Doctor’s spring allergy tool kit can minimize symptoms

Seasonal allergies are nothing to sniff at — they can cause sneezing, itchy eyes, a runny nose and a cough that can last for weeks or even months.

In NYC, spring kicks off tree pollen season, followed by grass pollen in the summer and weed pollen in the late summer and fall. Crosswinds carrying pollen from other regions, combined with warmer temperatures, are making symptoms more unpredictable.

When you breathe in pollen, your immune system releases histamine and other inflammatory mediators, triggering common allergy symptoms. Unlike a cold, which typically clears up in a couple of weeks, allergies can last much longer, often starting with a runny nose and progressing to nasal congestion, sinusitis, fatigue and headaches. 

The good news? You don’t have to live in a bubble to manage allergies.

As an allergy sufferer myself, my top advice is to start medications early and use them regularly throughout the season. Here’s what’s inside my seasonal allergy tool kit.

Over-the-counter medicines

Most first-line treatments are available at any pharmacy — no prescription needed. 

Nasal sprays

While many allergy sufferers reach for antihistamines first, a nose spray should be your daily go-to. Steroid nasal sprays reduce swelling and inflammation in the nasal passages, helping relieve congestion over time. They don’t work instantly but need to be used consistently for several days or up to two weeks before full relief. 

Look for nasal sprays containing fluticasone or triamcinolone. I always recommend stocking up when they’re on sale!

For best results, aim the spray toward your ear, rather than straight up the nose, for better absorption. Nasal rinses can also help flush out allergens and irritants we inhale throughout the day.

Oral antihistamines

Antihistamines in liquid or pill form can provide quick relief from seasonal allergy symptoms. For children with severe symptoms, combining antihistamines with a nasal spray can be even more effective. 

Look for brand-name or generic versions of non-sedating antihistamines like cetirizine, levocetirizine, loratadine and fexofenadine. These typically start working within 30 minutes and provide relief for 24 hours, compared to diphenhydramine, which can make kids sleepy and lasts only six hours.

Ideally, start taking antihistamines and nasal sprays about two weeks before spring, typically around Valentine’s Day. If you haven’t started yet, it’s not too late — begin now! 

Eye drops

For itchy, watery eyes, consider adding an allergy eye drop to your routine. Olopatadine can help prevent histamine release, the main trigger for eye irritation.

Eye drops come in different concentrations, and for children with severe symptoms, I recommend the highest concentrations once daily for all-day relief. Natural tears and warm compresses can also soothe irritation and keep eyes comfortable.

Beyond medications

Allergy shots (immunotherapy)

If OTC medications aren’t cutting it, immunotherapy, such as allergy shots, may be the answer.

Most allergists don’t recommend allergy shots for children under 5, but for school-age children and adolescents with persistent symptoms, allergy shots can help desensitize the immune system’s response to the allergen.

Other options include sublingual immunotherapy, which is Food and Drug Administration-approved for grass, weed and dust mite allergies. 

Lifestyle adjustments

Pollen is tiny and can travel long distances, so it’s important to track local pollen counts to minimize exposure at peak times. I use an app called Allergy Plus, which also monitors air quality.

Stay indoors on high pollen days and opt for activities like movies instead of the park. If you do venture out, take your meds, including asthma inhalers, and consider an extra dose if needed. Keeping windows closed in your home and car can help keep pollen out.

After being outside, bathe or shower immediately, wash hair and change into clean clothes to avoid spreading allergens indoors. Wearing an N95 or surgical mask may help block pollen, while wide-brim sunglasses and a hat can prevent pollen from sticking to hair. 

And don’t forget to run an air purifier as an extra precaution. I have several devices in my home due to my dust mite allergy. For a do-it-yourself air cleaner, the Environmental Protection Agency has a great suggestion.  

When to see an allergist

If symptoms persist despite using your allergy tool kit, it may be time to see an allergist to identify the root cause. Children should not miss school, and you shouldn’t miss work due to seasonal allergies.

If allergies lead to complications like chronic ear or sinus infections, asthma attacks or eczema flares, a specialist can help.

Allergy testing can provide peace of mind and important information on the exact reason for sniffling and sneezing. What seems like pollen allergies may be triggered by dust mites or pet allergies, which require year-round meds and different management strategies. 

At the Pediatric Allergy Program, we can guide your family through treatment options and testing. In addition to doctors and nurses, our team includes a child life specialist and a psychologist, provided by Sala Institute for Child & Family Centered Care, who can provide comfort and support during testing.

While some people outgrow seasonal allergies, the waiting game is unpredictable. Taking proactive steps before allergy season can make a big difference in how you feel. With the right medications, lifestyle adjustments and expert guidance, seasonal allergies don’t have to take over your life!

Kanwaljit (Rupam) Brar, MD, is a pediatric allergy specialist with advanced training in dermatology. She sees patients at the Pediatric Allergy Program at Hassenfeld Children’s Hospital at NYU Langone. She manages all children’s allergic conditions, including food allergies, rhinitis, eczema and asthma.