By contributor
updated 3/24/2004 9:05:06 AM ET 2004-03-24T14:05:06

After months of biting cold and bitter winds, most people welcome the sight of the first bloom of spring. They’re the ones without springtime allergies.

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Seasonal allergies, commonly referred to as hay fever (even though they may have nothing to do with hay and don’t involve fever), can seem like a stubborn cold. The symptoms -- including stuffy, runny nose, sneezing and wheezing -- certainly match the misery of a cold. But hay fever carries some telltale signs, the seasonal nature of symptoms being the major one.

If it seems like you get a "cold that won’t quit" at the same time every year, chances are it’s a seasonal allergy, says Dr. Christopher Bates of the National Jewish Medical and Research Center in Denver, a leading U.S. allergy and asthma center.

In the spring, tree pollen is the primary culprit in triggering hay fever, although in more humid areas outdoor mold can also spawn similar symptoms. Tree pollen can start to be a problem as early as February, according to Bates.

In general, itchiness in the eyes, nose, throat and even the roof of the mouth helps distinguish hay fever from a cold. Colds and hay fever also have very different causes. Allergies arise from an abnormal immune system response to substances in the environment. In diagnosing allergies, doctors can test for which specific environmental trigger or triggers are at the root of the problem.

Finding the culprit
Even though symptoms and their timing can indicate a springtime allergy, testing is the only way to confirm it and weed out which substances are causing the misery, Bates says.

Learn how allergic reactions occurIt’s true that tree pollen is the main culprit behind allergies that take their leave once spring has passed. But many people with allergies are sensitive to a number of substances; hanging out with the neighbor’s cat could also be contributing to those springtime sniffles.

In addition, people tend to seek treatment only when symptoms get severe, notes Dr. Jonathan Bernstein, an allergy specialist at the University of Cincinnati College of Medicine.

So even though you might be bothered enough to see a doctor only in the spring, it’s possible that other allergens -- perhaps the grass pollen predominant in summer or the weed pollen that abounds in autumn -- are producing milder reactions.

The usual method for diagnosing allergies is the skin prick test, which involves making a small break in the skin -- typically on the arm or back -- to introduce a tiny amount of a specific allergen, or substance that causes an allergic reaction. If the skin shows a reaction that looks and itches like a bug bite, that denotes an allergy to the substance.

In cases where the skin prick test results are unclear, doctors may inject a small amount of allergen under the skin with a syringe.

Confirming an allergy with diagnostic tests is "strongly recommended," according to Bernstein. "We have to really take the diagnosis of allergies seriously."

This is because a proper diagnosis sways treatment. For one thing, knowing which substances spark symptoms may allow an allergy sufferer to avoid the trigger.

Learn how to treat allergiesBernstein also points out that some people who appear to have seasonal allergies actually have non-allergic rhinitis. Their hay fever-like symptoms may be brought on by things like changes in temperature and humidity. Antihistamines, a mainstay of allergy treatment, are ineffective for people with non-allergic rhinitis, Bernstein says.

In addition, a specific diagnosis is necessary if the treatment of choice is allergy shots, which expose a person, over time, to small amounts of the allergy-causing substance in order to normalize the immune response.

This tactic often tackles hay fever, but if a person’s allergies are truly confined to the tree pollen of spring, allergy shots are probably unnecessary, Bernstein notes.

Alternative tests
Another testing option is a blood test that detects IgE antibodies, which are produced by the immune system in allergic reactions. However, it’s typically used only for people who cannot take the skin test because of a skin condition, such as eczema, or because they’re on certain medications. Some drugs, including antihistamines and antidepressants, interfere with skin test results.

There are some nontraditional tests purported to detect allergies, but experts say only the standard tests are proven to work.

Among the alternative tests the American Academy of Allergy, Asthma & Immunology considers unacceptable are applied kinesiology, which involves using muscle relaxation to uncover signs of allergy, and "provocation and neutralization" testing. This method involves injecting a person with a substance, and if there is an allergic reaction, injecting more of the substance to supposedly neutralize the response -- a potentially dangerous tactic.

According to Bates, most people find standard skin prick testing a fairly simple affair. It makes only a small puncture at the skin’s surface, and takes about 15 minutes to show whether a suspect substance is the guilty party.

If there is a skin reaction, it goes away quickly, Bates says, and a dab of a topical antihistamine like Benadryl will ease the itch.

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