As with most winters, many people in the Yankton area began looking forward to spring as soon as the holidays were over—for some, it was since that first cold snap last fall. But for those with allergies, the upcoming seasonal warm-up isn’t exactly something to look forward to.

While environmental allergies like pet dander, molds and dust mites don’t take a seasonal break, spring is notorious for incurring seemingly perpetual and sometimes severe cold-like symptoms on allergy sufferers, from sneezing and nasal congestion to sore throat and asthma.

Short of relocating to a region without an individual’s specific allergen, there is no foolproof way to avoid seasonal allergies, says Dr. Tyler Hanson of the Yankton Medical Clinic, though there are effective treatments. Especially for new allergy sufferers and their loved ones, though, a little education is in order.

How Allergies Develop

While allergies often mimic contagious respiratory illnesses, they’re very different. Allergies aren’t caused by a virus, bacteria or another disease-causing pathogen but by the body’s very own immune system designed to protect the body from foreign invaders.

What happens when allergies develop is that the body’s immune system over-reacts to a normal substance as if it was dangerous to the body, Hanson explains. That over-reaction causes physical discomfort to the body.

Dr. Carrissa Pietz of the Yankton Medical Clinic puts it this way: “When the body develops an allergy, it produces antibodies against specific allergens, or substances. When the antibody combines with the specific allergen, it triggers a chemical reaction in the body that leads to the development of the symptoms that we commonly associate with allergies”—that runny nose, rash, itchy eyes and other annoying symptoms that pop up as soon as the trees start flowering every spring without fail, or every time you visit your friend who has a house cat, for example.

Not everyone has an allergy, and certainly not everyone who has allergies has the same ones as other people. Allergies and allergy risk is tailored to each person.

“Our genes are what hold the blueprint for creating the proteins and chemicals in an immune response,” said Hanson, who is board-certified in internal medicine. “So often times, allergy problems will run in families.”

While the risk to develop allergies is genetic, specific allergies are not, Pietz says. Therefore, if a parent has seasonal ragweed allergies, the child would be more likely to develop an allergy himself but not necessarily to ragweed; it could be to ragweed, another type of pollen, a different allergen entirely, multiple allergens whether environmental or not—or nothing at all since family history increases risk, but that’s not always a given.

In addition, of those people who do develop allergies, some develop allergies as babies; others do sometime during childhood; still others begin suddenly reacting to something as an adult.

“When babies are first born, their immune systems are brand new and just learning how to respond to foreign substances,” Hanson said. “It takes time and exposure to multiple different potential allergens to fully develop a functioning immune system.

Just like adults, some babies as they get older develop an overzealous immune response to certain foreign substances as their immune system is learning how to respond. Sometimes it takes multiple exposures to an allergen before the immune system becomes hyperactive, and that is why some people don’t get allergies until later on.”

Because of this, different allergies tend to develop at different ages, Pietz added. Indoor environmental allergies can begin in the first year of life, while outdoor environmental allergies typically do not begin under after baby’s first birthday. The most common age of onset of environmental allergies for boys is 8 to 12 years old; for girls, it’s not until the teen years. While allergies can develop later in life, it is less common.

That said, adult women may report that they suddenly developed allergies after giving birth or that their allergies were relieved during pregnancy. Peitz says this is likely related to the changes a woman’s immune system experiences to protect the unborn baby.

Types of Allergic Reactions

Allergies—whether to pollen, pet dander, food, medication, bee stings, latex, nickel, soap, poison ivy or other allergens—all create the same immune response in affected people, referred to as an IgE reaction, Pietz explains. Environmental allergies tend to develop respiratory symptoms, Hanson adds, while food allergies manifest as diarrhea, rash and perhaps anaphylaxis. With contact allergies, the reaction is limited to a rash on only the part of the skin in direct contact with the allergen.

Some people can develop a common skin condition called eczema—an itchy, dry rash—and believe this is an allergic reaction, though the cause may be hard to pinpoint. Sometimes eczema is related to cold, dry air or another irritation, and other times, it is related to an allergy, especially to a food.

