What comes to mind when you hear that someone has allergies?

Maybe you think of sneezing, a runny nose or itchy and watery eyes. These are common allergy symptoms, and if you think of allergies as they are portrayed in commercials you might think these are the only symptoms.

This time of year I often see patients who think they do not have allergies, but know they had hay fever (seasonal allergies) as a child. Some complain of excessive snoring (caused by congestion), sore throats (caused by dripping of the nasal secretions) or eczema (red, itchy or sensitive skin).

These are all signs of allergies. Other symptoms include:

• Itchy throat and ears.

• Rash and hives.

• Feeling like your ears are “plugged up.”

• Coughing, wheezing, tightness or heaviness in the chest (caused by asthma).

If you had allergies, asthma, or hay fever as a child, you could outgrow your allergies, your allergies could become worse or the symptoms could change over time. People who never had allergy symptoms in childhood may develop symptoms in adulthood.

Most people with allergies do not need allergy testing, and many symptoms can be managed with home treatment. Several medications are available without a prescription.

However, if you have a history of poorly controlled asthma or anaphylaxis (life-threatening allergic reaction), talk with your health care provider about whether you should see an allergist.

Allergy medications are called antihistamines because they compete with the histamines your body releases during an allergic reaction. Histamines are part of what causes allergy symptoms.

Some short-acting (they last four to six hours), over-the-counter antihistamines that give relatively rapid relief include chlorpheniramine, clemastine and diphenhydramine.

These are useful if you know you will be around something that triggers your allergies for a short period of time or if you have a sudden onset of allergies. The downside to these medications is drowsiness.

Longer-acting (they work for 24 hours), over-the-counter oral antihistamines that cause less drowsiness include loratadine and cetirizine. Daily use of these medications works best.

Prescription nasal steroid sprays and eye drops can also help allergy symptoms. You may be able to further reduce your allergy symptoms with a daily sinus rinse kit or neti pot to irrigate nasal passages.

Environmental modifications are also helpful. Using high-efficiency particulate air (HEPA) filters can lower the amount of airborne allergens in your home. If you have allergies to animals, after petting them, do not touch your face, and be sure to wash your hands.

People allergic to dust mites and other household allergens can improve their symptoms by washing their sheets every week in hot water and by using mattress and pillowcase protectors designed to help with allergies. Children who have this problem need to have their stuffed animals washed regularly.

You may also find relief by using laundry detergent, bath soap and deodorant with no fragrance or dyes in them. Often, a combination of treatments and environmental modifications are required to control allergy symptoms.

If you have an unexpected allergy attack, a hot, soapy shower and changing into clean clothes can help get things under control by removing allergens.

The best way to treat allergy symptoms is to control them before they start. This means doing the things helpful for reducing your symptoms – like taking your allergy medicine or doing your sinus rinse – every day rather than waiting until your allergies have gotten so bad that you cannot take it anymore.

The reason for this goes back to those pesky histamines mentioned earlier. The histamine level in your body can increase as your exposure to allergens goes on day after day.

The higher your histamine level, the more measures (and possibly medications) it is going to take to make things better. It becomes like trying to stop a runaway freight train.

I recommend working to find the combination of treatments and environmental modification that improves your allergies. If you cannot get enough relief with environmental controls and other home treatments, then it is time to talk to your doctor about your allergies.

With some diligence, you can keep your allergies under control and get out and enjoy the summer.