Welcome to Charlotte, where the cost of living is reasonable, the pace of life is a bit less hectic, and the pollen counts are out of control. Believe it or not, the greater Charlotte area is one of the most densely pollinated communities in the US. While spring and fall tend to be the seasons in which most citizens will experience allergy-related symptoms, summer and winter can problematic as well.

Even if a patient has never suffered from allergy-like symptoms while living in other parts of the country, moving to Charlotte can be an eye opening experience. It is very common for us to encounter patients and parents who are caught off guard with regard to the abrupt onset of watery, itchy eyes, sneezing, “runny” nose, and persistent rubbing of the nose (nicknamed the “allergic salute”).

Seasonal allergies (formally labeled allergic rhinitis or AR) can be seen in a broad range of ages, with most clinicians agreeing to entertain this diagnosis in patients as young as six (6) months of age. However, mindful of the fact that infants and toddlers will still get their share of viral illness whose symptoms may mimic AR, an accurate diagnosis can be challenging in these age groups.

So what can we do to prevent or minimize the symptoms of seasonal allergies? One item which can magnify these (or any) symptoms is exposure to tobacco smoke. If this is something that is present in ANY amount in your home, this is a good place to start- STOP SMOKING!

Avoidance of allergens (i.e., those things in the environment which provoke symptoms such as a runny nose, sneezing, etc) is “first line” in terms of dealing with allergies. However, this would essentially entail remaining housebound for most of the year, and even then it would likely not be sufficient. Fear not, as there are several effective strategies which can mitigate the effects of seasonal allergies.

Most homes in our area utilize forced heat/air conditioning systems, and it is imperative that the filters for these be changed at least every three (3) months (these are the variably sized rectangular grates that are positioned in difficult to reach locations around your home). One piece of advice: you get what you pay for, i.e., do not purchase low grade, cheap filters. This is a good example of “you get what you pay for,” so buy higher end filters, which are available at local hardware stores.

Now you are ready to go outside, where all of this pollen resides. Are there other steps you can take to minimize their presence? This is a good time to discuss the use of non-sedating antihistamines with your child’s physician; the most commonly utilize medications in this class are loratidine (claritin), cetirizine (zyrtec), and fexofenadine (allegra). These medications are very safe and effective, with an extremely low incidence of the sedation often seen with medications like diphenhydramine (benadryl), and are given once daily.

Those of us with a long standing history of seasonal allergies will often need to have other medications added to our treatment plans. Quite commonly, an intranasal steroid (INS) such as flonase or nasonex will be utilized in conjunction with antihistamines such as claritin, allegra or zyrtec, and these combinations are often very effective in controlling seasonal allergy symptoms.

For those patients whose symptoms are not adequately controlled with these medications alone or together, we have been very pleased with the use of singulair, a newer medication initially used to treat those patients with asthma. Depending upon the individual person’s specific allergy symptoms, as well as the season in question, singulair may be used alone or another medication (e.g., claritin, nasonex, zyrtec, etc) may need to be added to adequately control allergy symptoms. The possible use of any of these medications is a very good topic of discussion that should be raised at your child’s next doctor’s visit.

Many patients with well established histories of seasonal allergies know which seasons are more problematic and therefore when they begin to use their medications. However, with decreasing rainfall and milder winters, the onset of those periods of time can be challenging to determine. We suggest to our patients that they to start their usual treatment plan several weeks prior to the expected onset of that season’s pollens, molds, etc., so as to minimize their allergy symptoms.

If you believe that your child may presently be experiencing symptoms consistent with AR, or has at other times of the year, please give their physician a call or be sure to bring this up at their next visit to Kids First Pediatrics.

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