Smart guide to seasonal allergies | members only

30. BATHE YOUR PET MORE OFTEN Even if you don’t have a pet dander allergy, your pet can carry pollen from outdoors to indoors and worsen your symptoms. Patel suggests bathing your pet more

frequently during allergy season to prevent worsening symptoms. The Humane Society of the United States recommends talking to your vet or other animal care professional to see what they

recommend for shampoo and soap. Keep Fido off your bed and couch if you’re concerned about pollen (or pet dander) on your furniture. 31. LEVERAGE YOUR WASHER AND DRYER Hariri suggests

washing your clothes and bedding in the hottest water possible to kill dust mites and remove pollen and other allergens. And don’t hang anything out to dry on a clothesline, Berger adds, or

it’ll collect pollen. Dryer sheets can be potentially irritating to those with allergies, asthma or skin issues, Rubin notes. Instead, use wool dryer balls or spritz white vinegar on a

washcloth and put it in the dryer. 32. KEEP THE DUST UNDER CONTROL For people allergic to dust mites or concerned about pollen from outside, vacuuming more frequently can help. Fabric

upholstery, rugs and carpet can harbor dust mites, so design and clean your space accordingly. But using a vacuum without a HEPA filter can make allergies worse by kicking up the dust. A

vacuum with a HEPA filter contains the allergens more efficiently. Another spot that collects dust you may not always see — your plant leaves. Clean them periodically to help them continue

to absorb the light they need to grow. And change your home’s air filter regularly, or if your furnace can handle it, use an allergy furnace filter. 33. DRIVE ALLERGY-SAFE In your vehicle,

keep windows closed during allergy season. Rubin recommends using your air conditioning on warm days instead, but always choose the setting that circulates cool air rather than bringing it

from outside. Next time you get your vehicle serviced, ask to have your AC system checked for excessive dust or pollen accumulation (and cleaned, if necessary). If you’re in the market for a

new vehicle, leather car seats are better than upholstered ones, which can harbor allergens. 34. DON’T CLEAN WITH A DRY RAG When you’re cleaning a dusty area, avoid using a dry cloth. “A

damp cloth will pick up the allergens, whereas a dry cloth will just move around the allergens,” says Payel Gupta, M.D., clinical instructor at Mount Sinai Hospital and medical director of

allergy, asthma, immunology and ENT at LifeMD. Consider wearing a mask when you dust, too, to prevent allergy symptoms. 35. SWAP YOUR CONTACTS FOR GLASSES If you have the option to wear

glasses instead of contacts, consider doing so when you go outdoors during allergy season. “Glasses act as a barrier to prevent allergens from getting into the eye and settling on the

conjunctiva,” Gupta says. “The longer an allergen sits on the surface, the more inflammation it will cause.” Clean your glasses regularly as directed after you go inside. If you ride a bike,

Gupta suggests wearing goggles, as they can protect your eyes from allergen-filled wind. 36. ZERO IN ON YOUR BEDROOM Altman usually suggests people with dust mite allergies take additional

steps to allergy-proof their bedroom. Change your bedding frequently, and consider investing in dust mite encasements for your pillows and mattress. “These products are tightly woven fabric

that’s too small for dust mites to fit through,” he says. Look for bedding, mattress covers and box springs that are feather-free, down-free and include “dust mite protector” and “allergen

barrier.” And wash all bedding in hot water at least once a week. 37. DESIGN AN ALLERGY-FRIENDLY SPACE Any fabric in your home can collect dust or other allergy-causing debris, which is why

Berger recommends leather furniture over upholstered alternatives and tile or wood floors rather than carpet. Try to minimize drapery and rugs to avoid indoor allergens, and declutter your

home, as stacks of books, magazines and knickknacks can collect dust. Berger says you can also purchase inexpensive vent covers that filter dust and other allergens from your home’s air. 38.

MAINTAIN YOUR HVAC Change the filter on your heating and air conditioning system at least twice a year to avoid blowing dust and other allergens into your home, Berger says. If you see dust

blowing from your vents, you can clean them with a wet rag. But if the problem doesn’t resolve, Berger says it may be beneficial to hire a professional air duct cleaning service. “We know

that there can be a lot of dust and mold inside vents, and cockroaches can die inside them, which is a major allergen for people,” he says. 39. CONSIDER MOVING It’s a drastic decision but

one that may bring relief. Moving to a region with different plant species may also change your symptoms. “Everybody’s pollen season is different depending on where you live. So it starts

earlier in the South and starts later as you go further north,” Rubin says. According to Patel, it usually takes two full seasons to develop a new allergy. “Beware of the honeymoon period,

that first two years where you think your allergies are better,” he says. This can also happen on vacation — you might not have any allergy symptoms during a time your allergies are usually

high. But if you visit that location frequently, your body might develop an allergic response. Getty Images TREATMENT OPTIONS 40. TREAT INDIVIDUAL SYMPTOMS AS NEEDED Only have eye or nose

symptoms? Local treatments are your best bet. Moss recommends over-the-counter allergy eye drops for relief of itchy, watery eyes. Corticosteroid nasal sprays, or steroid nasal sprays, such

