throat. Several eye drops are now over the counter as well.

Oral Steroids (Prednisone) are only used on a temporary basis to alleviate the most severe symptoms. Short term use is generally safe; however prolonged use carries many potentially serious side effects. These are prescribed by your doctor and should be monitored very closely while being used.

Other medications include certain inhalers (for the treatment of asthma symptoms), Leukotriene inhibitors (e.g. Singular) or decongestants (e.g. Sudafed) to treat several of the symptoms.

Allergy Shots (Immunotherapy)

Immunotherapy is a very efficient way of eradicating allergies. After skin testing, your allergist may begin weekly shots. These painless injections introduce low levels of the substance you are allergic to directly into the body. The goal of allergy shots is to "shut off" the allergy response. Immunotherapy can take several months to complete, but has been shown to be very effective.


Following the daily pollen count and trying to stay indoors when it is reported to be elevated is one way to lessen the symptoms of allergies. Using a HEPA (high-efficiency particulate air) filter can trap indoor allergens and other irritants. An air conditioner can also be helpful.

Given the warm winter in the Northeast, experts are predicting a long and difficult allergy season. Symptoms usually begin in April and may not end until the first frost in October. Identifying if you are allergic is the first step towards successfully treating this affliction. Visit your doctor to discuss testing and treatment options. Once treated, you can enjoy the beauty of the spring once again.

Dr. Michael Schwartz is Board Certified in Internal Medicine with a private practice in Darien. For comments or questions, please visit his website at