by Dr. Manav Segal, MD

Itchy eyes, sneezing, runny nose and nasal congestion — all are hallmarks of spring allergy symptoms. Does it seem like your allergies are getting worse each spring? Do you suspect you have allergies for the first time? You are probably not imagining it, because approximately one in five people suffer from seasonal allergies, and those numbers are on the rise.

For Dominique Ruggieri, Ph.D., who is a teaching faculty member for the Master of Public Health Program at the University of Pennsylvania, an uptick in her spring allergies became so incapacitating that she could no longer enjoy the outdoors. There were no more walks with her dog, eating dinner on the deck was unthinkable and plans for an outdoor vacation with her husband and 4-year-old daughter were tabled.

“Over the last few years, my allergies became debilitating,” Ruggieri said. “Colds lasted forever, I was constantly taking over-the-counter allergy medication, and my symptoms affected the quality of my life and my family’s lives. Springtime meant daily congestion, headaches and watering eyes. I used to love driving with the windows down. Last spring, we couldn’t even open the windows in the house.”

Climate change is thought to be playing a contributing role in the rising incidence of seasonal allergies. The change has affected northern states harder and has taken a particularly hard toll throughout the Delaware Valley.

In the spring, the warmer sustained climate contributes to higher carbon dioxide levels, higher humidity, and higher temperatures. This combination of factors leads to longer growing seasons and increased pollen levels. Carbon dioxide coupled with air pollutants can amplify and exacerbate allergy symptoms. Higher humidity and more rainfall will also drive up mold levels, another allergic trigger. When environmental allergies affect breathing, it frequently results in a visit to the emergency room.

“It took urging from my husband to finally get me to see an allergist,” Ruggieri recalled. “Dr. Segal explained how allergies could be impacting all of these activities that I loved, but I had no idea that treatment was about to change my life.”

I performed skin tests that revealed that Ruggieri had very high reactions to a wide variety of indoor and outdoor allergens, primarily tree and grass pollen and dog dander. I recommended allergy cluster immunization therapy, which helps to speed up the impact of allergy shots. Previously, patients would visit weekly for shots and begin feeling improvement within six months. But with cluster immunization therapy, patients visit once per week for three to four hours and are administered multiple shots. Cluster therapy dramatically shortens the timeline to results. Once at maintenance immunotherapy doses, patients reduce visits to monthly shots for a total of three years.

“Within five weeks, I was no longer taking medication for the first time in years!” Ruggieri said. “Between eight and 10 weeks, I stopped waking up with congestion, and I no longer had a reaction when walking our dog. My family has been blown away with the positive changes. This spring we are planning a hiking vacation in May. My life used to revolve around my allergies; now I’ve got my life back.”

How to Manage Seasonal Allergies

Seasonal allergies are not going away. The best offense is a good defense complete with strategies to prevent and manage allergy symptoms. There are a number of practical strategies which may include:

• Avoid: Whenever possible, avoid the conditions that cause irritation.

• Know when your allergy season occurs. Tree pollen season for the Philadelphia region runs March through April

• Stay indoors when tree pollen peaks in the early morning

• Stay indoors on hot, windy days when pollen levels tend to be higher

• Wear eye protection when biking

• Keep windows closed when driving

• Remove and wash clothes you’ve worn outside

• Shower to rinse pollen from your skin and hair

Treat: A number of prescription and over-the-counter medications can help. Use of medications should only be used as directed by prescribing information or as directed by your doctor.

• Non-drowsy antihistamines are the first line of defense: loratadine, cetirizine, fexofenadine, and levocetirzine are all examples

• Corticosteroid nasal sprays can also be used: any fluticasone nasal spray, budesonide nasal spray, or triamcinolone nasal spray

• Decongestants are helpful for nasal congestion, but side effects are common

See an Allergist: More serious allergy indications include asthma symptoms such as coughing, wheezing, and shortness of breath.

When avoidance and over-the-counter medications are not helping:

• See your allergist

• Testing can determine what you are allergic to in order to avoid specific triggers

• Testing can help determine treatments that are likely to work

• For some, immunotherapy can be a good option. Immunotherapy reduces immune system reactions and symptoms. Guided by a board-certified allergist, immunotherapy helps desensitize people to specific allergens by retraining the immune system to tolerate those allergens.

The key is to identify your seasonal allergy triggers and then work with your doctor to determine the right balance of strategies that enable you to reclaim your lifestyle and enjoy the season once again.

Segal is a leading Philadelphia-area allergist and immunologist with offices in Wyndmoor and Center City. He treats asthma and allergies in children and adults. He provides breakthrough Oral Immunotherapy (OIT) to treat severe food allergies and allergy cluster immunization therapy for seasonal allergies. Segal is Board certified by the American Academy of Allergy, Asthma and Immunology and the American Board of Internal Medicine, and is Chief of Allergy & Immunology at Chestnut Hill Hospital. Visit for more information.