Nasal Allergies: Treatment

From: http://www.healthscout.com/ency/68/98/main.html

Treatment of Allergies
There are three general approaches to the treatment of allergic diseases such as allergic rhinitis: avoidance of the allergen, medication to relieve symptoms and allergy shots.

Avoidance
Wear a pollen mask when mowing the grass or housecleaning.
Stay indoors in the morning (when the pollen count is at its highest) and on windy days.
Read and understand food labels (for people with food allergies).
Keep windows and doors closed during heavy pollination seasons.
Use the air conditioner in the house and car.
Rid the home of indoor plants and other sources of mildew.
Don't allow dander-producing animals in the house.
Change feather pillows, woolen blankets and clothing to cotton or synthetic materials.
Enclose mattress, box springs and pillows in plastic barrier cloth.
Wash sheets, mattress pad and blankets weekly in hot water (at least 130F).
Remove carpets and upholstered furniture (drastic measure).
Use acaricide (a chemical that kills house-dust mites) or a tannic acid solution (solution that neutralizes the allergen in mite droppings).

Use air filters.
Use a dehumidifier.

Medication
When avoidance or control of an allergen isn't possible, medications may be necessary. Common allergy medications are:
Decongestants: administered via spray or orally to unclog nasal passages. Examples of spray decongestants are oxymetazoline (Afrin) and phenylephrine (Vicks Sinex). Other medications or brands may be recommended by your doctor or pharmacist.

Oral decongestants include pseudoephedrine (Sudafed) and combinations of decongestants and analgesics.


Steroid nasal sprays: administered via spray to mute the inflammatory response. Medications include fluticonase (Flonase), mometasone (Nasonex), triamcinolone (Nasocort), and beclomethasone (Beconase, Vancenase).

Antihistamines: drugs that block the action of histamine, which is responsible for allergic symptoms. Short-acting antihistamines, which are generally over-the-counter (non-prescription), often relieve mild to moderate symptoms, but can cause drowsiness. A pediatrician should be consulted before using these medicines in children, as they may affect learning. One formerly prescription medication, loratadine (Claritin), is now available over the counter. It does NOT tend to cause drowsiness or affect learning in children. Longer-acting antihistamines cause less drowsiness, can be equally effective, and usually do not interfere with learning. These medications, which require a prescription, include fexofenadine (Allegra), and cetirizine (Zyrtec). Other nonprescription antihistamines include diphenhydramine (Benadryl), chlorpheniramine maleate (Chlor-Trimeton, Coricidin) and clemastine (Tavist).

New to the market, and available by prescription only, is an antihistamine nasal spray called azelastine (Astelin).

Cromoglycate (Nalcrom)or related agents: administered mostly as eyedrops or nasal sprays to help prevent attacks.

Immunotherapy
When avoidance, environmental control measures and medications fail to control allergy symptoms, the doctor may suggest allergy immunotherapy ("allergy shots"). Immunotherapy involves the injections of allergen extracts to "desensitize" the person.


Typically, the treatment begins with injections of a weal solution of allergen given one to five times a week, with the strength gradually increasing. When the maximum dose is reached, maintenance injections are given at increasing intervals until the patient receives injections only once a month.


It may take up to six months or so to show results. It usually takes about three to four years for the patient to be free of symptoms.