Allergy treatment in Puerto Rico: allergic rhinitis symptoms and video visits

Allergic rhinitis symptoms

Some symptoms start soon after contact with your trigger, and others develop later:

• Sneezing
• Runny nose with clear mucus
• Stuffy nose
• Itchy nose, mouth, eyes or throat
• Watery eyes
• Dark circles or puffiness under the eyes
• Cough, sore throat or throat clearing
• Tiredness and poor sleep from congestion

Common allergy triggers

Allergic rhinitis can be seasonal (from tree, grass and plant pollen) or year-round. The most common year-round triggers are dust mites, mold, pet dander and cockroaches.

Allergies run in families: a child is more likely to have them if one parent does, and much more likely if both parents do.

Allergies in Puerto Rico: humidity, mold and cockroaches

In a warm, humid climate like Puerto Rico’s, two triggers deserve special attention. Mold grows wherever there is moisture, leaks or flooding, and can cause a stuffy nose, cough, burning eyes and skin rash. The CDC recommends keeping indoor humidity at 50% or lower with air conditioning or a dehumidifier, and fully drying anything wet from flooding within 24 to 48 hours, for example after a hurricane.

Cockroaches live year-round in warm climates and are hard to get rid of; the allergy is caused by their droppings and body parts, not the insects themselves. Having them doesn’t mean a home is dirty. If you have just moved to the island and your allergies changed, new triggers like these may be why.

Allergy treatment options

The best treatment is avoiding your triggers, though that isn’t always possible. The most used medicines are:

• Steroid nasal sprays: the most effective treatment, working best when used every day during your season. Several are sold over the counter.
• Antihistamines: as pills, liquids, nasal sprays or eye drops. Some cause drowsiness; others hardly do. If one makes you sleepy, don’t drive.
• Decongestants: ease a stuffy nose, but decongestant nasal sprays should not be used for more than 3 days in a row.
• Saline nasal rinses: wash mucus and allergens out of the nose.
• Other prescription medicines, such as leukotriene inhibitors, and immunotherapy (allergy shots) when symptoms are hard to control.

Allergies, a cold or a sinus infection?

A cold is caused by a contagious virus, comes on gradually, often brings thick mucus and sometimes fever and aches, and lasts 3 to 10 days. Allergies aren’t contagious, flare as soon as you meet your trigger, cause clear mucus and itchy eyes, never cause fever, and can last weeks or months.

A sinus infection causes facial pain or pressure, thick mucus and sometimes fever, and often follows a cold. Poorly controlled allergies can lead to sinus infections. If your eyes are red and itchy too, see pink eye.

Allergies in children: age limits on antihistamines

Allergy medicines for children should be given only on a doctor’s advice, even when sold over the counter. Not every product is approved for every age: each label says the minimum age, and the dose depends on the child’s age and weight. Follow the label and ask before giving an adult product.

According to the American Academy of Pediatrics (AAP), "old-generation" antihistamines cause drowsiness, so if used they are best given in the evening. Several steroid nasal sprays are approved for children as young as 2. Decongestants taken by mouth can make children jittery, anxious, give them a racing heart or trouble sleeping, and are best not used daily for long periods.

Be careful with "cough and cold" products: the AAP does not recommend them under age 4, and from 4 to 6 only if a doctor advises it. The doctor sees children from 6 months with a parent or guardian on camera, and she is not a pediatrician; if your child wheezes or is short of breath, it could be asthma and needs assessment. See video visits for children.

What happens in the visit, and when to see an allergist

In an online doctor visit, the doctor asks about your symptoms, when they get worse, what sets them off and what you have tried. She then suggests a plan and, if appropriate, can prescribe medication. We do not prescribe controlled substances.

See an allergy specialist if your symptoms are severe, a treatment that used to work no longer does, you don’t respond to treatment, or you want to know whether immunotherapy is right for you. Allergy testing is done in person. If you have asthma, see asthma.

Frequently asked questions

How can I tell allergies from a cold?

Allergies cause itchy nose and eyes, sneezing and clear mucus, with no fever or aches, and can last weeks. A cold comes on gradually, sometimes with fever and thick mucus, and clears in 3 to 10 days.

What is the best treatment for allergic rhinitis?

Avoid your triggers when you can; for symptoms, steroid nasal sprays are the most effective treatment. Antihistamines help with itching and sneezing. The doctor can help you choose based on your symptoms and health.

When is an allergic reaction an emergency?

When there are signs of anaphylaxis: swelling of the face, lips or tongue, trouble breathing, wheezing, a hoarse voice, or hives together with any of those. Call 911 and use epinephrine if it has been prescribed for you.

Related pages

• Online doctor visit
• Sinus infection (sinusitis)
• Pink eye (conjunctivitis)
• Asthma in adults
• Eczema and dermatitis
• Online doctor for kids
• Emergencies
• Pricing