Pollen allergies: what are the simple actions to adopt on a daily basis?

The beautiful days are returning and with them: allergic rhinitis (hay fever), asthma attacks and other breathing difficulties. Between 20 and 40% of French people suffer from pollen allergies. For several days, half of France has been on red alert, mainly threatened by birch pollen in the north and plane tree in the south.

Everywhere in France, the risk of allergy is also at the high level for ash pollens. Charm pollens could also reach this level in a few days. In the southwest, the risk is medium for grass pollen, even if they are still present. The rise in temperatures announced this Tuesday, will have the effect of strengthening pollination. So how can you protect yourself effectively? What steps to take to limit the harmful effects of a pollen allergy?

How to protect yourself effectively?

If you are allergic, there are a few things you can do to help. The key is to limit contact with the outside when the risk is high: avoid walks in the forest or in the fields. If you are driving by car, keep the windows closed.

the National aerobiological surveillance network (RNSA) also recommends “to rinse the hair in the evening (otherwise the pollens are deposited on the pillowcase and maintain the irritation, editor’s note), to favor the opening of the windows before sunrise and after sunset (pollens are more present during the day, editor’s note), to avoid drying clothes outside, to follow your treatment well and to consult your doctor in case of symptoms … “. Change regularly if you can, pollens tend to stick to clothes.

How to confirm a diagnosis?

Allergy tests are needed to confirm a diagnosis of respiratory allergy. These tests are generally carried out on the skin (skin tests or Prick-tests) but can also be carried out in the form of serological tests (blood = dosage of specific IgE). In certain situations, particularly those where skin tests show more than one positive, molecular allergy tests may be used to confirm an allergy to birch pollen (a family of plant stress proteins called PR-10).

The different treatments

Systematic elimination of the allergen is not always possible, but the available treatments are effective and generally safe, if used correctly. It is recommended to take them systematically, every day, from the start of the signs and throughout the flowering period in question. In some cases, it is possible to take them even a little earlier, which avoids allowing the allergy to set in.

The oral antihistamines are the first-line drugs for allergic rhinitis. The oldest antihistamines have a potentially dangerous sedative effect when driving a car or in certain trades. The second generation antihistamines do not have a sedative effect and are now recommended as a first-line treatment for people who must take this type of medication: desloratadine, fexofenadine, loratadine, cetirizine … You should not hesitate to try several in order to find the molecule which is best suited to each person: there is indeed a strong individual susceptibility.

The topical nasal corticosteroids constitute the recommended first-line treatment in cases of moderate or severe rhinitis (budesonide, fluticasone, mometasone, etc.). They are recommended as a second-line treatment in patients with mild allergic rhinitis. Their regular use can even repair the effects of inflammation. Nasal corticosteroids have few side effects, but they can cause irritation or nosebleeds in 10-20% of people.

Topical nasal corticosteroids are superior to oral antihistamines for the treatment of allergic rhinitis. They offer a particularly significant advantage over antihistamines in people with perennial allergic rhinitis who experience moderate or severe nasal congestion. In this case, they should be the main treatment. Topical corticosteroids can be combined with antihistamines. In the form of eye drops, topical corticosteroids are effective in treating an allergy to the eye (“conjunctivitis”).

The antileukotrienes can be used to prevent rhinitis, mainly in people with asthma with nasal polyposis. Oral corticosteroids are not recommended due to side effects that occur at doses where they are effective. It is also necessary to avoid nasal sprays phenylephrine-based decongestant which poses a risk of stroke.

Can we cure an allergy?

A question remains: can we cure an allergy? To change the course of the allergic disease, it is possible to resort to specific immunotherapy, or “desensitization”: this technique makes it possible to induce tolerance to one or more allergens. The progress of recent years has reinforced the effectiveness of these treatments with better purification of allergens and the administration of some sublingually. Subcutaneous injections take place once a week for 3 months, then once a month for 3 years.

Subcutaneous immunotherapy controls the signs of allergies in more than two-thirds of people with allergic rhinitis and prevents the development of bronchial asthma and broadens the spectrum of allergies to others. allergen over time. Desensitization works all the better if it is initiated soon after the development of the signs. In the event of recurrence after desensitization, if the first immunotherapy was effective, it may be repeated.

An interesting alternative is sublingual immunotherapy which must be started at least a few months before the pollen season: it is interesting not only for the treatment of the symptoms of birch allergy but also for changing the course of the allergic disease.