How to Handle Hay Fever
Over the Counter
It’s that time of year when pollen is in the air! Trees and plants are growing and blooming, which is beautiful to see, but terrible to experience when you have allergies. Symptoms can range from itchy, watery eyes to a persistently runny nose, sore throat, and cough. Some people will have sinus headaches and others will have shortness of breath, wheezing, and asthma-like symptoms—in fact, allergies, asthma, and eczema (a dry, itchy skin rash) are closely related.
There are many good options available over-the-counter to treat allergies. I do not have a strong preference for brand name medications over their generic counterparts, and generally recommend trying the one that is nicer to the pocketbook first. I have had a few patients that found the brand name medication did work better for them, and so recommend that if the generic is tried but is not as effective as desired, the brand name medication might be more useful.
For people who have generalized allergy symptoms, tablets work well because once swallowed the medication is delivered by the blood stream everywhere in the body—to the nose, eyes, and airways, as well as to itchy skin. Non-sedating antihistamines are the most common. Claritin (loratidine) has the fewest side effects for most people, but is also the weakest. Zyrtec (cetirizine) is stronger for most people, but can cause drowsiness in about 10% of people who take it. Allegra (fexofenadine) is a good compromise—it’s not as sedating as Zyrtec, but also stronger than Claritin. I generally recommend Claritin for mild allergies, Zyrtec for severe allergies, and Allegra for people who don’t tolerate Zyrtec.
Benadryl (diphenhydramine) is a sedating antihistamine. It is generally stronger than the medications listed above but is far more likely to cause drowsiness and other side effects such as a persistent “hung-over” kind of fatigue during the day, as well as dry eyes and mouth. It works well for severe allergies, especially if taken before bed, and is a good option to try when the non-sedating antihistamines don’t work well enough.
For people who have localized symptoms—for example, only a runny nose—there are medications that are effective and have fewer side effects than oral medications. Flonase and Nasocort are nasal sprays that work best when used consistently for a week or more to treat nasal congestion. Topical eye drops such as Zyrtec Eye Drops (the generic is ketotifen, which is not the same drug as Zyrtec tablets) work great for allergic conjunctivitis—the red, itchy eyes many people get with their allergies. Topical Benadryl cream and hydrocortisone cream are good remedies for itchy skin, but should not be used for more than a few days without discussing it with a doctor.
These medications are all good first options in dealing with allergies. If you find, however, that they are not sufficient for your symptoms, don’t hesitate to call your family doctor to discuss further options. There are many things a doctor can do for severe allergies, ranging from prescription medications to immunotherapy (which can greatly lessen symptoms, and in many cases cure allergies completely). If my clinic can be of service to you, give us a call!