Every year, it seems that the news headlines proclaim that the current allergy season is “the worst” ever. So when headlines started popping up this year about the biggest, baddest allergy season yet, Healthland decided to ask Dr. Alan Omid Khadavi, an adult and pediatric allergy and asthma specialist in Los Angeles, for the lowdown.
Q: So are we currently having the worst allergy season ever? And how do you measure that anyway?
A: The most objective measurement is pollen counts. And it does seem like we’re having the “worst” allergy season [this year], because they are the highest that we’ve had in the past 10 years. For most patients, it seems like every year is the worst and that’s partially because people forget about their allergies during the winter.
(More on TIME.com: Get Out the Kleenex — Climate Change Lengthens Allergy Season)
Q: Is this part of a general trend? Is each year always worse than the last?
A: No, actually the last couple of seasons haven’t been that bad. Allergies have been high over a certain period of time, but it really wasn’t the worst — it just seemed that way.
Q: Where did we go wrong? Why is the allergy so bad this year?
A: The long winter and the rain that we’re having have a lot to do with that. It contributed to more fertile, longer [gestating] plants. The cold winter left more time for tree pollen to accumulate and then when the weather finally turned nice, everything began to bloom all at once, causing a lot of pollen in the air.
Q: You’re out in California, so you obviously didn’t have a long, cold winter. Are there regional differences in allergies?
A: Yeah, in California we’re not seeing it as bad as on the East Coast. We have pollen all year round. Here the weather is good, so the pollen is steady, but we do have peaks. We see small rises in allergies. We’re not having the worst year ever, but the Northeast and the South both are.
(More on TIME.com: Many Restaurant Workers Don’t Understand Food Allergies)
Q: It also seems that more and more people are developing allergies. Are adult-onset allergies on the rise?
A: In general, more adults in their 30s and even early 40s are coming in with allergies. That’s a phenomenon that we’re trying to figure out. Food allergies are starting at older ages as well. But that’s because more people are having allergies in general. Most people still present at earlier ages — most new patients are children — but because there is a higher percentage of people with allergies overall, that outlier group [of adults with new allergies] is bigger as well. The proportional amount is not more than in previous years, though.
Q: What is causing this phenomenon of higher allergy rates?
A: We’re not sure, but there is one theory called the hygiene hypothesis: many years ago — 40 to 50 years ago — we weren’t so concerned about hand washing and hand sanitizers and taking antibiotics for upper respiratory infections. Now we’re very clean, we don’t allow our kids to put toys in their mouths or play in sandboxes. So when our body doesn’t have the ability to start fighting infections, it develops an allergic response. When our T cells don’t fight infections at a young age, they start to attack other compounds and that can cause allergies.
Q: That would seem to apply to both seasonal and food allergies. Does it?
A: Actually, studies have not shown that food allergies are getting worse — it’s just that more people seem to think they have food allergies. But they really don’t — the national average for food allergies is about 3% of the population.
Q: But what about peanut allergies? Aren’t they on the rise?
A: That’s not definitive. Peanut allergies are on the rise anecdotally, though it’s possibly just in the diagnosing. Seems to be going up to me — I would argue that it’s going up, but it’s not a fact — just an anecdote.
(More on TIME.com: Spring Allergies: Can They Make You Depressed?)
Q: So let’s say I’m a new adult allergy sufferer. What should I do?
A: A lot of pharmaceutical companies now have over-the-counter drugs, so when patients come to see me, they have usually tried Claritin or Benadryl. If that doesn’t work, I recommend environmental control measures: if you’re allergic to pollen, avoid going outside in the early morning — between 5 a.m. and 10 a.m. — when the pollen is at its highest concentration. Keep your windows closed, run your air conditioner. Change your clothes between outside and inside because pollen travels on your clothing. When you’re outside, wear sunglasses, so pollen doesn’t get in your eyes. Shower before going to bed, because pollen sticks to your hair and eyelashes. Environmental control is a really effective thing to do and the cheapest.
Q: What about medication. What kinds of things do you prescribe?
A: If all that doesn’t work, I’ll give someone nasal steroids as a first line of treatment. Or we’ll try antihistamine eye drops. For patients who are the most resistant to treatment, we’ll use allergy shots, which help desensitize the patients to what they are allergic to. In the case of seasonal allergies, that’s trees, grasses and weeds. Tree pollen is an early spring phenomenon of April, May and June. Grasses start to pollinate in June, July and August, and then weeds like raagweed don’t come along until August and September.