as Beconase, Flonase and Nasacort, can reduce sneezing, runny nose and congestion by decreasing inflammation in the nasal passages. But these take longer to work. “I recommend starting a

nasal steroid spray about two weeks before allergy season commences, and then starting oral antihistamines and eye drops when people start to notice symptoms,” Moss says. Rubin agrees that

you’ll need to use these regularly to see results: “It’s not something that you can take for a day and expect it to work well, because steroid medications take a while to work, because

they’re actually trying to change how the cells operate. That takes time. So usually, you’re not going to see an effect for anywhere between three to up to seven days or so.” Always consult

with your physician and mention these types of medications when you talk to your doctor. 41. FIND THE RIGHT ANTIHISTAMINE FOR YOU Antihistamines, available over the counter, work by blocking

histamine, a chemical that triggers allergic inflammation. Moss suggests taking one as soon as you notice allergy symptoms; you may feel better within an hour or two. “You may need to take

[them] for a few days to notice the full effect, but that depends on how severe your allergies are to begin with,” Shum says. Either way, she says antihistamines are safe to take for the

entire allergy season, as long as you’re aware of side effects. Diphenhydramine (Benadryl) was once the gold standard antihistamine, but Moss says doctors don’t recommend it as much now

because it’s sedating and can cause unwanted psychiatric effects, especially in higher doses, and it may increase the risk for dementia and Alzheimer’s disease if taken long term. Now, the

most commonly recommended antihistamines are cetirizine (Zyrtec), loratadine (Claritin) and fexofenadine (Allegra). Shum generally recommends Allegra for older adult patients, because it’s

the least sedating (followed by Claritin and then Zyrtec). If your antihistamine makes you sleepy, she recommends taking it at night. Xyzal, another over-the-counter antihistamine, is

related to cetirizine and is associated with equal effectiveness and less drowsiness. 42. USE NASAL SPRAYS THE RIGHT WAY Nasal sprays, whether antihistamine- or steroid-based, can help

reduce eye and nasal symptoms. But make sure you’re using your spray correctly. Hariri suggests blowing your nose first and, if needed, irrigating your sinuses, which can ensure the

medication absorbs. Angle the spray bottle away from your septum, or the middle of the nose, when you spray. Spraying in the middle of your nose can increase the risk of nosebleeds or even

damage to your septum, Berger says. And you don’t need to snort or tilt your head back, which will only cause the medication to drain down your throat. Berger recommends tilting your head

down toward the floor when you spray and gently sniffing in each nostril: “I like to tell patients ‘nose to toes’ when they administer their nasal spray.” 43. HAVE SOMEONE HELP YOU WITH EYE

DROPS If itchy eyes are your primary symptom, antihistamine eye drops can help. If you struggle getting eye drops in, have someone help you administer them. Rubin suggests lying down with

your eyes closed and having someone place the drop in the inner corner of your eye. When you open your eye, the drop will distribute throughout your eye. To make your artificial tears eye

drops more effective, try keeping them in the refrigerator. The colder temp, Rubin says, can make the drops more soothing while also helping relieve inflammation in the eyes. 44. WHEN TO USE

DECONGESTANTS Decongestants — available as tablets or nasal spray — can help relieve nasal congestion due to allergies, but they don’t treat the core problem of inflammation. So while Moss

says you can try a decongestant, you’ll likely need other treatments. Decongestants can also cause significant side effects, like heightened blood pressure, rapid heart rate, feeling jittery

and problems sleeping, according to Moss. David Corry, M.D., a professor of medicine-immunology, allergy and rheumatology at Baylor College of Medicine in Houston, warns: “Oral

decongestants should not be used by anyone, hypertensive or otherwise, after about the age of 50 due to numerous potentially serious side effects.” 45. TAKE TIME OFF IF YOU USE NASAL

DECONGESTANTS Decongestant nasal sprays (oxymetazoline or xylometazoline) are known to cause dependence and worse congestion when you stop using them — that’s why Altman suggests using nasal

sprays for no longer than three days. “Basically, you sensitize the cells responsible for congestion,” he says. “If you overuse them, the cells can become inert to it, and you need more and

more.” If you’re having a hard time stopping your nasal decongestant spray, talk to your health care provider about how to do so safely. “Excessive use of nasal decongestant sprays causes

rebound vasodilation that worsens the congestion that was the initial problem, producing the condition formally known as rhinitis medicamentosa,” Corry says.  46. IF YOU USE MONTELUKAST,

KNOW THE RISKS Another oral allergy medication is montelukast (sold under the brand name Singulair and in generic form). Like antihistamines, this drug works by blocking inflammatory

chemicals called leukotrienes. Moss commonly recommends montelukast for people who still have symptoms while taking other medications, but it’s important to know the risks. In 2020, the U.S.

