Pollen, pet dander, dust and mold can send some people into a sneezing or itching frenzy. If allergies are making you uncomfortable—or downright miserable—you have options.
The two most common treatments are allergy medications and allergy immunotherapy (shots). But which one should you try? Christian G. Nageotte, M.D., an allergy and immunology specialist at Henry Ford Health, explains what they offer and how to decide which might be right for you.
Allergy Medication Options
Allergy medications are the go-to treatment for millions of children and adults with seasonal allergies. These medications block histamine, a substance the body produces that triggers allergy symptoms. Newer antihistamines don’t cause the drowsiness associated with older medications, and you don’t need a prescription for most of them.
"Oral antihistamines are a good first choice for people who have mild to moderate allergies,” says Dr. Nageotte. “Be sure to read the label, though, because some aren’t safe for children under age 2.”
Most people can start by trying one type of antihistamine for two to three weeks to see if it works for them. If you don’t find relief, Dr. Nageotte says it’s reasonable to try a different type or ask your healthcare provider for a recommendation.
A variety of antihistamines are available in most pharmacies, including:
- Cetirizine (Zyrtec®)
- Fexofenadine (Allegra®)
- Levocetirizine (Xyzal®)
- Loratadine (Claritin®)
Are Allergy Nasal Sprays Better Than Pills?
Allergy & Immunology At Henry Ford
If sneezing, congestion and sniffing are your primary issues, a nasal spray may provide more targeted relief than an oral medication. “Some sprays contain an antihistamine that goes directly into the nasal tissue to target allergy symptoms,” says Dr. Nageotte. “Oral antihistamines have to circulate through your whole body to reach your nose.”
Another option is corticosteroid sprays. “Steroid nasal sprays are very effective for nasal allergies,” says Dr. Nageotte. “They don’t target histamine itself, but rather, they calm the inflammation that causes allergy symptoms.”
Don’t confuse allergy sprays with nasal decongestant sprays, though. These sprays address nasal swelling, but they’re not a daily allergy therapy.
“Decongestant sprays provide temporary relief from congestion, but they’re not designed for long-term use,” Dr. Nageotte says. “If you use them for more than a few days in a row, your nasal passages can swell even more, and your symptoms may actually get worse.”
Should You Get Allergy Shots?
If medications aren’t an option or don’t work well for you, allergy immunotherapy (allergy shots) could be your answer. Instead of blocking your body's allergic response, allergy immunotherapy trains your immune system to tolerate allergens.
The treatment involves two phases. During the build-up phase, you receive weekly injections with gradually increasing doses of allergens for up to six months. Then you enter the maintenance phase with monthly shots for about five years.
"Allergy shots have a high success rate and provide long-term relief for most patients if they complete the full course," says Dr. Nageotte. "Shots can provide remission, meaning you have no symptoms at all.”
Still, they are a commitment. The build-up phase means weekly appointments, plus a 30-minute wait after the shot to make sure you don’t have a reaction. “We also need to do allergy testing before starting immunotherapy,” says Dr. Nageotte. “The testing shows us exactly which allergens we need to target.”
For those nervous about shots, Dr. Nageotte says the needle is much smaller than the one used for vaccines or blood draws. “The needle is tiny, and it goes just under the skin, not into the muscle,” he explains. “Most people experience very little, if any, discomfort.”
Which Allergy Treatment Should You Choose?
In general, it’s reasonable to start with medications for mild to moderate allergies. If you’re not getting relief, talk to your provider about shots. “I recommend immunotherapy if symptoms are negatively impacting your quality of life or if you’re experiencing side effects from medications,” says Dr. Nageotte.
You may also want to think about:
- Schedule and lifestyle: Can you commit to weekly appointments for six months, then monthly visits for years? "You have to consider whether you’ll be able to adhere to the schedule," Dr. Nageotte says.
- Exercise habits: Allergy shots require avoiding strenuous exercise for four hours after each injection—a consideration if you have a regular workout routine.
- Medical history: Certain conditions affect whether shots are safe for you. "If you’re pregnant, on blood pressure medicine or have uncontrolled asthma, starting allergy immunotherapy isn’t recommended, although patients already on immunotherapy may safely continue shots if they become pregnant,” says Dr. Nageotte.
Finding Relief
There's no single right answer when it comes to treating allergies. Both medications and immunotherapy are effective options—they just work differently and suit different situations.
If you're unsure which approach you should choose, an allergy specialist can provide guidance. “The best treatment is the one that controls your symptoms and fits your lifestyle,” says Dr. Nageotte.
Reviewed by Christian G. Nageotte, M.D., an allergy and immunology specialist who treats children and adults at Henry Ford Medical Center - Columbus, Henry Ford Medical Center - Fairlane and Henry Ford Medical Center - Sterling Heights.
