Living in Austin and the surrounding Hill Country provides warm sun and natural beauty most of the year. However, Central Texas is also fraught with allergies. This means itchy, watery eyes, frequent sneezing, nasal obstruction, and potentially, sinus infections. For some, this is just a nuisance, but for others, this can lead to decreased quality of life. Here is a basic guide for allergy home remedies, when to obtain allergy testing, and when to seek surgical consultation.

“The Solution to Pollution is Dilution!”

Airborne pollen, like Mountain Cedar, Ragweed, Johnson grass, and Oak as well as mold spores, like Alternaria, are very small particles by design. Pollen allows the parent plant (or mold) to rapidly disperse large volumes of genetic material over a large geographic area.  Nasal hygiene with saline sinus rinses (Tip #1) can help wash these particles from your nasal passages. Several companies offer isotonic saline kits over the counter. I recommend distilled, warmed (microwave), isotonic salt water (not hot!) twice per day. Follow this with topical therapy for maximal benefit.

Topical and Oral Therapies

Topical solutions of antihistamines (for eyes or nose) are currently only available via prescription. However, many oral (tablet) forms are available over-the-counter (OTC) and effective in stopping the histamine release that causes the itching and “leaky faucet” nasal drip. Try 24-hr formulations of cetirizine (Zyrtec) or fexofenadine (Allegra) for once daily dosing.

When taken daily, topical corticosteroids, like fluticasone and budesonide (OTC), provide long term benefit to prevent inflammation of the nasal mucosa. These drugs provide relief from the nasal congestion caused by allergic rhinitis.

I recommend a combination of sinus rinses, oral antihistamine, and topical nasal steroid (Tip #2) daily for at least a month before taking the next step.

Medical Examination and Testing

When the above therapies fail, it is time to consider identifying the cause or causes of your symptoms. Obtaining a nasal exam will identify causes of anatomic obstruction, like a crooked septum, turbinate hypertrophy, or nasal polyps. Allergy testing will help identify the exact pollens, molds, or other particles causing your symptoms. For some patients, environmental irritants, like smoke and weather changes, rather than allergens, are to blame.

Consult a Board Certified Allergist or Ear, Nose, and Throat (ENT) specialist for assistance (Tip #3).

Medical and Surgical Management

If home and topical therapies fail, significant anatomic nasal obstruction is identified on exam, or multiple severe reactions are identified on allergy testing, combination surgical and long term medical therapy is generally recommended. Current immunotherapy options include allergy drops (liquid allergen introduced orally) or allergy shots (allergens placed subcutaneously). Surgical treatments focus on improving nasal airflow, removal of obstructing tissue (turbinate hypertrophy), and improved sinus drainage.

More questions for Dr. Rosenberger? Email: [email protected]