ALLERGIES - Medicine for Mountaineering and Other Wilderness Activities - page 325

altitude orextreme latitude, butisacommon problem—occasionally asevere problem—in
warmer climates. Hay fever caused by pollens tends to be seasonal; hay fever caused by
other antigens such as animal dander may be a year-round problem. The nasal membranes
are red and swollen, causing nasal stuffiness and nasal discharge. Frequent sneezing is
common. The eyes are often red; excessive tearing is common.
Individuals with recurrent hay fever so severe it hinders routine activities should con-
sider desensitization and should consult a physician or allergist to determine the medica-
tions that are most effective for them personally. Some drugs and drug combinations are
more effective for certain individuals than others.
For individuals with less than severe hay fever, over-the-counter antihistamines that
cause little or no drowsiness and need to be taken only once a day are available. Other an-
tihistamines are effective but do induce drowsiness.
HIVES
Hives are often caused by food allergies—chocolate, seafood, and fresh fruit are the most
common offenders—but can occur as an allergic reaction to almost any substance, in-
cluding dusts and pollen, insect bites and stings, or drugs, occasionally even to drugs as
commonly used as aspirin. Hives appear quickly following contact with the allergen, are
often widely scattered, and consist of red or white raised wheals (bumps) that itch in-
tensely. Hives may rapidly appear and disappear several times from a single allergen ex-
posure. Repeated exposures to the same allergen usually reproduce the attacks indefinitely.
However, the condition is more miserable than serious.
The treatment for recurrent episodes of hives consists of antihistamines. Nonsedating
antihistamines are effective for some people, but the standard is diphenhydramine (Ben-
adryl®, Dramamine®, and others). Cornstarch packs or baths or bland lotions may help
reduce itching. Individuals who have hives with other symptoms, such as hoarseness or
throat swelling, should be evaluated bya physician and probably need to carry epinephrine
to treat recurrent or more severe symptoms. Spontaneous recovery occurs without treat-
ment if further exposure to the allergen is avoided.
CONTACT DERMATITIS
A rash occasionally develops following contact with jewelry, the case of a wristwatch, or
a similar material. Often the cause cannot be determined, and the rash may not be located
at the point of contact. The rash is usually more annoying than disabling, typically is com-
posed of multiple small blisters on a red background, and may itch or burn. Bothersome
rashes may be treated with 1 percent hydrocortisone cream or ointment, which are avail-
able over the counter.