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Avoiding the Springtime Allergy Blues

Wed, 6 Apr 2011 09:11:05 -0700

"Hay fever," otherwise known as allergic rhinitis in medical terms, affects over 35 million Americans. Common symptoms include a runny nose, nasal congestion and sneezing, and itchy eyes, throat or ears. Hay fever may be caused by one or more substances called allergens. Some examples of allergens include pollen, molds, pet dander and dust mites. While there are numerous medications, both over-the-counter and prescription, that can improve allergy symptoms, it is important to discuss ways to limit exposure to these allergens. In fact, avoidance measures can limit the need for medications by preventing exposure to allergens in the first place. I will summarize some common allergen avoidance measures for pollen and molds first. In my next entry I’ll discuss pet dander and dust mites.

Pollen

Pollen are tiny particles or air-filled "cells" that plants use for fertilization. Contrary to popular belief, most pollen does not come from colorful flowers. Insects carry pollen from one flower to another in this instance. Many other plants produce pollen that travels via wind to fertilize growth of new plants in different areas. These plants are comprise the most common pollen sources and are therefore responsible for most pollen allergy symptoms.

Plants release their pollen at typical times of year. Trees tend to release their pollen first, often as early as January or February in temperate climates. Grasses typically follow, and weeds are responsible for late summer and early fall pollen counts.

Since pollen is designed to float in the air, allergen avoidance measures focus on cleaning the air and preventing pollen from entering the home environment. Air filters that contain high efficiency particulate air (HEPA) filters are ideal for allergy sufferers. These filters are designed to capture the smallest of particles, including pollen and viruses. The bedroom is an ideal location for an air filter, as our children spend a good amount of time there. Keeping bedroom windows closed at night may prevent pollen from entering the bedroom, though this is more difficult to do on hot summer nights. Showering or bathing at night can wash away pollen that sticks to skin or hair. All of these measures serve to limit continued exposure to pollen.

Molds

Molds are small fungi that may be found indoors or outdoors. The release spores that float in the air much like pollen. As weather warms in the spring, mold levels rise and peak in the middle of summer. In temperate climates, mold spores may be found year-round.

If you are allergic to molds, there are many ways to limit your exposure. The advice varies depending on the source of the mold: indoor vs. outdoor. For indoor molds, limiting humidity levels is key. If you live in humid parts of the country, dehumidifiers can lower the home humidity levels and keep mold levels in check. Keep windows closed at night, avoid fans that bring outside air into the home, and recirculate air within the home, when possible. Thoroughly dry laundered clothing and fix any known water leaks in the house. For outdoor molds, avoid handling hay, mowing grass or working with mulch or compost, clean moldy outdoor areas with bleach or compounds designed to kill mold. Keep in mind that mold may be found in many outdoor places, including soil, plants and rotting wood.

New Allergy Treatment Available!

Mon, 31 Jan 2011 09:57:11 -0800

This is a quick entry into my blog, one that I hope will help many children and other allergy sufferers who fear allergy shots. Effective immediately, I am offering allergy “drops” in addition to allergy “shots!”

Allergy shots, known to allergists as subcutaneous immunotherapy, have existed for decades, and are quite effective. The upside to allergy shots is tremendous -- fewer allergy symptoms, fewer missed school days, etc. However, the downside is significant as well. Committing to allergy shots requires weekly visits to my office for the first 2-3 months, and waiting in my office afterwards. While this is convenient for many patients, for others it presents an obstacle that stands in the way of effective treatment.

This is why I’m so happy to offer allergy drops to patients. The process is simple, and can be done at home. Drops are placed under the tongue once per day for several weeks. These drops contain the exact same allergens that are found in allergy shots -- only the delivery system changes. The vials can be stored at room temperature or in the refrigerator, and the solution even tastes good as it is mixed with 50% glycerin -- a sweet-tasting, natural, odorless, non-toxic liquid. I provide all the necessary supplies and paperwork which walks patients through the entire process.

Studies show that sublingual immunotherapy, the official term for the drops, is safer than allergy shots. There are fewer side effects, and it is pain free!

I am pleased to announce this development, and I look forward to helping many of you with debilitating allergic symptoms!