Food and Drug Administration warned consumers and health care providers of psychiatric side effects, including aggression, depression, agitation, sleep disturbances, suicidal thoughts and

suicide. Moss says this effect is serious, but rare, and it should stop when you stop taking the drug. “Overall, montelukast is probably the most worrisome medication for use in allergies,

especially in those over age 50,” Corry says. “If standard medications are not working so that you are thinking of trying montelukast, it is preferred to go to an allergist and try

immunotherapy — allergy shots — before resorting to montelukast.” 47. BE SKEPTICAL OF DIRECT-TO-CONSUMER ALLERGY TABLETS Sublingual allergy tablets, which introduce allergens in oral liquid

or tablet form, have been shown in a few small studies to improve allergy symptoms. But they’re not FDA approved, and according to the American Academy of Allergy, Asthma & Immunology,

there’s not enough consistent evidence about their safety or efficacy. Allergy drops are typically sold from direct-to-consumer companies rather than prescribed by allergists, and the

purchase process may involve customers pricking themselves to test for allergies. But relying on the consumer to take data can result in inaccurate treatment. “That’s really concerning,”

Patel says. “You’re asking a consumer to do something, and their whole treatment is based on that.” 48. TALK TO YOUR EYE DOCTOR ABOUT USING CONTACTS WITH ANTIHISTAMINES Johnson & Johnson

received FDA approval in early 2022 for disposable contact lenses called Acuvue Theravision with Ketotifen, which delivers a well-known antihistamine (ketotifen) to the eyes to fend off

allergy symptoms. The pros are that they are convenient and effective in controlling ocular pruritus (eye itch) due to allergies. But Corry says recent reports of blindness and death

happening to those using eye drops contaminated with pseudomonas (a type of bacterium) is worrisome. “Putting anything in the eyes confers higher risks as compared to the application of

medication to other organs,” he says. “The long-term safety of drug-eluting contact lenses is unknown, and it may be best to wait for postmarketing surveillance reports to begin accumulating

in a few years.” Your eye doctor, Moss adds, is the best resource if you want to talk it over. You can also use allergy drops in your eyes before putting in your normal contacts, and again

after you take them out at night. Wait at least 15 minutes after using allergy drops before putting in your contacts. 49. BE WARY OF ALTERNATIVE MEDICINE Alternative allergy treatments,

including acupuncture and an herbal supplement called butterbur, have been shown in some studies to improve people’s symptoms. But according to Corry, research on alternative remedies is

often not as robust or reliable as for mainstream treatments — plus, the FDA doesn’t regulate supplements for safety and efficacy — so he generally doesn’t recommend them. Instead, focus on

treatments your health care provider recommends. 50. CONSIDER IMMUNOTHERAPY Immunotherapy is a treatment that desensitizes your immune system to allergens that affect you. Subcutaneous

immunotherapy — or SCIT — involves getting injected with small amounts of allergens at an allergist’s office. Studies show it’s highly effective, and that people report decreased symptoms

for years after therapy, but it’s a big time investment: Most people go every week for several months, and then receive monthly maintenance shots for three to five years afterward. “I’ll

usually offer it to people who aren’t getting any benefit from over-the-counter drugs or prescription medications,” Louisias says. Some clinics offer at-home immunotherapy shots, but

Louisias cautions against those. Allergy shots can cause severe allergic reactions, so they’re best done in a doctor’s office. Because immunotherapy involves introducing actual allergens to

your body, it isn’t a safe option for everyone. For example, Corry says allergists usually advise against allergy shots for people with lung or heart disease, and people prone to hives.

People who take beta-blockers for high blood pressure may not qualify for allergy shots, because these drugs may lead to more severe (or even life-threatening) anaphylaxis that is difficult

to treat. 51. TRY SUBLINGUAL IMMUNOTHERAPY (SLIT) IF YOU HAVE JUST ONE ALLERGY If you’d rather not spend years getting shots, sublingual immunotherapy — taking a dissolvable tablet at home —

is an option. According to Patel, doctors may recommend SLIT to people who aren’t eligible for subcutaneous immunotherapy, such as patients on blood thinners who shouldn’t get shots due to

bleeding risk, or people prone to swelling. While subcutaneous immunotherapy can introduce multiple allergens at once, the tablets only include one allergen. “This is a great way to get

desensitized from grass, ragweed and dust mites and is safer and more convenient than SCIT,” Corry says. “Unfortunately, SLIT is only available for a few things and so is less effective for

folks with multiple allergies. It’s also more expensive than SCIT.” 52. IF ALL ELSE FAILS, ASK ABOUT BIOLOGICS Patients who aren’t candidates for traditional immunotherapy aren’t out of

options. Xolair, a biologic drug, can alter people’s immune response to allergens without exposing them to the actual allergen. When you breathe in an allergen, your body releases an

antibody called immunoglobulin E (IgE), which then attaches to the allergen and inflammatory cells. Biologic drugs like Xolair — typically administered as a shot — contain proteins that bind

to the antibodies, so they can’t attach to inflammatory cells. Currently, the FDA has approved Xolair for allergic asthma but not seasonal allergies. Still, Corry says many allergists

prescribe it “off-label” for patients who have severe allergies but can’t undergo immunotherapy.