Summer brings warm weather, outdoor activities, and allergens like grasses, weeds, and tree pollen in the air. Patients with allergies will have more frequent and severe symptoms during the summer. It’s crucial to identify your patients’ triggers, relieve their symptoms, and help them avoid suffering.

Summer Allergies

Summer allergies are most frequently in reaction to pollen produced by grass, weeds, and trees. Tree pollen is most common in spring, while grass and weed pollen peak in summer and fall. 

Since these allergens are inhaled, most symptoms are respiratory. Common manifestations are sneezing, itching, watery and itchy eyes, running nose, ear fullness, and congestion. Other manifestations are allergic conjunctivitis and sinusitis. Seasonal allergies often worsen asthma.

Identifying Summer Allergies

Patients with allergy symptoms may find it difficult to identify their triggers. Ask them to keep a symptom diary to help differentiate perennial allergies from seasonal ones.

The seasonality gives clues to the cause. Trees produce pollen in early spring. Grass pollen is most troublesome in late spring and summer. Ragweed, Canada’s most common summer allergy, produces pollen from late August until the first frost. A definitive diagnosis can be confirmed by skin prick testing.

Summer Allergies — Treatment

Allergy symptoms differ in severity and frequency among patients. The treatment will vary accordingly:

Episodic symptoms. Oral or nasal H1 antihistamine and oral or nasal decongestant

Seasonal or perennial mild symptoms. Nasal steroid, and oral or nasal H1 antihistamine or a leukotriene-receptor antagonist

Moderate or severe symptoms. Nasal steroid, or nasal steroid plus nasal H1 antihistamine. Allergen immunotherapy for patients not relieved by drugs.

Nasal decongestants are more effective than oral but must be used briefly to avoid rebound congestion. Intranasal steroids (glucocorticoids) are the most effective therapy for seasonal allergic rhinitis. Allergen immunotherapy can be given by subcutaneous injection or sublingually and requires readiness to manage anaphylactic reactions. 

Preventing Summer Allergies

You can predict the onset of summer allergies and advise timely precautions. Preventative medication is most effective if started before symptom onset. Immunotherapy before the allergy season also is useful.

Advise your patients about measures to reduce their allergen exposure and allergic symptoms, which can include:

• Monitor their local pollen bulletins
• Begin or step-up their preventative medication as advised (oral antihistamines and/or nasal steroids)
• Try remaining indoors when wind speed and pollen count are high
• Reduce outdoor sports, camping, and other activities
• Keep windows shut, especially on hot and dry days
• Install particle filters in cars
• Shower and change clothes after outdoor activities

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