Pollen allergy: how to deal with it?

“By allergy, we usually mean an abnormal response of the immune system to normally harmless substances present in the environment, called allergens. In people suffering from allergies, contact with these substances causes a violent reaction with the release of large amounts of histamine, responsible for inflammatory and allergic reactions, and therefore also large amounts of immunoglobulin E (IgE). This causes inflammation with symptoms affecting various organs and systems, such as the lungs, skin, eyes, nose,” explains Dr. Milani.

Pollen allergy

Besides dust mites, animal epithelium and various foods and drugs, pollen is one of the most common allergens:

“It is an allergen defined as 'seasonal' because it has different diffusion characteristics depending on the flowering period of the plant, as well as geographical areas. In Italy, for example, in the spring the number of flowering plants increases, in particular trees such as grasses, birches, cypresses and parietaria, releasing a large amount of various pollen into the air. When it is this type of allergen that causes an allergic reaction, we can talk about pollen allergy or hay fever.”

“Symptoms may vary depending on the amount of pollen a person is exposed to and the route of exposure, such as inhalation, ingestion, or contact with skin or mucous membranes (nose, eyes, respiratory tract).

Upon contact with the upper respiratory tract and eyes, an allergic reaction may occur:

1. rhinitis,
2. continuous sneezing,
3. nasal congestion,
4. conjunctivitis with red, watery eyes,
5. increased sensitivity to light.

If the skin is damaged, the following may appear:

• dermatitis,
• urticaria with severe itching.

If the lower respiratory tract is affected, the following may occur:

• asthma, with the appearance of bronchospasm,
• shortness of breath (lack of air),
• feeling of tightness in the chest,
• cough with frequent awakenings at night due to the manifestation of symptoms even during sleep,” explains the specialist.

To understand whether you have an allergy, and in particular to pollen, you must first visit an allergist. Then the allergist will indicate what diagnostic tests need to be performed:

• blood tests to check the amount of immunoglobulin E (IgE) present in the blood;
• skin tests, more commonly known as allergometric tests, of which the most common is the prick test.

The most effective therapy is assessed by a specialist after:

• understanding which plant you are allergic to;
• assessing the severity of symptoms.

The first measure you should take to limit the risk of allergic reactions is to limit your exposure to the allergen as much as possible.

For example, in the specific case of pollen, it may be helpful to look at a pollination calendar to understand when the plant you are allergic to blooms. You can then take some daily precautions to help reduce your exposure to pollen, such as keeping your windows closed for the most part during this particular period.

To relieve symptoms in the acute phase of an allergy, a specialist will be able to assess whether topical pharmacological therapy should be prescribed, such as:

• eye drops,
• nasal sprays,
• devices for the treatment of asthma.

Antihistamines

“The class of drugs used also includes antihistamines, which reduce the release of histamine into the blood and relieve most symptoms, in particular itching, sneezing or watery eyes, but, unfortunately, do not have anti-inflammatory power and, therefore, are not therapeutic as opposed to local therapy. The typical side effect of older generation oral antihistamines, drowsiness, is very limited today. If such therapy does not give the desired results and for longer-term coverage of allergic reactions, an alternative may be the use of specific immunotherapy, the so-called vaccine,” explains Dr. Stefania Milani.

“Specific immunotherapy has advantages:

• relieve symptoms,
• fight the causes of allergies.

In fact, the World Health Organization recognizes it as the only treatment that can “result in a cure for allergies and change the patient's quality of life.”

How does it work?

It involves injecting the allergic person with small amounts of allergen extracts that cause an allergic reaction to encourage the immune system to tolerate the allergen itself. It is especially indicated for those who suffer from:

• respiratory allergies to pollen, mites, mold;
• allergy to hymenoptera such as bees, wasps, hornets.

Immunotherapy is administered in two ways:

• sublingual: the allergen is left under the tongue for several minutes. This form is usually well tolerated, and the patient can cope with it independently at home;
• subcutaneously: the allergen can be administered subcutaneously by an allergist in a hospital setting in increasing doses until the maximum therapeutic dose is reached.

With both routes of administration, the duration of the therapeutic cycle varies from 3 to 5 years depending on the allergen in question.

“In the specific case of pollen allergy, in order for immunotherapy to be well tolerated without side effects, it is necessary to start it before the flowering season of the plant to which you are allergic. This therapy rarely causes side effects and these are mild local reactions, such as itching or swelling at the injection site or periodic tingling in the mouth and swelling in the sublingual area when taken sublingually,” the specialist concludes.