In Conversation

Sniffles and sneezes: A Q&A about allergies with Dr. Ryan Steele

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With allergy season upon us, YaleNews spoke to Dr. Ryan Steele, instructor of clinical medicine at Yale School of Medicine, about the current season, prevention, treatments, and other facts allergy sufferers need to know. When he’s not treating patients at Yale Health or the Yale New Haven Health Interventional Immunology Center, Steele teaches allergy and immunology research and practice to fellows, residents, and medical students. He also recently launched the Contact Dermatitis Clinic, where he and his colleagues evaluate patients with allergic skin conditions and offer a range of diagnostic and therapeutic options. The following conversation has been edited.

What causes allergies during this season?

Seasonal allergies are due to pollen and mold spores in the air. Although we may think of pollen as coming from flowers like roses where insects help in pollination, it’s the pollen spread by wind that gives us most of the typical allergy symptoms like nasal congestion and itchy, watery eyes.

When exactly is the pollen season and what should we look out for?

Plants usually have a period of pollination that remains fairly stable from year to year, but the amount of pollen can be influenced by the weather. Spring is when we see tree pollen, and during the spring to summer transition is when grass pollen often becomes a problem. Late summer to fall is the time when the weeds come out. In warmer climates, we can even see year-round pollination. Other allergens, such as molds, can have some seasonal variations as well, starting to increase in concentration in the warmer weather, and often peaking between July and October, while in warmer parts of the country they can be present year-round.

Is this year going to be bad for allergy sufferers?

When we try to predict what may make a bad allergy season we focus on two factors. The first is a pollen forecast, which uses information about past pollen seasons and weather forecasts to predict what we can expect for the coming season. The second thing we look at is the pollen count, which is a real-time tracker of current regional pollen conditions. This will tell us what we can expect on any given day. Cloudy, rainy, and windless days tend to be better for allergy symptoms than hot, dry, and windy days.

A great tool to keep on your computer desktop or smartphone is a pollen counter, which anyone can download from an app store on a smartphone. Don’t forget, we are still in flu season, and influenza activity is elevated nationally, including in Connecticut. It can sometimes be hard to distinguish between the symptoms of infection and allergy. If you have more than your typical allergy symptoms and think you are sick, consult your doctor so you can take steps to feel better and limit the spread of infection.

Do people with food allergies suffer more? Why?

Certain pollens and some foods, such as raw fruits and vegetables, share common allergens, causing some people with seasonal allergies to experience symptoms when eating these foods. Symptom severity can range from itchy mouth and some lip or tongue swelling to more serious but rare reactions. This is called the Pollen-Food Allergy Syndrome, and characteristically someone can tolerate the cooked but not raw forms of these foods. If a patient has questions about a food allergy, they should see an allergist to help discern the type of reaction that may be occurring.

What can people do at home to try and minimize the symptoms of seasonal allergies?

The first step is to find out what you are allergic to so a treatment plan can be tailored to best fit your needs. This can be done by seeing an allergist who will not only talk to you about your allergic history, but will often evaluate your potential allergens through skin testing or bloodwork.

Treatment can range from some simple changes to your daily routine to medications and sometimes allergy shots. Some non-medication measures you can take include: keeping the windows closed in your home and car; using air conditioning as it cleans and cools the air; avoiding going outside when pollen counts are high; and, when you come in from the outside, taking off any hats, jackets, or shoes — and showering before you go to sleep — to wash off all those outdoor pollens.

In addition to these measures there are numerous, effective over-the-counter and prescription medications. For long-term relief, allergy shots are a kind of vaccine for your allergens that are usually administered at your allergist’s office.

Are there any new treatments for allergies that we should know about?

There is a very effective home therapy that works similarly to allergy shots, but comes in tablet form. Called sublingual immunotherapy, the tablets are designed to be used daily and dissolve under the tongue. This therapy delivers small doses of your allergens in order to make you less allergic over time so your symptoms and need for medications decrease. Currently there are products for grass, ragweed, and dust mite allergies that are FDA-approved and more are likely to become available in the future.

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