Hay fever, a common allergic inflammation, affects millions of Americans every year.

Allergies, including the common condition known as hay fever, affect an estimated 40 to 50 million people in the United States. Also known as allergic rhinitis, hay fever is a common condition hallmarked by symptoms such as a runny nose, sneezing, nasal congestion, itching and watery eyes. In the last year, 16.9 million adults and 6.7 million children were diagnosed with the condition.

What does it mean?

The name hay fever was originally coined because of symptoms in the late summer and fall that were believed to be due to the harvesting of hay. Similar symptoms in the spring were dubbed rose fever since they occurred about the time roses began to bloom. We now know the symptoms are due to pollens (trees in the early spring, grass later in the spring/summer and weeds in the late summer/fall) and mold allergens (which can occur year-round when temperatures are above freezing with no snow cover), and call the condition seasonal allergic rhinitis (SAR). Year-round symptoms are called perennial allergic rhinitis, which are typically due to indoor allergens and mold. The most common indoor allergens are dust mites, followed by furry animals. Other indoor allergens include mold, cockroaches and mice.

How does hay fever develop?

Allergies are triggered as your immune systems response to genetically predisposed allergens, initiating a chemical release made by the body and released into the tissues that leads to allergy symptoms. Allergies can occur at any age; sensitivity can be detected through exposure to allergens even in infancy during the first year of life. Allergic asthma that occurs early in life can also increase in severity if not recognized and treated by an allergist. While more than 50 percent of people develop allergies in childhood, it is a myth that children outgrow allergies and that they become more rare later in life. Recent studies have shown it is not uncommon for people to develop late-onset allergies.

Allergy symptoms are your immune systems response to genetically predisposed allergens.

Is it a cold or allergies?

Although cold and allergy symptoms are similar, a common cold is caused by a rhinovirus, starts mild, escalates and peaks at about day four and is resolved in seven to 10 days. Depending on the allergen that affects an individual, allergy symptoms may be more immediately severe, caused by multiple factors and may last hours, days, weeks or year-round. Seasonal allergies tend to escalate during their peak time, while perennial allergies may fluctuate from chronic to severe, and can often be confused with infectious sinusitis or bronchitis.

How can I manage them?

Seasonal allergic rhinitis is diagnosed through a careful medical history and physical exam from an allergist. It might not be much of an exaggeration to say that nearly everyone who suffers from SARtries over-the-counter medications before seeing a doctor, yet only a small percentage finds adequate relief. Surveys conducted by the American College of Allergy, Asthma & Immunology (ACAAI) found that nearly half of allergy and asthma sufferers surveyed reported that they self-identify as having moderate to severe allergies. These people can benefit from seeing a board-certified allergist/ immunologist (BCAI) to identify what they are clinically allergic to and whether they would benefit from starting allergen immunotherapy, also known as allergy shots.

Treatment is like a three-legged stool: education about avoiding what you are allergic to, effective  medications and allergy shots. Once a patient with moderate to severe allergies sees a BCAI to receive a proper diagnosis and identification of allergen sensitivity, an individualized plan can be developed and the patient can start experiencing relief.

10 ways to improve indoor air quality and reduce your allergen exposure

  1. No smoking inside the home at any time.
  2. Measure the indoor humidity with a digital humidity and temperature monitor and keep it below 50 percent. Do not use vaporizers or humidifiers; you may need a dehumidifier. Use vent fans in bathrooms and when cooking to remove moisture. Repair all water leaks.
  3. Remove wall-to-wall carpets from the bedroom if possible. Use a central vacuum or a vacuum with a HEPA filter regularly. Remember, it takes over two hours for the dust to settle back down.
  4. Wear an N95 particulate mask (Centers for Disease Control (CDC) NIOSH rated) when vacuuming, sweeping or doing yard work to reduce your exposure to fine particulates and allergens.
  5. Keep pets out of the bedroom at all times. Use a HEPA Air Cleaner in the bedroom withan adequate CADR (Clean Air Delivery Rate) for the size of the room.
  6. Encase mattresses and pillows with mite-proof covers. Wash all bed linens weekly using hot water.
  7. Install a MERV 11 or 12 disposable high-efficiency media filter in the furnace and air-conditioning system. Change the filter every one to three months (with the change of the seasons) to keep the air cleaner year-round.
  8. Leave a fan on to create whole house air filtration and remove particles that may trigger allergies and asthma.
  9. Have your heating and air-conditioning units inspected and serviced every six months.
  10. Vent gas appliances and fi replaces to the outside and maintain them regularly.

Dr. James L. Sublett, M.D., FACAAI, is the ACAAI vice president and co-founder/managing partner of Louisville, Ky.-based Family Allergy & Asthma. He is clinical professor and the section chief of pediatric allergy at the University of Louisville School of Medicine and is the founder and chairman of AllergyZone LLC, a company dedicated to developing products for the relief of allergy and asthma. Dr. Sublett is also past president of the Joint Council of Allergy, Asthma & Immunology.