Contact my office or me directly at joshua.davidson@me.com if you are interested!

New Food Allergy Guidelines

Thu, 23 Dec 2010 08:43:12 -0800

National allergy experts just released a set of new guidelines for the diagnosis and management of food allergies. While the guidelines were intended for medical professionals, I think there is a wealth of information for families and patients.

I’ve put together a “Question and Answer” sheet that addresses many common concerns regarding food allergies. Click here to read it! If you have any questions, simply email me at joshua.davidson@me.com.

Have a wonderful holiday and a happy new year!

The Winter Season and Eczema

Fri, 3 Dec 2010 08:44:44 -0800

While our winters here in Southern California are not exactly harsh, it can still get very dry. We do live in a dry environment to begin with, and the cold dry air only makes it more difficult. For patients with eczema, a common allergic skin condition, dryness can make eczema far worse.

Eczema is commonly seen in young children, even in the first few months of life, and it’s characterized as a red itchy rash. Young children often develop patches of eczema over their cheeks and often in the “folds” of their arms, legs, or neck. In adults with eczema, their hands and feet are most often affected.

I mentioned above that eczema is itchy. This tends to be an understatement as eczema is EXTREMELY itchy. It can keep patients up at night, and some individuals will even scratch in their sleep.

So what causes eczema, and how do you treat it? Well, there are many causes, but the most common include allergies to “inhalant allergens,” i.e. pollens, dust mite, pet dander and other allergens that we inhale as we breathe. Food allergies account for about 15-20% of eczema cases in children, so the majority of kids with eczema do not suffer from food allergies. Both inhalant and food allergies can be diagnosed with skin and/or blood testing, and I have experience with both. If you want to learn more just give me a call or make an appointment.

The hallmark of treatment is moisturizing and treatment to calm the immune response that creates the redness and itching on the skin. Moisturizing is accomplished by bathing daily, sometimes twice daily, for 10-15 minutes in warm water. After the bath it’s important to apply a medicated cream or ointment to the affected skin, and moisturizer to the unaffected skin. Keeping the moisturizer and medication separate is very important as mixing them can weaken the medication.

Sometimes medications are needed as well, and the most common class of medications are topical steroid creams/ointments. The word “steroid” can be scary for parents, but keep in mind that these are topical only, and are not being absorbed by the entire body as with oral or injected steroids.

Ultimately, with proper testing and treatment eczema can be controlled. It is a chronic illness, however, and can affect some children into adulthood. Most children “outgrow” their eczema by kindergarten, and those who have it as adults often have more mild symptoms.

I hope this information is helpful for you, and if you or your child suffers from eczema, let me know and I will be happy to help!

Back to School = Back to Asthma

Fri, 10 Sep 2010 09:52:33 -0700

Technically speaking, summer is not over, but for most parents and their children, summer ends when school starts. For children and adults with asthma, this begins a typically difficult time of year. Why? Well, there are a couple of big reasons.

First, the late summer and early fall bring high levels of weed pollens and mold spores. Those of you with sensitivities to some of these troublemakers know all-too-well about this time of year. Ragweed pollen is one of the most troublesome weed pollens as it is very allergenic. That is, even small amounts of ragweed pollen can cause significant allergy symptoms in an allergic person. Soil mold spore levels also rise, and the typical fall-dominant Santa Ana winds that we get here in L.A. can disturb the soil, sending spores into the air. These spores are well known to cause asthma exacerbations, particularly Alternaria tenuis, a type of mold that is specifically tied to asthma trouble.

The second reason that asthmatics have trouble around school time is the common cold. Viruses spread like wildfire once children return to school. Since children spend their summers on vacations, in camps, etc., they bring home various viruses from all over California and the US. These viruses take a couple of weeks to get passed around, and wham, viral season hits! Viruses are the most troublesome trigger for asthma symptoms in children and adults. Once children bring the school-borne viruses home, they are spread among the family, and parents/siblings get infected.

The heightened incidence of asthma exacerbations places importance on making sure you have enough rescue medication, controller medication, etc. Give my office a call if you’d like to check in and make sure everything is looking good! It’s a great time of year for asthma check-ups, before the asthma storm hits!