'Tis the season to be -- sniffly? Although many people assume that winter hails the end of high pollen counts and pesky seasonal allergies, the holiday season has a slew of allergy woes all its own.
And for those with serious food allergies, holiday parties and visits to friends and family can make dodging dangerous foods quite a feat.
With travel and holiday visits, "people leave their safe zone," says Dr. Michael Daines, a pediatric allergist in Cincinnati.
"Foods are mixed and cross-contaminated, ingredients are hidden, things are mislabeled, people consume alcohol and make bad choices [or] forget their medication ... it makes control of allergies almost impossible."
Add indoor dust allergies and possible irritants such as scented candles or preservatives sprayed on Christmas trees, and a very sniffly holiday season may be in store.
I'll Be Home for Christmas (From the E.R.)
Although it's not unheard of to tear up at the sight of a beautifully decorated Christmas tree, it wasn't nostalgia that made Devin Brown's eyes water on his first Christmas. It was the tree itself.
Raised Jewish, the New York City resident didn't experience Christmas trees as a routine part of the holidays until his mother remarried when he was 9. That December, Brown was excited when his stepdad brought home a real Christmas tree. But the new festivities produced a little more excitement than he bargained for.
"I started putting on the lights and all of a sudden I had puffy eyes and was sneezing. It took a little while to realize that I was actually allergic to the tree," Brown, 35, says.
It wasn't the tree, per se, that bothered Brown. It was a substance in the oil and sap of the pine called terpene. For allergic individuals, contact with evergreens used for garland, wreathes, and Christmas trees -- especially when they are fresh-cut and shedding needles -- can cause skin rashes, itchy, watery eyes and sneezing.
Since that ill-fated first Christmas, Brown has had to be careful about staying away from cut pine trees, garland and wreathes.
"If I walk past the pine tree stands in the city, I start sneezing," he says, recalling a scare when, as a joke, a classmate threw a wreath around his neck like a collar; bad news for someone with a terpene allergy.
Needless to say, most Brown family Christmases since have featured an artificial tree.
While terpene allergies are relatively rare, milder allergic reactions to the chemical sprays used to preserve Christmas trees, pollen on the trees or the mold that can grow while they're sitting in the lot are much more common.
"Live Christmas trees are actually dead, of course, and stuck in a pot of water," allergist Daines says. "Various molds that are usually only outdoor allergens are brought inside with the tree and can cause symptoms."
Dr. Clifford Bassett, medical director of Allergy and Asthma Care of New York, says, "people come into the office with watery eyes and a runny nose -- they don't consider themselves to have allergies. But [if you point it out], they'll note that they have this problem every year around the holidays. I like to call it 'Christmas Tree Allergy Syndrome.'"
Bassett suggests using a leaf blower outside to blow pollen off you and washing the tree -- especially the trunk -- with a garden hose when you bring it home. Let it dry in the garage before decorating.
Allergic to the Christmas Spirits
Hopping from one holiday party to the next can leave you drained and possibly feeling a little under the weather. But your sniffles and itchy eyes may not be a cold coming on. There could be something in that seasonally spiked beverage that's getting you down.
While an actual allergy to alcohol is quite rare -- less than 3 percent of the population has it -- there are many ways that holiday beverages may aggravate your allergies.
If you find that drinking wine aggravates your allergies, you might be intolerant to sulfur dioxide, a common preservative found most often in wine and dried fruits.
The FDA reports that one out of every hundred people is sensitive to sulfur dioxide and, according to the Academy of Allergy and Asthma, those who are asthmatic are even more likely to have a serious reaction to sulfites.
If you think you might be intolerant to wine but aren't sure if it's the sulfites, Bassett points out that dried fruits can be an indicator. Because dried fruits have a much higher level of sulfites than wine, if you can tolerate these, you most likely don't have sulfite intolerance.
If sulfites are the culprit, beware that other holiday brews may have hidden sources of sulfur dioxide such as maraschino cherries, pickled cocktail onions and the bottled lemon and lime juice often used at bars.
More often, other additives in drinks such as the sulfites in wine, the yeast and grains in beer or hidden ingredients in drinks are to blame for a negative reaction.
Eggnog provides a staunch warning with its name alone to those with egg allergies. But unless you have an allergy-conscious hostess, drinks served at holiday parties do not usually come with an ingredients list.
Daines notes that if you have a life-threatening allergy, it's difficult to trust food prepared by others because "you never know what people are going to substitute into food and recipes," and it may be wiser to bring your own.
"The bigger issue with alcohol," Daines adds, "is that people who drink do stupid things. If you look at death from a food allergy, alcohol consumption is often involved. People make bad decisions and don't take care of the reaction [in time]."
Jingle Bells, That Candle Smells, My Nose Is Getting Red?
From pine-scented potpourri to snow-in-a-can, there are many ways that we try to bring the sights and smells of the season into our homes. But for people prone to allergies, the synthetic sprays and smells can be irritating to the lungs and eyes.
"Individuals with asthma have sensitive airways, so strong odors like scented candles can cause symptoms," says Dr. Miles Weinberger, director of the Pediatric Allergy and Pulmonary Division at the University of Iowa.
And while artificial snow in aerosol cans can make the windows looks extra festive, the spray releases chemicals into the air that can trigger an asthma attack or an allergic reaction, Bassett says.
"Artificial snow is a no-no," he says. "it's almost like an air pollutant."
And the holidays "are a period of time when people may not suspect that they have allergies," he adds.
They're not on the lookout because "they're not putting together that there's a pattern around this time of year."
One troublemaker around the holidays is a common household item: dust.
When decorations are stored in attics and cellars for months before the holidays, they tend to gather dust and even mold, which can cause adverse reactions.
Combine the dust stirred up by a dozen or so trips to the basement with the dry air blowing around by a central heating system and it's a perfect storm for those with dust allergies, Daines notes.
"Anytime someone is up in the attic getting things out or turning on the furnace for the first time of the season," he says, "and it blows dust out of the ducts -- [it] can make anyone with asthma have a mild flare."
So if you're noticing a runny nose and itchy eyes that may not be just the beginnings of a cold, Bassett suggests taking steps to reduce the dust.
Wipe down dusty decorations before putting them out and make sure to bring your allergy medication with you when you travel to help reduce symptoms, and be prepared in case of an allergic episode.
Tips and Tricks for Tinsel Time
So what can you do to avoid having a Rudolph-red nose -- or, worse, a trip to the E.R. -- around the holidays? Bassett and Daines give the following advice on dodging allergies this winter.
O Christmas Tree
Wash off Christmas trees with a garden hose to get rid of extra pollen or mold that may be on the branches and let them dry out in the garage before bringing them into the house.
Wear long sleeves and gloves when handling the tree to avoid skin irritation.
If a real tree is aggravating to your allergies, consider using an artificial tree but be sure to store it in an airtight container to prevent dust and mold from collecting, and wipe it down when you take it out from storage each year.
If you have a life-threatening allergy, make that clear to your server and perhaps even write it down for them or call ahead to inform the restaurant.
Make sure kids with allergies wear medical bracelets that clearly state their allergies.
Avoid buffets if you have food allergies because oftentimes serving utensils are used for multiple dishes and can cross-contaminate food.
When in doubt, bring your own snacks as back-up.
Stay Merry, Not Miserable
Stress can hinder the immune system and aggravate asthma or allergies, so make time to escape the chaos of the holiday season and be sure to get plenty of sleep.
Don't be too busy to take care of yourself: Keep up with medications and address symptoms immediately.