Seasonal Allergy

Article written by Dr. Francisco Recio (Pediatric Pneumologist)

With the arrival of spring and good weather comes one of the most feared enemies for allergic patients: pollen. Although there is pollination in almost every season of the year, the two pollens that cause the greatest number of cases of severe allergic rhinoconjunctivitis are grass and olive tree pollens. Their concentration levels in the air are not usually excessively high compared to other pollens, but the irritation of mucous membranes and the severity of their symptoms make them an allergen that generates a considerable worsening in the quality of life of many people in Madrid during the pollination season.
We should know that allergic rhinitis is the most frequent chronic allergic disease in older children and adolescents. Environmental allergy is due to a hypersensitivity reaction to an allergen mediated by an immunoglobulin type E mechanism. It is necessary to have had at least one year of exposure to an environmental pollen in order to present symptoms of pollen allergy in successive years. For this reason, allergy in children under 2 years of age is very rare.

The children most predisposed to suffer from pollen allergy are those with a personal history of atopic dermatitis and/or food allergies, a sequence of diseases known as “the atopic march”. In turn, if any of the parents has suffered from any allergy, the risk of suffering from any type of environmental allergy is also increased.

An interesting issue that should not be forgotten is the poor quality of life that can be generated by suffering from allergic rhinitis to pollens. Those who have suffered from it know that the symptoms are very annoying and that they alter both daytime life and nighttime rest. This can worsen not only the quality of life of the children but also produce a worsening of their academic performance, difficulties to concentrate in class and decrease their sports performance or their desire to play. If they are also asthmatic children, the risk of suffering a bronchospasm crisis doubles, so they should limit their exposure to outdoor environments in order not to present respiratory distress that will not always respond well to inhalers.

In Madrid there are four main pollens that cause allergy in the majority of the population: cupressaceae (arbaceae), shade banana, grasses and olive trees. The pollination season follows this order: in winter the arizonias start, followed at the end of March by the banana tree and finally from mid-April to June (and sometimes July) the “dreaded” grasses and the olive tree pollinate. Knowing the time of pollination of a plant to which we are allergic is essential to know if we have to protect ourselves more outdoors or if we cannot forget the antihistamine drugs at home.

To diagnose a pollen allergy there are multiple laboratory tests but it is essential to emphasize the importance of a good medical history taken by a specialized medical professional. This is the only way that subsequent skin or blood tests will have an adequate clinical translation and will not overdiagnose allergies that are not allergies. As an interesting fact that should be of general knowledge, positive results of a skin test or molecular allergens in blood only indicate hypersensitivity to an allergen, they do not indicate allergy. It is therefore a proper correlation of compatible clinical findings with positive complementary tests that truly diagnoses an allergy.

The medical evaluation also takes into account that, although we are in the middle of spring allergy season, not all sneezing, itchy eyes or runny eyes are allergies. Sometimes other common conditions such as viral colds simulate symptoms similar to allergic conditions or may even coexist with them, so it is important to make a proper diagnosis in order to prescribe the necessary treatments.

The main treatment is pollen avoidance. Yes, it sounds strange to say that the main measure for the treatment of an environmental allergy is avoidance, but after reading these words I think it makes some sense. No food allergic patient would expose himself to the risk of ingesting the allergenic food and thus suffering an allergic reaction. The same applies to children allergic to pollen: extreme precautions should be taken when they are exposed to environments with pollens. It is not a question of keeping them completely isolated at home, but they should minimize avoidable trips outdoors and walks or play in areas and at times with high pollen levels. In addition, wearing a face mask and/or goggles will prevent pollen from entering the mucous membranes, which is the site where the allergy is clinically expressed.

Once the primary prevention of pollen has been explained, when the symptoms of nasal discomfort with sneezing and itchy eyes are already present, drugs such as antihistamines (oral, ocular) and corticoids (nasal) should be used to relieve the symptoms and reduce the inflammation of the airways, which is responsible for the fact that many rhinoconjunctivitis do not improve if they are treated with insufficient or incorrect medication.

In short, pollens are here to stay for a season. It is important to recognize the symptoms of allergy, know the pollination season to suspect which pollen is causing the symptoms, avoid harmful exposures and treat with appropriate drugs to keep symptoms under control.

Do not hesitate in writing us if you have any doubts.