Allergies don't take a break just because it's cold

ask the expert alvin sanico greater baltimore medical center

December 08, 2008|By Holly Selby | Holly Selby,Special to The Baltimore Sun

Ah, December. Cold, dry air, evergreen trees, boxes filled with holiday decorations - and possibly molds and dust - brought down from the attic. And you thought that this was an asthma- and allergy-free season. Among the estimated 16 million adults and 7 million children in the United States who have asthma, slightly more than half of the cases are attributable to allergies, says Dr. Alvin Sanico, medical director of the Asthma Sinus Allergy Program at Greater Baltimore Medical Center and assistant professor of medicine at the Johns Hopkins University.

Allergy season is typically considered to be spring to fall, when many trees and plants are pollinating. Does this mean winter is allergen-free?

It would depend on the specific allergens to which you are sensitive, which can easily be revealed by allergy skin testing. If you are allergic to pollen from trees, your symptoms could be worse from spring to early summer, when the tree pollen counts are typically elevated. For grass pollen it would be late spring to summer, and for weeds it would be fall. If you are sensitive to allergens from dust mites, pets such as cats and dogs, cockroaches or molds, then winter doesn't represent relief because these things can be found indoors.

What are the symptoms of asthma and allergies?

Symptoms develop as a result of inflammation and can include any combination of breathlessness, cough, wheezing, chest tightness, runny nose, postnasal drip, sneezing, nasal congestion and itchy, watery eyes. Depending on several factors, the symptoms can range from mild to severe and from intermittent to persistent.

Are there particular triggers to watch out for during this season?

Aside from the aforementioned indoor allergens, other potential triggers for asthma exacerbation to watch out for include irritants such as cold, dry air, strong scents, smoke from tobacco or [a] wood-burning fireplace, as well as respiratory infections such as the common colds that tend to be more prevalent during the winter.

Are there any precautions you can take?

If you are allergic to molds, watch out for their presence on evergreen trees, as these could account for symptoms related to live Christmas trees. Molds can also grow on certain artificial trees and other holiday ornaments that are improperly stored in damp areas. If you are allergic to dust mites, apply dust mite-proof encasements for your pillows and mattress, and wash your regular beddings using hot water at 140 degrees Fahrenheit. If you use the fireplace, make sure that the ventilation system is working well. When you spend time outdoors, wear protective clothing over your face to minimize inhalation of cold, dry air.

What if you are traveling for the holidays?

If you are allergic to cats or dogs and are visiting friends or family with these pets, make sure that you take all appropriate medications to ensure that your condition remains under good control. Be aware that cat and dog allergens can be transported through clothing, so minimize the amount of allergens that you bring home by isolating and washing exposed clothing accordingly.

We've heard a lot about hypoallergenic dogs recently. Are there some dogs that might cause fewer allergic reactions?

There are a lot of misconceptions about this subject that could lead to detrimental consequences. The fact is that there is no such thing as a hypoallergenic dog breed. All dogs and cats produce allergenic proteins that can be found in their dander, saliva and even urine, regardless of their breed or the characteristics of their hair - or lack thereof. Recent news reports of pet pundits proposing "hypoallergenic breeds" ranging from the Portuguese water dog to the Peruvian hairless dog for the future First Family can be misleading. The American Kennel Club even conducted a poll to elect the presidential pet for Malia Obama, who has asthma and allergies, and the poodle won. That is really ironic because a study by French scientists found that, compared to other breeds, poodles had the highest level of allergenic proteins in their dander. One key finding was the significant variability of levels of allergens from individual dogs within the same breed. The answer then is that some dogs may produce more - or less - allergens than others simply as part of their individual nature.

What advice would you give to someone who is experiencing symptoms of allergies?

The first step is to identify the specific allergens to which you are sensitive, if any, through a needle-free allergy skin test. This standardized test is simple and shows the results in 20 minutes. Based on these results, the three approaches to consider may include avoidance measures, use of medications that are either used daily to control your condition or used as needed to relieve breakthrough symptoms, and allergen immunotherapy that would take several months to take effect but can provide long-term benefits.

Holly Selby is a former editor for The Baltimore Sun.

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