• Allergic shiners – dark circles under the eye due to chronic nasal congestion
• Allergic crease – visible line in skin across middle of nose caused by constant rubbing
• Allergic salute – upward rubbing of the nose to decrease itch
• Itching of the nose, ears, mouth or throat
• Sneezing, watery nasal discharge
• Nasal congestion
• Snoring
• Dry, irritated or sore throat
• Chronic cough
• Continuous throat clearing
• Headaches
• Fatigue

• Periodic flares that usually occur during plant-pollinating seasons
• Spring season for trees
• Late spring and early summer for grasses
• Autumn for weeds

• Symptoms occurring year-round
• Caused by allergens such as animal dander, dust mites, molds, cockroaches
• Can occur after several weeks or months of daily exposure

• Genetics play an important role in the development of allergies.
  • About 20-30% of general population has allergies
  • 30-40% of children have allergies
  • Each child has 80% chance of becoming allergic if both parents have allergies,
• Inhalant allergens (pollens, animal dander, dust mites and molds) are the most frequent triggers.

• Adults – decreased work performance
• Children – more likely to exhibit shyness, depression, anxiety, fearfulness and fatigue
• Contributes to two million school absences each year
• Risk of child’s learning ability impairment in poorly controlled AR

• Often present together
• Share a common respiratory pathway
• Asthma flares more frequent during pollen seasons
• Asthma symptoms decreased with effective AR treatment (Read more about asthma)

• Mucosal drainage dysfunction
• Nasal mucosal swelling
• Increased mucous production

• Allergic children more susceptible to both AR and ear infections
• Fewer ear infections from improved nasal functioning due to AR treatment

A small sample of an allergen (pollen, grass, animal dander, mold, food) is applied to skin, assessing for reaction or hive to appear.

Our allergists have access to samples of 100+ allergens to determine which allergens to test for based on medical history, environmental survey and physical examination.

Once allergens are placed, results are read in 20 minutes.

• First-generation antihistamines
  • First developed, most available over-the-counter meds used alone or in combination with decongestants
  • Common brand names: Benadryl, Dimetapp, Chlortrimeton
  • Reduce symptoms of sneezing, itching, runny nose and eye irritation but have little effect on congestion
  • Usually work in 1-3 hours
  • Possible side effects – tiredness, dizziness, impaired driving and ability to operate heavy equipment, dry mouth, constipation and difficulty urinating
  • Should be used cautiously
• Second- and third-generation antihistamines
  • Very effective, typically do not cause many side effects
  • Cause less fatigue than first-generation antihistamines
  • Second-generation brand names: Astepro, Astelin, Patanase, Zyrtec, Claritin
  • Third-generation brand names: Clarinex, Allegra

• Reduce nasal congestion
• No effect on sneezing, itching or eye symptoms
• May be most effective in combination with antihistamines

• Should only be used for short duration (three days)
• Can cause rebound congestion after stopping if used for prolonged periods

• Treatment for both seasonal and perennial AR
• Work best when taken regularly on daily basis
• Rapid onset of action (12-24 hours)
• Increasing evidence of effectiveness if used intermittently

• Have been found helpful to modify effects of leukotrienes, which cause inflammation and bronchial constriction
• Can contribute to nasal congestion
• Common brand names: Singulair, Accolate, Zyflo

• Other treatments are failing or ineffective
• Medications cause side effects
• Symptoms occur for a significant part of the year and require daily medications
• Patients/families prefer long-term decrease in allergic inflammation and minimal medication exposure
• Children are at higher risk of developing asthma