Spring and summer usher in warmer temperatures, brighter days, greener trees, flowers bursting with colors and...ah...AH...AH-CHOOO!
As nature comes back to life, so do many allergies with sneezing, coughing, itching and congestion ringing in the warmer seasons for many allergy sufferers.
Unfortunately, experts believe the annual allergy tradition has become worse over the past few years.
What causes allergies
"Tens of millions of people have allergies in the United States alone," said Thanai Pongdee, an allergist and immunologist at Mayo Clinic in Rochester, Minnesota.
According to Pongdee, allergy sufferers can experience a variety of symptoms. They arise when the immune system recognizes an allergen and then releases certain chemicals in response.
One of those chemicals, histamine, triggers symptoms such as sneezing, itching, congestion and asthma for people who are allergic to pollen.
"All these things are basically an overactive immune response when you're sensitive to these allergens," Pongdee said.
An extended pollen season
For people allergic to pollen, allergies occur in traditional pollen seasons.
Some examples include trees, which tend to pollinate in the spring; grass, which tends to pollinate in the summer; and weeds, which tend to pollinate in the fall.
"The variability there is going to depend on what part of the country you're in, because those seasons vary depending on how far north or how far south you live," Pongdee said. "But in general, those are the seasons that those particular plants pollinate."
However, those seasons are undergoing some changes.
"There are a number of studies conducted in recent years that do demonstrate the pollen season is getting longer," Pongdee said.
According to Pongdee, a number of studies have shown that the traditional length of pollen seasons and the temperature of those seasons have changed these past few years due to climate change.
"If you look at that across all the growing seasons — from spring to the first hard frost in the fall — you can imagine if it's warmer and things can grow longer, then that season gets longer," he said.
For example, in Minnesota, Pongdee noted that trees that typically do not start pollinating until late March have begun to pollinate a week or two earlier.
"There's lots of pollen counters around the country and you can actually document — pollen counts are occurring sooner than they have in prior years and ending later in the year than prior years," he said.
This means that pollen allergies will last for longer stretches of time.
But that’s not all.
"Not only is the season longer, but it also appears that the intensity of the pollen production is increasing," Pongdee said.
This greater intensity, combined with the longer season, makes allergies even worse.
Despite the worsening of allergies, allergy sufferers can take some precautions.
"I would say the first thing is to confirm what allergies you do and don't have," Pongdee said, recommending patients to see an allergist and consider some type of allergy testing to determine specific allergies.
"Just knowing the landscape of your specific allergies is helpful in the beginning because that's going to help the planning going forward."
Once the allergies are identified, Pongdee said patients have two main options for managing them.
One option is avoidance.
"If [the allergen] is pollen outside, that may be hard to do because we all have to go outside for various things," Pongdee said.
But indoors, the allergen can be easier to control. Pongdee recommended keeping windows closed as much as possible and running an A/C or HVAC system to circulate cool air in the home.
He also noted how pollen may be brought indoors, as it can stick to clothes. In that case, people allergic to pollen should change their clothes once they are inside.
Another option for allergy sufferers is medication.
"Common medications include nasal steroid sprays that can be quite effective to manage allergies," Pongdee said. "Many of those are available over the counter, and similarly, there are many oral antihistamine pills, which can also be quite effective."
He added that allergy immunotherapy or allergy shots can also be effective options for many people.
As the timeline and intensity of seasonal allergies are changing, allergy sufferers must make adjustments to help them manage their allergy symptoms.
"The symptoms are chronic in nature — they're going to actually affect your activities every day," Pongdee said.
"We want to take great care of our patients. We want our patients to feel better and if they feel better, then every other aspect of their lives is better."