“The underlying mechanism leading to eczema, or atopic dermatitis, is believed to be a problem with the integrity of the epidermis, which is the outer layer of our skin,” said Pietz, who is board-certified in family medicine. “In this condition, the epidermis doesn’t act as an effective barrier, so allergens or irritants can cross through the barrier, putting into motion the IgE reaction that leads to the itchy rash classically associated with this condition.”

Are Seasonal Allergies Life-Threatening?

While all allergies have the potential to develop into a possible fatal anaphylactic reaction; characterized by hives, flushing, airway swelling, trouble swallowing and sometimes shock, seasonal allergies—like other environmental allergies—typically do not lead this this type of reaction. However, seasonal allergies can rarely lead to allergic asthma, which can become an emergency situation.

“The symptoms seen with seasonal allergies are usually referred to as allergic rhinitis,” Pietz said. “These symptoms can be very bothersome and affect a person’s quality of life, but the reaction will not be life-threatening.”

Common Seasonal Allergies

Some people report that they didn’t develop seasonal allergies until moving to a certain region or that their longtime allergies suddenly cleared up when they traveled to a different climate.

Because seasonal allergies depend on the plants in the local environment, it stands to reason that allergies can develop or disappear depending on the region.

“If you go outside of the Midwest, the same plants may not be present or they may pollinate at different times of the year depending on the climate, which results in the variation of allergic symptoms based on geographic location,” Pietz said.

The most common seasonal allergies in the Yankton area are: tree pollens in the spring including oak, cedar and others; grasses in late spring and early summer, and ragweed in late summer and early fall, Hanson explains. When the types of pollen are most problematic to allergy sufferers depend on each plant species’ time of pollination, Pietz adds. For trees, this is the classic springtime—March through May. Grass season typically begins at the end of May, peaks during the first two weeks of June and is done by the Fourth of July. Ragweed season usually starts around Aug. 10, peaks from Aug. 20-Sept. 10 and has ended by Oct. 1.

The more troublesome days within these timeframes for seasonal allergy sufferers are those that are warm and windy, Hanson says. Symptoms will be more severe on days with higher pollen counts.

Treating Seasonal Allergies

Once an allergy has developed, there is no cure so that the person will no longer have an allergic reaction to the specific allergen. And because the risk of allergies is genetic, there is no way to prevent the development of allergies. Thankfully there are many treatments available.

“In the case of seasonal allergies, the main focus is to act early to control symptoms prior to or right at the beginning of that particular season starting,” Pietz said.

The most effective treatment of any allergy is avoidance, but while this can work well for allergies to foods, medications, bee stings and other non-air-borne allergens, it is nearly impossible for sufferers of seasonal allergies without relocation to a new climate without the allergen.

The next line of defense is symptom relief. Pietz recommends a steroid nasal spray, used daily, during the season of the offending allergen. For example, a ragweed allergy sufferer should begin the steroid nasal spray at the beginning of August and use it daily into November. In addition, oral antihistamines or antihistamine-decongestants can be used as needed, as well as nasal saline, topic decongestants and antihistamine sprays.

Hanson suggests trying over-the-counter medications like Claritin, Allegra, Zyrtec and Bendryl. Flonase is a commonly used steroid nasal spray, which is prescription-only, as is Singulair, which is particularly helpful for allergic asthma. An EpiPen is required if an allergic individual is known to have an anaphylactic reaction.

“Once allergy symptoms get beyond a certain point, then an oral steroid, such as prednisone, may be indicated,” Pietz said.

However, “there are many potential side effects to oral steroids, so they are not a first line treatment. An injectable steroid is also sometimes used.”

There are cases when severe symptoms warrant allergy shots, when other treatments prove ineffective, she adds. Allergy shots, clinically known as allergy immunotherapy, are a type of exposure therapy, meaning the patient is receiving small doses of the allergen with each injection. The dose is started low and then increased as the patient’s immune system desensitizes to the allergen, evident by symptom control.

“Since this treatment involves injecting the allergen into the allergic person, it is possible for an anaphylactic reaction to occur,” Pietz said. “Therefore these injections always need to be performed in a clinic or hospital setting, and this is also why allergy shots are a treatment of last resort.”