UNC allergy expert gives tips to help you deal with the pollen season

We're seeing the effects of a longer pollen season in North Carolina.

The highest pollen counts are usually recorded between the last week of March and the second week of April. However, warmer temperatures during winter can mean an early start to allergy season and a more troublesome spring for allergy sufferers.

An unexpected early snap of pollen in February brought on what we're seeing now. Feb. 28 was the earliest on record that pine pollen showed up. On March 7, we saw a pollen count of 1,379, remarkably high for that point in the season.

In February, we saw:

• 11 days where the temperature reached 70 degrees
• Two days where the temperature got above 80 degrees
• An average mean temperature for the month of 53.5 degrees

All of this led to more blossoming outside and while it looked pretty, it was a burden for some people. Unfortunately, an early start to the season doesn't mean there will be an early finish. N.C. State professor Dr. Kelly Oten said said we were three weeks ahead of schedule for pine pollen in March.

"It just means we're going to have a longer season, giving our trees more time to emit pollen and unfortunately make those allergies that much worse," Oten said.

You can see a pollen report for Raleigh that's updated on a daily basis here.

Dr. Edwin Kim, Director of the UNC Allergy and Immunology Fellowship Program, is seeing the effects of this jump start to the season from patients.

Here's a partial transcript of an interview with Kim and WRAL News. You can see more of Kim's thoughts in the attached video above.

What impact does the warmer weather in February (like we saw this year) have on pollen?

"It does seem to be a trend to be going on for a few years now where it's getting warmer earlier and earlier, and so we're getting pollen earlier and then it's lasting longer as well. It seems like the winters are little bit milder at this point. It's equally important that it's not as cold as it has been in the past in December and January to really knock out a lot of that growth with those hard frosts. So, we sort of have this perpetuating pollen season that just doesn't want to go away. Now, the problem for allergy sufferers is it's catching us unprepared because it's coming before we normally expect it. Most people think March is when they have to worry."

What are the most frequent questions you get this time of year?

"The No. 1 question is 'how do I make this go away?' and 'how do I feel better?' They're very much treatment-focused questions. We've been somewhat limited on what options we have. Most people are familiar with the anti-histamine tablets like Zyrtec, Claritin, Allegra. A lot of people know about the nose sprays like Flonase and Nasonex and at the same time a lot of people don't like to put stuff in their nose. Beyond that, there really aren't a lot of options so the biggest question is how do I make it better and the follow up question to that is 'what is going on, I don't remember it being this bad last year.' For that one, it just seems like we've had a streak of warmer seasons, not a lot of hard frost to knock out the pollen and I think it's leading to more pollen and some people would argue more potent pollen."

How long is pollen season in NC? | What's a timeline over the year of the most potent kinds of pollen?

"We know that allergies can be caused by allergens both indoor and outdoor. Around where we are in North Carolina, we're mostly focused on the outdoor stuff. In springtime, most people recognize the yellow pollen that's out there. That comes from our pine trees. What I think is important for people to recognize is that there's lots and lots of other tree pollens that's coming out at the same time, sometimes earlier, that you can't see. Some of the most potent ones of those are going to be from oak trees, hickory trees as well as birch trees. Those are the ones that are heavy, heavy, pollinators and big reasons for people to have allergies. They're actually a lot bigger problem for people than pine pollen, the yellow stuff. It's just that the yellow stuff is what we see and we recognize. That tree pollen is really huge around here, these days, starting in February going through about May.

"When we get to the summer, the tree pollen usually slows down a lot and then what we're stuck with is the grass pollen. You have your Bermuda grass, you have your baseball field grass, those guys are growing like crazy. I joke with my patients and say that neighbor who's not cutting their grass and that furry stuff that's on the tip of the grass, that's all getting airborne. Mid-summer, that's really going to be grass season. In September, not only are people getting back together for back-to-school, that's classic ragweed season. All kinds of weeds are coming out from September through December, but ragweed is the one that people know the most and the most potent one that hits people in fall.

"I would think that tree pollen is the worst around here and then in a lot of places, the ragweed pollen in the fall would be the really bad stuff."

Does rain effectively wash it all away?

"It's very temporary. While it's actually raining, that's exactly what the trees want. As soon as that dries up, the trees are super excited because now they're well-watered and it's warm outside so those next couple days could be dramatically bad as the trees are pumping out a lot more pollen."

Which allergy medications and treatment methods do you usually recommend?

"What I would say treatment-wise is the nasal sprays tend to be the best. The reason for that is it goes right at the source. Those symptoms that people are getting, the congestion, the runny nose, even the eye symptoms, the darkness under the eyes, all of that really starts at the nose with all the swelling that happens in there, the nose sprays go right at the source and shrink that swelling and congestion. The problem is that a lot of people don't like to put something in their nose. We also know that the nasal steroids tend to be really slow. It really takes one or two weeks of using it. By the time you're feeling pretty miserable, you're not willing to wait that long. The tablets do work really quickly, they're really good at drying some stuff up like your runny nose and all. They're maybe not as good, not as strong at fixing the congestion. Some people don't like the idea of medicines. Another option is what a lot of people call a Neti Pot or a saline rinse. It's not a medicine so you shouldn't have any side effects from it. What that can do is wash a lot of that mucus and wash some of the pollen out, too. It's almost like, instead of washing your hands, you're washing your sinuses and getting some of that junk out."

Are allergy shots a viable treatment method?

"I wouldn't call it a last resort. It's just another option. What allergy shots are doing is actually taking exactly what you're allergic to, the specific pollens whether it's oak tree or it's ragweed and actually putting it into a medicine and giving it to your body. What we do is, if we gave it to you at a full dose, of course you would probably have allergy symptoms. So, what we do is we start with a tiny dose, big enough so that your immune system sees it but not so big that you have those outward allergy symptoms, and then each time that you get that shot we slowly ramp that dose up. The idea there is we're retraining your immune system to not be reactive to it anymore. So, it can be a really effective treatment but it's not an easy one. A lot of people don't like the idea of shots and it does require a lot of visits to the doctor's office. For the people who do it, it can be really effective."

What are some often-heard misconceptions about allergies/pollen?

"I do have a lot of patients that get concerned that foods are giving them the same symptoms. They'll come in and tell me they've got this chronic runny nose for the last three or four weeks. Or they've got this post-nasal drip and they can't get it to stop or they're really congested and they're convinced that it's the wheat that they're eating or it's got to be the dairy that they're drinking as opposed to the outdoor things that they're exposed to like pollen. What I would say there is that food is very uncommon to cause those types of symptoms and if it does cause it, it's typically just when you eat it. But as soon as you stop eating it, those symptoms should clear within a day. For people who have ongoing allergy symptoms, that's going to be much more something that you're chronically exposed to like outdoor pollens or in the house, dust mites or animal hair or something like that."

What would you say to someone reluctant to see a doctor over their allergies?

"It really is a quality of life thing. There' some people where even the smallest bit of symptoms, that's just too much for them. Others can deal with a lot. I think it's just a personal decision. For folks who the over-the-counter stuff is not enough, that's the person who should come and see us. It's two-fold. No. 1, we can help them identify what is it. If it is spring-tree pollen, if it's indoor dust, whatever, we can try to give some advice on how to minimize that exposure. I think avoidance plus medicine is going to be more effective. Then also, we can offer those allergy shots that might sort of have a stronger benefit and one of the benefits, we hope, from allergy shots is trying to change the immune system long-term. We're essentially trying to cure that allergy, which we know that the tablets and nose sprays can't do."