Interview. Pollens: what are the treatments to treat allergies?

In case of allergy to pollens, the allergist will be able to guide you towards the appropriate treatment. (© Photographee.eu / AdobeStock)

Runny nose, itchy eyes, fatigue that sets in… Every year, people who suffer fromPollen allergy they fear the arrival of good weather.

Fortunately, there are effective treatments, as explained by Dr. Isabelle Bossé, an allergist.

What to do if you have a pollen allergy?

The first treatments are local: we always start with wash nose and eyes to remove the pollens which are deposited on the nasal and conjunctival mucosa.

A gesture to perform every night, using warm water compresses or possibly products such as physiological saline, nasal sprays or anti-allergy eye drops.

What if that’s not enough?

We add a antihistamine in tablets or as drops in the nose and eyes. Corticosteroids may also be prescribed, only in the form of nasal drops.

These treatments work well for mild to moderate symptoms, although some antihistamines can cause drowsiness in some people.

For childrenSuitable antihistamines are available, in the form of a drinkable suspension.

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And for asthmatics?

Or asthma is present year-round and patients are already under background treatment and in this case, it is sometimes necessary to consolidate the latter.

Or some people are ashamed only in spring ; then we established a daily treatment that includes inhaled corticosteroids alone or a combination of bronchodilators and inhaled corticosteroids.

Can it be useful to identify the allergens to which we are sensitive?

If the allergic rhinitis is very mild and does not affect the quality of life of patients, this is of little interest.

On the other hand, if moderate or even severe, patients should undergo mandatory screening, knowing that moderate to severe allergic rhinitis worsens from season to season and over time can lead to comorbidities : sinusitis, asthma, sleep problems…

Allergic rhinitis can sometimes make you smile, it’s even known as ” hay fever “ – but for 2 or 3 million people in France, it is extremely disabling. For these patients, the interest in identifying the responsible allergens is to treat the root of the problem thanks to desensitization.

Who is this desensitization for?

desensitization is the only treatment capable of curing allergy sufferers. It is used in cases of moderate to severe rhinitis that affect quality of life, but also when drugs are not effective enough.

It is a treatment that extends for several years. For pollens, we generally start four months before the theoretical start of the pollen season in question; For example, birch pollen arrives in March, so we start treating in December.

The treatment lasts until the end of the pollen season: about six months a year, for at least three consecutive seasons. It can be continued for two additional years depending on the results.

What techniques are used?

The allergenic immunotherapies that are practiced are sublingual, in the form of drops deposited daily under the tongue. There are also pills for allergies to grasses.

There is another technique: it consists of an injection on the shoulder performed by the allergist, every week for eight weeks and then once a month. This is the most widely used mode of treatment in the world, but it is currently abandoned in France.

It will be done again at the end of the year for dust mite allergy and a little later for grass pollen, probably in early 2023.

Regardless of the technique used, desensitization has proven its effectiveness: between 50 and 70% of treated patients see their condition improve or be completely cured.

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