Springtime and the nose is itchy...

Cape Town - Spring has arrived and with it the annual run of allergies.

But what exactly are allergies? They are a hypersensitivity disorder of the immune system. Allergies are caused by the immune system’s overreaction to a harmless substance, such as animal dander or pollen. A substance that causes a reaction is called an allergen. The over-eager system results in many side effects and typical clinical symptoms and signs due to the excessive release of inflammatory mediators like histamine and cytokines.

Pollen rises into the lower atmosphere throughout the day and begins to fall back to the ground as the temperature drops. Credit:

Signs and symptoms

The effects can vary, but the most common are due to airborne allergens.

Dust or pollen cause symptoms in areas in contact with air, such as eyes, nose and lungs.

Allergic rhinitis, also known as hay fever, causes irritation of the nose, sneezing, itching and redness of the eyes.

Inhaled allergens can also lead to asthmatic symptoms, caused by narrowing of the airways and increased production of mucus in the lungs, shortness of breath, coughing and wheezing.

Other more serious systemic allergies can lead to abdominal pain and vomiting because of foods, insect stings, and reactions to medications like aspirin and antibiotics such as penicillin.

When the reaction to an allergen is life-threatening it is called anaphylaxis.

This is when the airway constricts and the heart and lungs are severely effected. Adrenalin is essential in treating this condition and can save a life.


Treatment is aimed at blocking the chemical reactions that result in allergy symptoms.

Medical treatment options include steroids, used to modify the immune system in general, and other medications such as antihistamines and decongestants which reduce symptoms. There are systemic and nasal spray preparations available. Often, people request intramuscular steroid injections, but the efficacy is variable.

Non-medical options:

HEPA (high-efficiency particulate air) filters can trap some of the allergens circulating in your home. Vacuum cleaners should have the same filters or will just shoot the tiny allergens back into the air.

Patients claim results when flushed three times daily and over four to six weeks. Some even claim to use less prescription meds when doing this.

A common “recipe” for the salt-water solution is to mix a quart of water with two to three teaspoons of picking, canning, or sea salt and one teaspoon of baking soda. Store at room temperature in a covered jar or bottle.

Don’t use standard table salt, due to the presence of iodine and other additives. A drop or two of Eucalyptus oil can also be added and is said to constrict the blood vessels, reducing the inflammation. Irrigate each nostril with about one-half cup of the solution, a few times daily for acute conditions or once daily for maintenance.

Allergy shots or immunotherapy offer a permanent solution. By injecting small but increasing amounts of an allergen under the skin, you can gradually get your immune system used to it. Eventually, even large amounts may not trigger symptoms. This approach takes time – usually months – and it’s not always successful.

What is immune system hypersensitivity?

Allergy is one of four forms of hypersensitivity and is formally called type I (or immediate) hypersensitivity.

Allergic reactions are distinctive because of excessive activation of white blood cells called mast cells and basophils by a type of antibody called Immunoglobulin E (IgE).

This reaction results in an inflammatory response which can range from uncomfortable to dangerous. - Cape Argus

He features on 567CapeTalk, and is a regular guest on SABC3 and the Expresso show. Dr Green works as an emergency medical practitioner at a leading Cape Town hospital and completed four years of training as a registrar in the specialisation of neurology.