Cosmetic Surgery: Spring Allergies: How a Nose Specialist Deals with His

Photo Credit: SpooSpa

Ah, springtime. Trees, grasses and other plants return. The world looks green and better. Except for those of us with inhalant allergies. The lining tissues of the nasal passages swell, the nose becomes stuffy. This gives rise to the pressure sensation, headache, difficulty breathing, itching, sneezing, post-nasal drip, coughing and sometimes even loss of taste, due to temporary loss of smell.

While allergies are rarely "cured" (they represent a mismatch with the environment), relief of symptoms is the goal. And, while some people have long-standing breathing problems because of a deviated nasal septum or nasal fracture, even they can obtain relief when further burdened by an allergic attack.

The following treatment plan has been effective, for me and my patients, to relieve the burdensome nasal symptoms.

I use two nasal spray medications. First, Afrin, or Otrivin, well-known, non-prescription spray-mists, which shrink the lining of the nose and provide almost instantaneous relief from the blockage and pressure sensations. This drug, a cousin of adrenaline, shrinks the internal nose's blood vessels, which are dilated maximally as part of the body's reaction to the inhaled allergens. Typically, I will spray four sprays into each nasal passage, wait four minutes, and then again install four sprays into each nasal passage. It is important to allow that four-minute waiting period, since the initial sprays will shrink only the swollen front portion of the nasal interior. Following the pause, the second round of sprays will then gain access to the back portion of the nasal passages.

While it is easy to fall in love with the effectiveness of these sprays, the user is reminded that after five to seven days, there comes the "rebound effect", whereby the internal nose becomes intolerant to the spray that now does less and less. Some unfortunates become habituated to its use. I once had a physician-patient who had become so hooked, he sported an Afrin-containing holster on his belt!

The second medication is a prescription cortisone nasal spray. Brand-names include Flonase, Nasalide, Nasacort, Vancenase, Beconase, Nasonex. The mission of these sprays is to blunt the biochemical reaction that the offending invisible allergic particle has incited, causing the swelling of the tissues. These sprays are designed for long-term use; there is no tolerance developed. However, there is a several day "ramp-up" before the medicine reaches peak effect, hence the wisdom of utilizing, temporarily, the immediate-action oxymetrazolamine to provide relief until the steroid spray kicks in.

Non-prescription decongestant nasal sprays last eight to twelve hours; the prescription cortisone nasal sprays typically last twelve hours. For the first week of treatment while waiting for the cortisone to take effect, as both sprays are being used, I use the decongestant first. One half-hour later, the steroid spray, now entering an unblocked nose has room to work its magic.

Incidentally, the same program works for the common cold. In that case, the nasal tissues become swollen because of the reaction to the cold-causing virus.

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