So you’re standing in the drugstore aisle with your eyes watering and your nose running, desperately trying to find something that’ll make your symptoms go away yesterday. You thought this would be a quick trip, but once you see all the bottles, boxes, and sprays on the shelves, you know you thought wrong.
Yep, we’ve all been there. Learning what triggers your symptoms and when to expect them is confusing enough without you having to become an amateur pharmacist too. That’s why we’re taking the guesswork out of your next drugstore run (or better yet, home delivery) by breaking down all the different types of allergy treatments (and how to know which to choose).
Before we dig into how to choose between pills, sprays, and other forms, let’s break down another important way of classifying allergy medications—by the way they work.
Histamine is a substance your immune system churns out to defend your body from invaders. That works well when you’re dealing with an actual enemy, like a flu virus, but in the case of your allergies, your immune system is a little confused. It reacts to what could be a harmless visitor, like pollen, as if it’s a deadly threat, and you suffer the consequences—sneezing, sniffling, watery eyes, and all your other allergy symptoms.
So you can probably guess what antihistamines are for: By preventing your body from processing histamine, antihistamines stop your symptoms before they start.
Even if you didn’t know what an antihistamine was until just now, you’ve probably heard of some of them:
Not every allergy treatment fights symptoms at the source like antihistamines. Instead, decongestants work to relieve the impact of one particular symptom: a stuffy nose. They do that by narrowing the swollen blood vessels in your nose (another part of your immune system’s response to allergens), clearing the way so you can breathe again.
Like antihistamines, decongestants come in a bunch of forms, including pills, liquids, and (of course) nasal sprays. Some are package deals that combine a decongestant with another medication, like an antihistamine or a pain reliever.
You might recognize some of these popular decongestants:
Corticosteroids, often shortened to steroids, also work by preventing inflammation, which is what causes swelling. Steroids aren’t just great for allergic rhinitis (the medical term for allergies)—they’re also used to treat many other conditions, including eczema, dandruff, asthma, ulcerative colitis, and hemorrhoids.
As you may’ve guessed by now, you can find many different forms of steroids, such as tablets, liquids, eye drops, and sprays and inhalers.
Here are a few examples of corticosteroids:
Now that you’ve got a handle on the different classes of allergy medications, let’s talk about all the different forms those treatments can come in.
Oral medications are pills, tablets, or capsules you ingest by mouth. They can be antihistamines like loratadine and diphenhydramine, decongestants like Sudafed® and Mucinex Sinus-Max®, or another class of medication entirely, like the antileukotriene montelukast.
You’ll usually take an oral medication at least once a day, making this form a good choice for people who are great at sticking to a daily routine. This is also an excellent way to be prepared for symptoms in advance (and possibly avoid them entirely), rather than just reacting once your sniffles start. One downside of some (but certainly not all!) oral medications is drowsiness, so keep that in mind when you’re planning out your treatment regimen.
Nasal sprays are exactly what they sound like—medications you spray directly into your nose. There are antihistamine nasal sprays (like azelastine), steroid nasal sprays (like fluticasone), and even natural options. Because they target nasal symptoms, nasal sprays tend to make great decongestants.
So how do you choose between oral medications and nasal sprays? For that, let’s turn to expert allergist and Picnic Medical Director Dr. Amina Abdeldaim.
“Compared with oral antihistamines,” Dr. Amina says, “nasal sprays need more time to build up. That's because they work by cooling inflammation at the source, which takes longer but may be more effective."
The bottom line is that both of these types of medications are excellent at taming allergy symptoms, so it really comes down to which form you prefer—not everyone’s comfortable putting something up their nose, but some people consider daily pills a deal-breaker.
So, you have a solid grasp on how the best allergy treatments work and what forms they can take—but how do you know which one is best for you? There are a few different ways you can think about it:
And if that’s not enough, why not let an expert make the decision for you? Take our allergist-built quiz and a Picnic doctor can recommend the best combination of allergy treatments for your specific needs. That’s right—finding relief doesn’t have to be complicated.
Hopefully after reading all this you have a much clearer idea of your options when it comes to allergy treatments. But here’s the kicker: You don’t have to choose just one form. Many allergy sufferers find relief by combining two or more treatments, like a steroid nasal spray and an oral antihistamine.
And who knows? If you try a few treatments, you may find yourself favoring a medication or form you never expected to (just ask anyone who can’t live without their nasal spray).