Las Vegas Sun

October 21, 2017

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Allergies got you down? Fight back with these tips

Ask allergists in Las Vegas, and they will tell you they see them in their waiting rooms every spring.

A lot of seasonal-allergy sufferers move to the desert with visions of clear, non-itchy eyes and voices that are no longer scratchy or nasal-toned.

But sufferers of allergic rhinitis, or hay fever as it's commonly called, who move to desert environments like Southern Nevada in search of relief from seasonal allergies frequently are sorely disappointed.

Maybe not at first, but eventually.

"Typically there is a honeymoon period," said Sean McKnight, a Las Vegas doctor specializing in allergies, asthma and immunology. "If you have never lived in the desert before and never been exposed to the grasses, weeds and trees here, but have had allergies before, there is usually a honeymoon period of two to five years. Initially you will do very well, and then it will start and gradually get worse."

Turns out the valley is full of native and non-native plants and trees that can inflame allergies with their pollen.

"The mulberry tree pollinates around this time, and the olive tree, which pollinates in about a month, is also a big one," said Joel Katz, a Las Vegas allergy, asthma and immunology doctor. "Ash trees are already pollinating. ... There is the tree and grass pollination from golf courses and weed pollens like ragweed that you'll get in the spring and the fall."

The high-pollen season in Southern Nevada typically runs from March through June. Then, after a brief respite thanks to the triple-digit summer temperatures, there is a second allergy season from September through October, according to McKnight.

McKnight says in the general U.S. population, 40 percent of children and 30 percent of adults suffer from seasonal allergies. And, as allergy-sufferers who have long since passed their "honeymoon" period know, the desert offers no salvation.

"We get people in the office all the time who are surprised to have seasonal allergies," McKnight said. "It's a common myth that the desert is a great place for allergy-sufferers. We actually have a long allergy season because of how warm it is. The season starts so soon partly because we don't have snow on the ground. If you have frost, there is no pollen."

If you are one of those suffering, here are some tips for making life easier when pollen proliferates:

    • Know the symptoms

      Even though allergic rhinitis is known as "hay fever," it is rarely accompanied by a fever, McKnight said.

      "The biggest complaint will be nasal congestion, a runny nose that almost feels like a cold but it doesn't go away. Unlike a typical viral infection that leaves after one to two weeks, allergies keep going. ... Other symptoms are itchy, watery eyes and frequent sneezing."

      Allergies can be especially problematic for asthma-sufferers.

      "Some people will have shortness of breath, wheezing or asthma symptoms when they have allergic reactions with the pollens," Katz said. "People with asthma particularly have trouble. When pollen counts are high, it causes inflammation in the lungs."

      Those with hay fever should also be aware of oral allergy syndrome. In some cases an allergy-sufferer's immune system will respond to some food proteins as it would pollen proteins. Allergic reactions to certain pollens are tied to reactions to particular foods.

      "People who are allergic to ragweed may have oral allergy syndrome when they eat bananas, melons and cucumbers, for example," Katz said. "There is a cross-reactivity between airborne pollens and fruit allergens."

      The chances are that if you suffered from hay fever in some other region of the country, it will eventually hit you in the desert, too.

    • Pay attention to current conditions

      Clark County used to measure airborne pollen levels and release daily reports, but that program ended in 2010 due to economic belt-tightening.

      Katz and McKnight said local allergists are in talks with educational programs in the valley about setting up a new pollen-counting project, but nothing has been finalized.

      For now, most days valley residents can simply look out the window and know if they need to pocket a packet of tissues on the way out the door.

      "On a typical high-pollen day, you'll see pollen on the ground, you'll see it on your car and you'll see it dusting the streets," McKnight said.

      If pollen counts are high, allergy sufferers should limit their time outdoors and be careful with where and when they exercise.

      If you plan to exercise outdoors, early mornings are best; especially windy parts of the day should be avoided, allergists said.

      Days with rain are the best days to be outside and active, according to McKnight.

    • Control your environment

      Before turning to pills, shots and sprays, there are other actions an allergy-sufferer can take to lessen symptoms.

      Air conditioning is your friend. Doctors recommend shutting windows and running the air conditioner in both your home and car. It is important to change the filters in air-conditioning units frequently.

      Pollen can stick to clothing and other fabrics and follow you home. It can stick to your body, too.

      "You should shower and wash your hair every night to remove allergens," Katz said.

      It is also wise to limit dust, mold, pet dander, smoke and other irritants in your home that can make symptoms worse.

    • Consult a doctor

      Many people who experience hay fever turn to a bevy of nondrowsy allergy medications, such as the antihistamines Claritin, Allegra and Zyrtec, now available over the counter.

      If the symptoms persist, consult a doctor. An allergist will perform a skin test that takes about a half hour to determine what, exactly, the patient is allergic to.

      Sometimes an antihistamine and an anti-inflammatory nasal spray in combination may be sufficient treatment.

      "You have to be careful with the over-the-counter nasal spray," McKnight warned. "You shouldn't use it for more than three days, and long-term use can lead to rebound rhinitis, where the symptoms return worse than they were before."

      McKnight also cautioned against steroids used to treat allergies, because they can lead to side effects such as osteoporosis, cataracts and hypertension.

      There is also immunotherapy, where a patient is exposed to small, but increasing doses of the allergen over long periods so the individual's immune system response is eventually diminished.

      The process takes a commitment of years but can free a patient from an annual regimen of pills and sprays. McKnight, who said as a kid he was "allergic to the world — trees, grasses, dust mites, mold, cats, dogs, all of it," is a strong supporter of immunotherapy, which he started when he was 6 years old.

    • Don't make the problem worse

      Some trees, such as the fruitless mulberry and European olive, can no longer be planted in the valley due to a 1991 Clark County ordinance designed to decrease the levels of airborne pollen.

      While keeping your own yard free of offending high pollen-producing plants and trees will not have much impact in the grand scheme of the region's pollen count, there is no need to add to the problem.

      Trees that are legal in the county, but should be avoided, include ash, western oaks such as scrub oak and Arizona oak, elms, cottonwoods and pines. Ragweed, and other weeds and grasses, can also be high pollen producers and should be banished from local landscapes.

      Nonetheless, there is no escaping the pains caused by the blanket of pollen that falls on the region every spring.

      "As the community has grown larger, there are more trees, and every year more pollen is produced," Katz said. "It's relative to size, and as our trees continue to mature, there will be more and more pollen in the city."

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