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Pollen Allergies: Diagnosis, Treatment & Prevention

Pollen is one of the most common triggers of seasonal allergies. Many people know pollen allergy as “hay fever.”

Experts usually refer to pollen allergy as “seasonal allergic rhinitis.”

Each spring, summer and fall, plants release tiny pollen grains to fertilize other plants of the same species. Most of the pollen that causes allergic reactions come from trees, weeds and grasses. These plants make small, light and dry pollen grains that travel by the wind.

Grasses are the most common cause of allergies. Ragweed is a main cause of weed allergies.

Other common sources of weed pollen include sagebrush, pigweed, lamb’s quarters and tumbleweed. Certain species of trees, including birch, cedar and oak, also produce highly allergenic pollen.

Plants fertilized by insects, like roses and some flowering trees, like cherry and pear trees usually do not cause allergic rhinitis.

Symptoms of Pollen Allergies

People with pollen allergies only have symptoms when the pollens they are allergic to are in the air. Symptoms include:

  • Runny nose and mucus production
  • Sneezing
  • Itchy nose, eyes, ears and mouth
  • Stuffy nose (nasal congestion)
  • Red and watery eyes
  • Swelling around the eyes


How Do Doctors Diagnose Pollen Allergy?

Doctors use two tests to diagnose a pollen allergy.

Skin Prick Test (SPT)

In prick/scratch testing, a nurse or doctor places a small drop of the possible allergen on your skin. Then the nurse will lightly prick or scratch the spot with a needle through the drop. If you are allergic to the substance, you will develop redness, swelling and itching at the test site within 20 minutes. You may also see a wheal. A wheal is a raised, round area that looks like a hive. Usually, the larger the wheal, the more likely you are to be allergic to the allergen.

A positive SPT to a particular pollen allergen does not necessarily mean that a person has an allergy. Health care providers must compare the skin test results with the time and place of a person’s symptoms to see if they match.

Specific IgE Blood Test

Blood tests are helpful when people have a skin condition or are taking medicines that interfere with skin testing. They may also be used in children who may not tolerate skin testing. Your doctor will take a blood sample and send it to a laboratory.

The lab adds the allergen to your blood sample. Then they measure the amount of antibodies your blood produces to attack the allergens. As with skin testing, a positive blood test to an allergen does not necessarily mean that an allergen caused your symptoms.

How Can I Prevent an Allergic Reaction to Pollen?

There are actions you can take to reduce allergic reactions to pollen:

#1 – Limit your outdoor activities when pollen counts are high.

This will lessen the amount of pollen allergen you inhale and reduce your symptoms.

#2 –  Keep windows closed and use a HEPA filter.

Keep windows closed during pollen season and use central air conditioning with a HEPA filter attachment. This applies to your home and to any vehicle (car, bus, train, etc.).

#3 – Start taking allergy medicine before pollen season begins.

Most allergy medicines work best when taken this way. This allows the medicine to prevent your body from releasing histamine and other chemicals that cause your symptoms.

#4 – Bathe before bed.

Bathe and shampoo your hair daily before going to bed. This will remove pollen.

#5 – Regularly wash your bed linens.

Wash bedding in hot, soapy water once a week.

#6 – Wear sunglasses and a hat.

This will help keep pollen out of your eyes and off your hair.

#7 – Limit time with pets.

Limit close contact with pets that spend a lot of time outdoors.

# 8 – Change and wash clothes worn during outdoor activities.

If you’ve spent time participating in outdoor activities – or even if you’ve spent a prolonged amount of time outside, change your clothes immediately once you get inside.

# 9 – Dry your clothes in a clothes dryer, not on an outdoor line.

It might cost you less to let your clothes air dry outside, but you’ll be paying the price in other ways.


Avoiding Allergens

The best way to prevent symptoms and limit your need for allergy medicine is to avoid your allergens as much as possible.

This includes removing the source of allergens from your home and other places you spend time. You can also reduce your symptoms to airborne allergens by washing out your nose daily. You can do this by using a nasal saline rinse using a squeeze bottle or a Neti pot.

Allergic Emergency

If you think you are having anaphylaxis, use your self-injectable epinephrine and call 911. Do not delay. Do not take antihistamines in place of epinephrine.

Epinephrine is the most effective treatment for anaphylaxis.

Some over-the-counter cold medicines are a blend of different medicines. Many include aspirin or other NSAID.

Aspirin may cause asthma attacks in some people.

If you have asthma, talk to your doctor before taking over-the-counter allergy or cold medicines.

New prescription and over-the-counter medicines are approved from time to time. Be sure to discuss all of your medicines with your doctor.

About Patrick Donahue, MD

Dr. Patrick Donahue is the Medical Director for WakeMed Physician Practices – Urgent Care.