Hay Fever

Causes

• Pollen: Released by trees, grasses, and weeds, and is often seasonal.
• Mold spores: Can be found both indoors and outdoors and may be year-round or seasonal.
• Dust mites: Tiny creatures that live in house dust.
• Pet dander: Shed skin and hair from animals like cats and dogs.

Symptoms

• Sneezing
• Runny or stuffy nose
• Itchy nose, throat, mouth, and ears
• Watery, red, or itchy eyes
• Coughing
• Postnasal drip (mucus running down the back of the throat)
• Headache
• Fatigue
• Loss of smell
• Pain around the sides of the head and forehead

Diagnosis

• Physical exam: To check for signs of allergies, such as swollen nasal passages or pale skin under the eyes.
• Skin prick test: A small amount of suspected allergens is pricked onto the skin to see if a reaction occurs.
• Allergen-specific IgE blood test: Measures the level of specific allergy antibodies in the blood.

Treatment

• Avoidance: The best way to manage hay fever is to limit exposure to known allergens. This may involve staying indoors on high pollen days, using air filters, and regularly cleaning to reduce dust mites and pet dander.
• Medications:
  • Antihistamines: Help to relieve itching, sneezing, and runny nose. They are available as pills, nasal sprays, and eye drops.
  • Corticosteroid nasal sprays: Reduce inflammation in the nasal passages and are often the most effective treatment for nasal symptoms.
  • Decongestants: Help to clear a stuffy nose and are available as pills and nasal sprays. Use nasal decongestants sparingly as prolonged use can worsen symptoms.
  • Cromolyn sodium nasal spray: Can help prevent allergy symptoms by blocking the release of histamine. It works best when started before exposure to allergens.
• Nasal irrigation: Rinsing the nasal passages with a saline solution can help to clear mucus and allergens.
• Allergen immunotherapy (allergy shots or sublingual tablets): Involves gradually exposing the body to increasing doses of allergens to build tolerance over time. This treatment is usually reserved for severe cases that don't respond well to other treatments.

Prevention

• Monitor pollen counts and stay indoors when they are high.
• Keep windows and doors closed during pollen season.
• Use air conditioning with allergen filters.
• Shower and change clothes after being outdoors.
• Avoid mowing the lawn or doing other gardening chores that stir up allergens.
• Dry clothes in a clothes dryer rather than hanging them outside.

Living With Hay Fever in Florida

Hay fever is usually described as a seasonal condition, and in most of the country it is. Here it is not. Tree pollen runs from roughly January into May, grasses take over through the summer, and ragweed carries the autumn, with mould and dust mites active all year in our humidity. There is no dormant season to reset, which is why treatment that works elsewhere as a six-week course often needs to run continuously in St. Petersburg.

Treat before the season rather than during it

Antihistamines and especially intranasal corticosteroids work considerably better when started a week or two ahead of an expected rise in pollen. Blocking receptors before mediators are released is more effective than trying to catch up once symptoms are established, and steroid sprays in particular need several days of consistent use before they reach full effect. Patients who use them only on bad days routinely conclude they do not work.

Indoor exposure often matters more than pollen

Most people spend the majority of their time indoors, and in this climate dust mites and indoor mould are a year-round load that no amount of pollen avoidance addresses. Keeping indoor humidity between 30 and 50 percent, changing air-conditioning filters every one to two months rather than every three, and using mattress and pillow covers frequently produce more improvement than anything done outdoors.

When it is not allergy at all

Non-allergic rhinitis produces identical congestion and runny nose but is triggered by humidity, temperature change, and odours rather than allergens, and it does not respond to antihistamines. A complete lack of response to allergy treatment is a reason to revisit the diagnosis rather than to escalate the dose. Our ENT and allergy team can distinguish the two, and the year-round Florida allergies guide covers the local trigger calendar. For background on allergic disease, the NIAID allergy resource and the CDC pollen and allergen overview are both useful starting points.

Rinsing is underrated

Saline nasal irrigation removes pollen and mucus mechanically and improves congestion in a way that costs nothing and interacts with nothing. Used before the medicated spray it also improves how well that spray is delivered. Showering and changing clothes after extended time outdoors during a heavy pollen period keeps the exposure out of the bedroom, which matters because that is where the longest continuous stretch of breathing happens.

If your symptoms are not controlled on daily treatment, or they are affecting sleep and work, schedule a visit — allergen immunotherapy is the only treatment that changes the underlying allergy rather than suppressing symptoms, and it is worth discussing.