Allergies are an immune system response to normally harmless substances, known as allergens, causing symptoms from sneezing to skin reactions. Effective treatments are available, with the best choice depending on specific symptoms and individual health.
Types of Allergy Medications
Antihistamines block histamine, a chemical released during allergic reactions. First-generation antihistamines, such as diphenhydramine, cause drowsiness because they can cross the blood-brain barrier. Second-generation antihistamines, including loratadine, cetirizine, and fexofenadine, are less sedating as they primarily act on peripheral histamine receptors. These medications are available as oral tablets, syrups, nasal sprays, or eye drops.
Decongestants relieve nasal stuffiness by narrowing blood vessels in the nasal passages. They are available as oral medications, such as pseudoephedrine, or as nasal sprays like oxymetazoline. Oral decongestants can elevate blood pressure and may cause jitteriness or insomnia. Nasal decongestant sprays should only be used for a few days to avoid “rebound congestion,” a condition where symptoms worsen after stopping the medication.
Nasal corticosteroids are anti-inflammatory medications applied directly to the nasal passages through a spray. These medications, such as fluticasone and budesonide, reduce inflammation and swelling in the nose, providing relief from sneezing, runny nose, and congestion. Consistent daily use is often necessary for optimal benefit, as their full effects may take several days to develop.
Cromolyn sodium acts as a mast cell stabilizer, preventing the release of histamine and other inflammatory chemicals from mast cells. It is most effective when used before allergen exposure or regularly to prevent symptoms. Cromolyn sodium is typically available as a nasal spray or eye drops.
Allergy eye drops target ocular symptoms like itching, redness, and watery eyes. Some contain antihistamines to block histamine, while others use mast cell stabilizers like cromolyn sodium to prevent inflammatory mediators.
Topical creams and ointments, like hydrocortisone, manage allergic skin reactions such as rashes, itching, and inflammation. Hydrocortisone is a corticosteroid that reduces local inflammation and suppresses the immune response in the skin. These topical treatments are applied directly to the affected skin areas for localized relief.
Selecting the Right Medicine for Your Symptoms
Choosing the right allergy medicine starts with identifying your specific symptoms. For instance, if sneezing, a runny nose, and itchy eyes are primary concerns, an oral antihistamine or a nasal corticosteroid might be suitable. If nasal congestion is the main issue, a decongestant can be considered, alone or in combination with an antihistamine. For localized skin reactions, a topical hydrocortisone cream is often effective.
The severity and duration of your symptoms also influence medication selection. Mild, intermittent symptoms, such as those occurring only during specific seasonal allergen exposures, may respond well to on-demand oral antihistamines. Persistent or severe symptoms, particularly those that affect daily activities or sleep, often benefit from daily use of nasal corticosteroids, which provide more comprehensive and sustained relief.
Considering potential side effects is important when choosing an allergy medication. If drowsiness is a concern for daily activities like driving or working, non-drowsy second-generation antihistamines are preferable over first-generation options. Individuals with certain health conditions, such as high blood pressure, glaucoma, or prostate enlargement, should avoid decongestants due to potential adverse effects. Children and pregnant individuals also require careful consideration, and medical advice should be sought before administering any allergy medication.
Combination products, which contain multiple active ingredients like an antihistamine and a decongestant, offer convenience by addressing several symptoms simultaneously. However, using these products requires careful attention to avoid overmedication, especially if only one symptom is present.
When Over-the-Counter Isn’t Enough
Sometimes, over-the-counter allergy medications may not control symptoms or worsen despite treatment. If severe symptoms persist, disrupt daily life, or you experience adverse reactions, consult a healthcare professional. A doctor can diagnose the specific allergens triggering your reactions and develop a more targeted treatment plan.
Prescription-strength medications offer additional options when OTC remedies are insufficient. Leukotriene modifiers, such as montelukast, are oral medications that block leukotrienes, chemicals involved in allergic inflammation. Other prescription options might include stronger nasal sprays or specialized eye drops.
Allergy shots, known as immunotherapy, are a long-term treatment for severe or persistent allergies. This treatment involves a series of injections with gradually increasing doses of specific allergens to build tolerance. Sublingual immunotherapy (SLIT), an alternative to injections, involves placing allergen extracts under the tongue. These methods modify the immune system’s response to allergens, leading to lasting relief.