(May 21, 2009 - Insidermedicine) In this video, Dr. Clifford Bassett MD, FACAAI, FAAAI, Medical Director of Allergy and Asthma Care of New York, discusses what he would do if he had cold-like symptoms and suspected he had allergies. Dr. Bassett is Assistant Clinical Professor of Medicine at SUNY-Health Sciences Center, as well as Clinical Instructor at NYU School of Medicine.

What are the symptoms of allergy?

Allergic conditions typically run in a family. Itchiness of the eyes nose and the throat, sneezing, respiratory-related symptoms, especially after being in a park during the day in the spring time, or throughout the year if you are exposed to a pet, or you’re sweeping and are exposed to dust, precipitating nasal and eye symptoms, these are the chief hallmark signs of allergies.
Itchiness, in particular, is something that is associated with allergies almost exclusively.


How do allergies differ from colds?

Colds come on suddenly, typically over the period of a couple days, and are associated with symptoms such as chills or fever, sore throat, cough, and loss of appetite. They’re typically gone in about 7 days.

Allergies may be seasonal in nature, or may be year-round. Allergy symptoms are associated with nasal symptoms too, such as nasal congestion, post nasal drip, a variety of cold symptoms including colour change of the mucus coming from your nose, as well as other things that are really important for you to see a practitioner about to get specific medications for these symptoms. 


When do I need to see a doctor?

If you suspect you have allergy symptoms, and especially if you have a family history, it is very important to see an allergist for the proper testing to find out indeed whether you have allergies, a cold, or a sinus problem. Frequently, these can be confusing; this is why it is important to have an evaluation and develop an allergy plan once the diagnosis has been confirmed.


What symptoms differentiate an allergy from a cold?

Allergy symptoms are frequently accompanied by itchiness of the eyes, nose, and even throat associated with nasal congestion, sneezing. These tend to manifest particularly around a pattern – petting the dog, cat exposure, sweeping or vacuuming, and, in particular being outside in a park during the day in the pollen season – causing those really irritating itchy eyes and allergy symptoms that drive people crazy.

It’s important to understand that cold symptoms are different. They occur over a week or so. They usually come and go; they usually follow a pattern. Cold symptoms include fever, chills, sore throat, cough, and other things that make us feel really lousy and tired. These are all associated with a common cold and/or sinus problems.


How does the management differ between these conditions?

For the most part, cold symptoms are managed with what we call supportive care. You don’t really need prescription medication or antibiotics for colds. Typically a nasal saline wash can be helpful if you have a lot of mucus or post-nasal drainage, while things such as analgesics can help control fever, and any aches and pains that may be associated with a cold or a flu. If symptoms persist, you should see a provider for an evaluation – about ten percent of colds actually require antibiotic related care since there may be underlying sinusitis.

Allergies on the other hand, you want to treat the underlying trigger. The mainstay of our treatment is oral antihistamines that are designed to reduce itchiness of the eyes, nose and throat, sneezing, and other allergy-related symptoms. Frequently we combine that with a nasal spray, such as a nasal corticosteroid spray for nasal congestion as well as a nasal antihistamine. Finally, eye drops may be very helpful in addition to eyelid irrigation to provide relief of ocular symptoms such as itchiness of the eyes, redness, and a lot of discomfort associated with blepharitis or inflammation of the eyelids as a result of allergies. Allergy care can be individualized once we know what your triggers are.


If I had cold-like symptoms…

If you have cold symptoms and they’re on a regular basis or they’re recurrent, or there is a pattern, and you have a family history of allergy, get tested, find out indeed if you have allergies, whether they be indoor or outdoor allergies, to get the specific treatment that you need. If you have a cold and it’s over the course of 5 or 7 days, and it resolves itself pretty quickly, supportive care, nasal saline irrigation, steam, getting rest, drinking lots of fluids is just good common sense for cold symptoms.