Now that it is officially Spring, many people will begin to feel the unwanted allergic symptoms of hay fever (i.e., allergic rhinitis). In the Washington, DC, Northern Virginia, and Maryland metropolitan area the allergens responsible for these symptoms are mostly due to the tree and grass pollens. If someone continually notices allergic symptoms throughout the year, then they may also be allergic to other allergens such as dust mites, molds, weed pollen, cats, dogs, and/or cockroaches. The typical allergic symptoms that are characteristic for this time of year may include some or all of the following: runny nose, nasal congestion, post-nasal drip, sneezing, itchy nose, itchy eyes, watery eyes, puffy eyes, redness of the eyes, dark circles under the eyes, itchy throat, snoring, wheezing, shortness of breath, chest tightness, coughing, fatigue, headaches, sinus congestion, and/or sinus pain.
In many individuals, their underlying environmental allergies predispose them to sinus issues. Patients with sinus problems should be skin tested for allergies to environmental allergens by an board certified allergist to see if there is an underlying allergy that is predisposing them to sinus symptoms. In some, it is just a matter of experiencing mild sinus congestion, nasal congestion, post-nasal drip, and/or sinus pain. Often there is associated discolored nasal mucus with colors ranging from light yellow to green to brown. In others, the sinus symptoms can be debilitating resulting in a poor quality of life. Many develop sinus infections (i.e., sinusitis) as a result of their underlying allergic diathesis. There are 3 types of sinusitis: acute sinusitis, chronic sinusitis, and recurrent sinusitis. Below each one is discussed a little further:
Acute sinusitis: This is the most common type of sinus infection. It is usually caused by the development of an infection with either a virus, bacteria, fungus, or rarely a parasite. Most cases of acute sinusitis are caused by viruses. Many of these infections are self-limited and they will resolve on their own. It may be helpful to use saline irrigation, antihistamines, decongestants, mucus-thinning medications, nasal sprays, and/or over the counter analgesics in selected patients. It is however not uncommon for a viral acute sinus infection to be secondarily infected with a bacteria. If this occurs, it is important that one see their board certified allergy doctor, as it is usually necessary in this case to treat the bacterial acute sinus infection with a course of antibiotics. In recalcitrant cases, it may be necessary to use longer courses of antibiotics to completely rid the sinuses of the causative bacteria.
Chronic sinusitis: This type of sinus infection is not as common as an acute sinus infection and usually results from a non-complete resolution of an acute sinus infection. Chronic sinus infections are more difficult to treat, however, they can be eradicated most of the time. They are usually caused by bacteria or a fungus. The symptoms that one exhibits when they have a chronic sinus infection may be the same as with an acute sinus infection, however, the symptoms may be much more indolent. It is therefore not uncommon for individuals with chronic sinus infections to only have one or more of the following non-specific symptoms: cough, sore throat, chest congestion, wheezing, and/or headaches. The diagnosis of chronic sinusitis may be difficult and elusive due to its non-specific symptoms that often present in these individuals. The diagnosis is generally made by obtaining a CT scan of the sinuses. The treatment is usually a prolonged course of antibiotics for generally a 30 day course. It may be necessary to repeat another prolonged course of antibiotics if the symptoms resolve and then re-occur. In rare instances, sinus surgery may be needed. If one suspects a chronic sinus infection, it is necessary to see your allergist, so that treatment can ensue.
Recurrent sinusitis: This type of sinusitis manifests itself as an acute sinus infection that is treated and re-occurs usually within 1-2 months of completing a course of antibiotics. It can continue to re-emerge and it is not uncommon for some patients to have 6-8 sinus infections per year! In patients with recurrent sinusitis, it is imperative that they seek advice of a board certified allergist/immunologist like the ones at Black & Kletz Allergy who have decades of experience in diagnosing and treating these types of sinus problems. In individuals with recurrent sinusitis, it is important for the allergist to do an immune workup, in addition to skin testing for environmental allergies, in order to ascertain if there is an immune deficiency. If there is an immune defect, then intravenous immunoglobulin or subcutaneous immunoglobulin therapy can be implemented to “reverse” this immunodeficiency and thus prevent further sinus infections.
If you suffer from hay fever (i.e., allergic rhinitis), asthma, or sinus-related symptoms, please call Black & Kletz Allergy and schedule an appointment with one of our board certified allergists. They specialize in both pediatric and adult allergy, asthma and immunology. Black & Kletz Allergy has 3 locations in the DC metro area with offices in Washington, DC, McLean, VA (Tysons Corner, VA), and Manassas, VA. All office locations have on-site parking and the Washington, DC and McLean, VA offices are also Metro accessible. We also offer a free shuttle that runs between our McLean, VA office and the Spring Hill metro station on the silver line. In addition to calling one of our 3 office, you may click Request an Appointment and we will respond within 24 hours by the next business day. The allergy doctors at Black & Kletz Allergy have been treating allergies, asthma, immune disorders, and sinus disease for more than 50 years. We use the most current leading-edge diagnostic techniques along with the administration of a variety of medications [i.e., allergy shots (allergy immunotherapy), biologicals, nasal sprays, antihistamines, eye drops, decongestants, leukotriene antagonists, etc.] in order to diagnose and treat each specific patient’s unique condition(s) that ultimately results in an improved quality of life for that individual. We make it a point to cater specific therapies to each individual’s needs and desires.