Mold allergy

The best way to manage an allergy is to avoid exposure to triggers. However, molds are common, and you can't completely avoid them.

While there's no sure way to cure allergic rhinitis caused by a mold allergy, a number of medications can ease your symptoms. These include:

• Nasal corticosteroids. These nasal sprays help prevent and treat the inflammation caused by an upper respiratory mold allergy. For many people, they're the most effective allergy medications, and they're often the first medication prescribed.

  Examples include ciclesonide (Omnaris, Zetonna), fluticasone (Flonase Allergy Relief, Xhance), mometasone (Nasonex), triamcinolone and budesonide (Rhinocort). Nosebleeds and nasal dryness are the most common side effects of these medications, which are generally safe for long-term use.

• Antihistamines. These medications can help with itching, sneezing and runny nose. They work by blocking histamine, an inflammatory chemical released by your immune system during an allergic reaction.

  Over-the-counter (OTC) antihistamines include loratadine (Alavert, Claritin), fexofenadine (Allegra Allergy) and cetirizine (Zyrtec Allergy). They cause little to no drowsiness or dry mouth.

  The nasal sprays azelastine (Astelin, Astepro) and olopatadine (Patanase) are available by prescription. Side effects of the nasal sprays can include a bitter taste in your mouth and nasal dryness.

• Oral decongestants. OTC oral decongestants, such as Sudafed 12 Hour and Drixoral Cold and Allergy, can raise blood pressure, so avoid them if you have high blood pressure (hypertension). Other possible side effects include insomnia, loss of appetite, heart pounding (palpitations), anxiety and restlessness.
• Decongestant nasal sprays. These include oxymetazoline (Afrin, others). Don't use these medications for more than three or four days, as they can cause congestion to come back with worse symptoms when you stop using them. Other possible side effects include headaches, insomnia and nervousness.

• Montelukast. Montelukast (Singulair) is a tablet taken to block the action of leukotrienes — immune system chemicals that cause allergy symptoms such as excess mucus. However, concerns about side effects, including anxiety, insomnia, depression and suicidal thinking, are increasing. The U.S. Food and Drug Administration recently put a warning on the box about the drug's use.

  Like antihistamines, this medication is not as effective as inhaled corticosteroids. It has been used when nasal sprays cannot be tolerated or when mild asthma is present.

Other treatments for mold allergy include:

• Immunotherapy. This treatment — a series of allergy shots — can be very effective for some allergies, such as hay fever. Allergy shots are used for only certain types of mold allergy.

• Nasal lavage. To help with irritating nasal symptoms, your doctor might recommend that you rinse your nose daily with salt water. Use a specially designed squeeze bottle, such as the one included in saline kits (Sinus Rinse, others), bulb syringe or neti pot to irrigate your nasal passages. This home remedy, called nasal lavage, can help keep your nose free of irritants.

  Use water that's distilled, sterile, previously boiled and cooled, or filtered using a filter with an absolute pore size of 1 micron or smaller to make up the irrigation solution. Be sure to rinse the irrigation device after each use with similarly distilled, sterile, previously boiled and cooled, or filtered water and leave open to air-dry.

To keep mold allergy symptoms at bay, take these measures:

• Sleep with your windows closed to keep out outdoor mold. The concentration of airborne mold spores tends to be greatest at night, when the weather is cool and damp.
• Keep indoor humidity below 50% and correct any moisture or water damage in the home. You can measure relative humidity with a small moisture meter, available at many hardware stores.
• Wear a dust mask over your nose and mouth to keep mold spores out if you have to rake leaves, mow your lawn or work around compost.
• Avoid going outdoors at certain times, such as immediately after a rainstorm, in foggy or damp weather, or when the published mold count is high.

Many people are diagnosed and treated for allergies by their primary care physicians. However, depending on the severity of your allergies, your primary care doctor might refer you to a doctor who specializes in treating allergies.

Here's some information to help you get ready for your appointment.

What you can do

• Ask if there are any pre-appointment restrictions when making your appointment. For example, if you're having allergy tests, your doctor will likely want you to stop taking allergy medications for several days before the test.
• Write down your symptoms, as well as where you were and what you were doing when the symptoms started.
• List all the medications, vitamins or other supplements you take, including doses.
• Write down questions for your doctor.

For a mold allergy, some questions you might want to ask include:

• What do you think is causing these symptoms?
• Are there tests available that can confirm a specific allergy? Do I need to prepare for these tests?
• How can I treat a mold allergy?
• What side effects can I expect from allergy medications?
• How can I get mold out of my home?
• I have another health condition. How can I best manage these conditions together?
• Do you have brochures or other printed materials I can have? What websites do you recommend?

What to expect from your doctor

Your doctor is likely to ask you questions, such as:

• Exactly what are your symptoms?
• What seems to trigger symptoms or worsen them?
• Are your symptoms worse during certain times of the year or certain times of the day?
• Do your symptoms flare up when you're in certain locations, such as outdoors or in your basement?
• What other health problems do you have?
• Do other members of your family have allergies? What kinds?
• Are you exposed to mold, dust, fumes or chemicals at work?
• Do you know if you have mold in your home?

What you can do in the meantime

While you're waiting to see your doctor, there are numerous over-the-counter allergy medications that may ease your symptoms.

If you have visible mold in your home, have someone who's not allergic to mold clean the area using a solution of 1 cup (250 ml) of bleach to 1 gallon (3.8 liters) of water or a commercially available mold-cleaning product. If you have to clean up the mold yourself, be sure to wear long rubber gloves, safety goggles and a mask to limit your exposure to the mold.