This year so far it has been much warmer than usual for Winter. Typically in the Washington, DC Northern Virginia, and Maryland metropolitan area, trees begin to pollinate in March. Over the last few years however, tree pollination began in February. This year, we have seen tree pollen in the air in January and February! For many individuals, tree pollen is the cause for terrible hay fever (i.e., allergic rhinitis) symptoms. In addition to hay fever, tree pollen can and does exacerbate asthma symptoms in those who are allergic to trees and also have asthma. Some of the first trees to pollinate in this area include cedar, maple, elm, alder, birch, and poplar. Later in the Spring season, the principal tree that causes difficulties for people with tree pollen allergies is the oak tree. Other trees that pollinate during this later time frame include walnut, hickory, and pine.
Interestingly, it is not the flowering trees that generally cause allergy symptoms. Most people think that in the Washington, DC area that the cherry blossoms are a major cause of allergies. In fact, cherry blossoms rarely cause allergies but they tend to bloom when other trees that cause allergies in the area pollinate. People either suffer from tree pollen allergies or see others suffer from tree pollen allergies and associate the blooming of the cherry trees with allergies. It is the “ugly” non-flowering trees that tend to cause allergy symptoms. Why, you may ask? Flowering trees (e.g., dogwood trees, cherry trees, redbud trees, magnolia trees) are pretty for a reason. The pollen from flowering trees is relatively heavy. Since the pollen is heavy, it needs the help of bees to help cross-pollinate. The abdomen of the bees land on the pollen of a flower after being attracted to the flower. The bees then land on another flower and the pollen from their abdomen cross-pollinates the other flowers. Non-flowering trees (e.g., maple trees, oak trees, birch trees, hickory trees), on the other hand, have much lighter pollen which is easily wind dispersed. They cross-pollinate by releasing their pollen into the air and having it blow to other trees. It is the result of this wind dispersal that leads to people becoming allergic to tree pollen. Individuals inhale the tree pollen and they may become sensitized to the pollen which manifests itself by the classic allergy or asthma symptoms.
What are the allergy symptoms for tree pollen allergies? The classic symptoms may include runny nose, nasal congestion, post-nasal drip, itchy nose, itchy throat, itchy roof of mouth, sneezing, sinus congestion, sinus headaches, itchy eyes, watery eyes, puffy eyes, dark circles under the eyes, and/or redness of the eyes. Other less common symptoms may include fatigue, sore throat, snoring, hoarseness, itchy skin, coughing, and/or feeling like you are in a “fog.” Tree pollen can also trigger asthma or even cause asthma symptoms in those who have never had asthma or asthma symptoms. The classic symptoms of asthma may include chest tightness, wheezing, coughing, and/or shortness of breath.
The diagnosis of tree pollen allergies begins with a comprehensive history and physical examination by a board certified allergist. Allergy testing by skin testing or blood testing is often performed in order to determine if the allergies are caused by tree pollens or other allergens such as molds, grasses, weeds, and/or dust mites. In addition to finding out what the patient is allergic to, the degree of the allergy can be ascertained by the severity of the reaction on skin testing or the degree of positivity on the blood tests.
The management of tree pollen allergies begins with avoidance or prevention, if at all possible. Individuals are encouraged to monitor the pollen counts which can be tracked on the top right of our homepage by clicking Today’s Pollen Count. In one’s car, it is advisable to keep one’s windows and sunroof closed and to turn on the air conditioner and change the air filters regularly (about once a month). Use the re-circulate feature in the car so that the air is not coming into the vehicle from the outside. Choose an automobile that has a filter in its air conditioning unit, if possible. Stay indoors wherever possible when the pollen count is high (i.e., generally on dry warmer days). It is important to realize that rain washes away pollen from the air causing pollen counts to be lower on wet cooler days. Since pollen is released in the early mornings, try to avoid exercising during this time. If a person goes outdoors, shower, wash one’s hair, and change one’s clothing before returning home in order to lessen one’s pollen exposure. Avoid drying clothes outdoors when the pollen count is elevated. Avoid yard work and mowing lawns, if possible. If one needs to do yard work, wear a filtration face mask in order to reduce exposure to the tree pollen. Avoid contact lenses which may trap pollen in one’s eyes. Wash one’s pets regularly and avoid close contact with a pet that goes outside during the pollen season since pets carry tree pollen on their coats.
The treatment of tree pollen allergies varies depending on how severe the patient’s symptoms are and if and how the trees affect and alter the desired lifestyle of the individual. Some people do not mind staying indoors in the Spring where others want to participate in outdoor activities such as golfing, jogging, baseball, etc. Oral antihistamines [Clarinex (desloratadine), Allegra (fexofenadine), Zyrtec (cetirizine), Claritin (loratadine), Xyzal (levocetirizine)] and nasal corticosteroids [Flonase (fluticasone), Nasonex (mometasone), Nasacort AQ (triamcinolone), Rhinocort Aqua (budesonide)] are usually the first medications prescribed in individuals that have tree pollen allergies. Oral decongestants [Sudafed (pseudoephedrine)] may be useful in certain patients with nasal congestion assuming there is no contraindication for using them such as hypertension. Other medications may be used and some of these may include oral leukotriene antagonists [i.e., Singulair (monteleukast)], nasal antihistamines [i.e., Patanase (olopatadine), Astelin (azalastine)], nasal anticholinergics [i.e., Atrovent (ipratropium bromide)], and various eye drops. For the treatment of asthma induced by tree pollen, inhaled corticosteroids, leukotriene antagonists, long acting beta 2 agonists, and/or short acting beta 2 agonists are utilized.
The board certified allergists at Black & Kletz Allergy have 3 offices in the Washington, DC, Northern Virginia, and Maryland metropolitan area and treat both children and adults with tree pollen allergies. We have offices in Washington, DC, McLean, VA (Tysons Corner, VA), and Manassas, VA. Black & Kletz Allergy offers on-site parking at each of their 3 office locations and the Washington, DC and McLean, VA offices are also Metro accessible. There is a free shuttle that runs between our McLean, VA office and the Spring Hill metro station on the silver line. To make an appointment, please call our office or you can click Request an Appointment and we will respond within 24 hours on the next business day. Black & Kletz Allergy has been serving the asthma and allergy needs of the Washington, DC metro area community for more than 5 decades and we strive to offer the highest quality allergy and asthma care in a compassionate and specialized environment.