I’m so itchy! or Would you Stop Scratching?!

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Allergies are a common problem this time of year and they can affect your ears, nose, throat, lungs, and skin.

Timing: When the weather is changing, so do the plants. They put out pollens based on weather triggers such as warming up, cooling down, wetness, and dryness. In addition the Santa Ana winds blow dry air full of pollen from the deserts into the valleys of Southern California. Also, when it is hot or there isn’t much of a wind, the allergic reactions from smog are worse.

General symptoms: Usually there are no swollen lymph nodes/glands in the neck, fever, chills, or sweats with an allergy. The appetite and energy level are unaffected unless you have lost sleep from not being able to breathe well, or coughing. The symptoms of allergies are in each section below.

Skin is typically itchy in the winter due to dryness. Colder air holds less moisture and when we heat it at home, at work, or in public places, it is very dry. That causes the skin to dry out and become itchy. A good method to treat this is to dry yourself, not to thoroughly, after bathing and apply a thin layer of petroleum jelly, such as Vaseline over the itchy areas. This will trap in the moisture and protect you from further drying out. This is not a true allergy but since it itches and happens this time of year, I thought I would include it.

Itchy eyes: The lids and the eyes can become itchy and red with this weather. The lids may need an antihistamine pill, but the eye may need topical treatment, starting with the easiest to the most expensive: washing with water and using artificial tears are good ways to help without using medication. Decongestants (like Sudafed pills, but in drops) like Visine or Murine, are over the counter. You need a prescription for Patanol which is an antihistamine and helps prevent the continuing cascade of the allergic reaction. Naphcon-A can has the benefits of both classes of medications.

Itchy throat: The throat can also feel like something is there, it feels itchy or swollen in a certain part, or just plain hurts. An antihistamine or decongestant can help. I explain these later. If the pain is bad, then you may need a topical treatment which doesn’t really treat the causes as the pills do. Cough drops help soothe the area as does lemon and honey. Chloraseptic spray can be directed right to the sore area and swallowed. I have some next to my bed so I can get some sleep when I have a sore, allergic throat. Unlike the liquids, lozenge, or troche, the spray avoids the tongue so you can taste food.

Itchy or runny nose: Usually the mucus is clear. Phlegm or nasal mucus can be colored in the morning due to the lack of coughing at night and all the dust we breathe in. Providers don’t pay much attention to this unless the color is green, yellow, brown, or gray after the morning mucus and clearing. Nasal steroid sprays can help. Be careful with over-the-counter sprays since the nose can become dependent on the medication and you will have to use the medication daily for years due to this dependence. I recommend Afrin spray sometimes for very congested noses but just for 3-4 days at a time to avoid dependence.

A Neti Pot can be very helpful for allergic noses, colds and sinusitis. It looks like a small teapot with a narrow spout that fits into your nostril which you can buy online. You put warm water in it and a little salt and irrigate your nose and sinuses. The method is a little tricky but it really gets rid of the mucus for an hour or more. Too much or too little salt can cause burning and more swelling of the tissues. My nose is used to snorting up warm water without salt. These methods also get rid of the dusts and pollens we have breathed in during the night that may still bother us.

Cough: Usually this is from a tickle, a “dry” area, a swelling, or an irritation in the throat or from the lungs. The irrigation above, lozenges, honey and lemon, or cough drops can help. But occasionally a cough medication is needed. The most famous cough syrup, Robitussin, has a main ingredient that isn’t well-proven to be of benefit. The other ingredients in all the Robitussin syrups have activity, especially Dextromethorphan (DM). A prescription is needed for the other cough suppressants: codeine (also in Tylenol #3) and hydrocodone (also in Vicodin). Another suppressant, not commonly used but effective, is Tessalon, in a pill form. I’ve found it effective for patients when the others don’t work well. It is non-narcotic and has less side effects that the codeine and hydrocodone.

Asthma is an allergy in the lungs and we have discussed this before.

Medications: The medications for allergies, viral infections, and bacterial infections of this area are usually one or a combination of the following:

Antihistamines: These attack the actual chemical reaction in the body that releases histamine that causes the swelling and mucus. The ones that cause less drowsiness are: Claritin, Zyrtec, and Allegra. The older ones that cause somewhat less are: chlorpheniramine and brompheniramine. The ones that cause more drowsiness are Benadryl, Atarax, and Phenergan. Some get no drowsiness from these.

Decongestants: The main one is Sudafed, but also phenylpropanolamine and phenylephrine are in some preparations. There are restrictions on Sudafed since you can make crystal methamphetamine from it.

When to seek a medical provider: If you have poor appetite or energy, or have fevers, chills, or sweats or are concerned about your condition, then consider seeing a provider. You may notice that antibiotics are not listed since they do not help allergies or for that matter, viral infections.

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