While most of us look forward to spring, native Charlestonian David Harley used to dread it.

Tips for fighting allergens

Spring means flower buds and blooming trees. And, if you're one of the millions of people who have seasonal allergies, it also means sneezing, congestion, runny nose and other bothersome symptoms.

Seasonal allergies, also called hay fever and allergic rhinitis, can make you miserable.

Try these simple strategies to keep seasonal allergies under control.

Cut exposure to allergy triggers

Stay indoors on dry, windy days. The best time to go outside is after a good rain, which helps clear pollen from the air.

Delegate lawn mowing, weed pulling and other gardening chores that stir up allergens.

Remove clothes you've worn outside; you may also want to shower to rinse pollen from your skin and hair.

Don't hang laundry outside as pollen can stick to sheets and towels.

Wear a dust mask if you do outside chores.

Act early when pollen count is high

Check your local TV or radio station, your local newspaper or the Internet for pollen forecasts and current pollen levels.

If high pollen counts are forecasted, start taking allergy medications before your symptoms start.

Close doors and windows at night or any other time when pollen counts are high.

Avoid outdoor activity in the early morning when pollen counts are highest.

Keep indoor air clean

Reduce allergens from surroundings

Use the air conditioning in your house and car.

If you have forced air heating or air conditioning in your house, use high-efficiency filters and follow regular maintenance schedules.

Keep indoor air dry with a dehumidifier.

Use a portable high-efficiency particulate air (HEPA) filter in your bedroom.

Clean floors often with a vacuum cleaner that has a HEPA filter.

Source: Mayo Clinic.

All that sunshine and warmth marked the beginning of months of suffering from seasonal allergies caused by pollen.

FAQs on the OTC

Here are of the most frequently asked questions about Nasacort Allergy 24HR.

1. Is it safe?

Not only can the new nasal allergy spray relieve congestion, sneezing and a runny nose, it does not cause drowsiness and is nonhabit forming. Improper use of nasal sprays may cause nasal bleeding. Follow the package instructions and inform your allergist if bleeding occurs.

2. Can I stop antihistamines?

If you find solely using the nasal allergy spray is helping to suppress your symptoms, you may not need to take an antihistamine. Each person is different and will have to be the judge of how they feel only using one medication. If you're not finding relief from one or both medications, however, you should speak with your allergist.

3. Is it safe for a child?

The medication is approved for children two years and older. But it may complicate some infections your child might have, so check with your allergist.

4. Can it be used year-round?

Yes, it is approved for year-round use. Many allergy sufferers that have year-round allergies to pets, dust and mold often find nasal sprays are not enough for symptom relief. Many allergists prescribe immunotherapy (also known as allergy shots), which not only provides symptom relief, but can modify and prevent disease progression.

5. Will my insurance cover it?

It is unlikely your insurance provider will cover over-the-counter nasal allergy sprays, even if it was covered when it was prescribed.

6. Do I need to keep following up with my allergist?

Allergy sprays are merely a medication and not a cure for allergy. Because allergies can change over time, it's important to be under the care of an allergist for proper testing, diagnosis and treatment that may go beyond over-the-counter medications. Allergies can also cause symptoms such as chronic sinus infections, nasal congestion or difficulty breathing.

Sources: Dr. Jeffrey Dietrich, Charleston Allergy & Asthma; American College of Allergy, Asthma and Immunology

"When the pollen started falling as soon as late February, I'd be sneezing until June," recalls Harley, a West Ashley resident who works for a local beer distributor. "I wouldn't let it (pollen) keep me from being outside, but I was miserable."

Harley tried using the over-the-counter spray, Afrin, but after months of use, he became accustomed to it and needed to use more than the recommended dosage to get relief.

"After years of suffering, my wife said, 'You need to see an allergist,' " recalls Harley, who two years ago stopped by the Charleston Allergy &Asthma office in Summerville to set up an appointment.

After an exam, he was prescribed one of an array of prescription nasal sprays, in his case Nasonex, and found the relief he needed.

"I don't dread spring anymore," says the 36-year-old, married father of two children.

OTC nasal sprays

Seasonal allergies affect an estimated 40 million Americans, according to the Centers for Disease Control and Prevention, and Charleston is among dozens of cities in the Southeast ranked among the worst in the nation for allergies caused by pollen.

As the Lowcountry trees and grasses awaken from a long hard dormancy of a cold winter, seasonal allergy season caused by pollens has arrived.

But along with it is the availability of a former prescription nasal spray, which is a corticosteroid, that is now available over-the-counter.

Last October, the Food and Drug Administration approved triamcinolone acetonide, known commercially as Nasacort Allergy 24HR, as an over-the-counter medication. TV commercials pitching it started airing last month.

Part of the pitch is that the spray works differently than other over-the-counter medications, notably oral antihistamines, in that it relieves a full range of symptoms, including nasal congestion, by stopping the chemical responses that cause those symptoms.

The American College of Allergy, Asthma and Immunology agrees, adding that the spray does so without drowsiness caused by many oral antihistamines nor does it create the dependency of other nasal sprays.

While local allergy experts say that's true, they also say the use of all nasal spray corticosteroids, such as the generic version of Flonase, work similarly.

However, the medications require a different approach in taking the medication, and Nasacort (retailing for about $12 for a .37-ounce bottle, or 60 "sprays") may not be as inexpensive as other sprays, depending on medical insurance.

The caveats

Allergist Dr. Jeffrey Dietrich of Charleston Allergy & Asthma says that sufferers need to exercise caution when using sprays and that some may still need the advice of a professional.

"Some medications merely mask symptoms without tackling the root of the allergy. And often patients will find what medication once suppressed their symptoms no longer does."

Dietrich says oral antihistamines and nasal sprays are vastly different.

While oral medication takes effect nearly immediately, Dietrich says nasal sprays require consistent daily use, as directed, and improve symptoms over time, typically a few days with significant relief in two weeks.

However, Dietrich says improper use of sprays may cause nasal bleeding and patients should be monitored periodically. He adds long-term use can cause problems, such as perforations in the nasal cavity,

Making the switch

Dr. John Ramey of National Allergy, Asthma and Uticara of Charleston says the only reason more people don't switch from oral antihistamines to more effective nasal corticosteroid sprays is knowledge about them, including the proper use of the sprays.

"People often don't know how to use them properly," says Ramey, noting that many will inhale while spraying, causing most of the medicine to go down the back of the throat instead of into the nasal cavity.

Ramey adds that he thinks nasal corticosteroids are safer than over-the-counter antihistamines, such as Benadryl, which cause drowsiness, and Afrin, which can be habit-forming.

Ramey, whose clinic posts daily pollen indexes on Facebook and Twitter, says that the severity and length of this year's winter won't have as much bearing on pollen this spring as the number of warm days without rain and cold snaps this spring.

Reach David Quick at 937-5516.