When Singers Have Allergies
In the Northeast, this spring seems to be one of the worst for allergies. The singer community, still trying to regain a sense of normalcy from COVID restrictions, has been hit hard. Here are some general observations and recommendations from a long-time allergy sufferer and singer.
Before you read on: I am not a medical doctor, and only your doctor can tell you what is right for you.
An allergy is an abnormal reaction to a common substance. In this post we’ll talk about seasonal allergies, also known as “hay fever,” and what a singer who is sensitive can do. These allergies are generally due to pollens in the air, coming from trees in spring, grasses and weeds in the summer season, and grasses and weeds in the fall. There are also some outdoor molds that reside in the soil or in wet leaves, these go all season except when there is snow cover or In very dry environments. You breathe these mostly invisible substances, and they affect the same respiratory system that is the physical basis for singing. What to do?
- First, try to figure out what triggers your allergic response. Make a diary or log. Look at your local allergy reports on weather outlets, go to pollen.com for more detailed information and try to find a pattern.
- Minimize exposure. Try to avoid outside activities on the days when you have to sing. Usually the active pollens change every 2 or 3 weeks, so your condition may be very temporary.
- What to do when you have been exposed. Pollens and other allergens cling to your clothes, your hair, your skin, and your nasal cavity. Try not to bring these allergens into your indoor environment. When you come in from outdoor activities, change your clothes and put the worn clothing into the laundry. Take a shower and shampoo your hair. Do a nasal rinse with saline solution. Then you won’t be exposing yourself for the rest of the day.
- There are many over-the-counter medicines for allergies. I would say try the simplest first, and take only medications that have one ingredient, so you know what your response is. I remind you I am not a medical doctor.
- First and foremost there are the nasal sprays. These are usually recommended first because they don’t enter the bloodstream as much as oral medications. They deal with the problem primarily where it starts, in the nose. When you are having an allergic response, the nose is most notably affected. Mucus production increases, and the mucus is thick. You sniffle, you sneeze, and you have post-nasal drip that can cause a tickle in the throat and coughing. Flonase became available over the counter a few years ago and is still widely prescribed. Beware of some of the nasal sprays for colds, they are not as good for allergies.
- Next we deal with expectorants. These (Mucinex being the main one, but also guaifenesin cough medicine) thin the mucus, allowing the body to get rid of it.
- Next we find decongestants. You get stuffed up because of enlarged blood vessels in your nasal and airway membranes. These enlarged blood vessels make it hard to breathe and can trap mucus. Decongestants narrow blood vessels. This lets mucus drain so you can breathe. Many decongestants have a stimulating effect; you might feel jittery or have trouble sleeping.
- Next we come to the antihistamines. It is important for singers to understand that all antihistamines have a drying effect. That can have an impact on how the voice feels to you, and even how well the vocal folds work. The old-style antihistamines (e.g. Benadryl, Atarax) can cross the brain barrier and make you drowsy. The newer antihistamines such as Allegra and Claritin generally do not cross the brain barrier. Zyrtec seems to affect some people more than others with regards to drowsiness. With these medications, you may have to take them for a few days to get the full effect. You will also need to increase your fluid intake to counteract the dryness.
- Medical approaches. If your symptoms persist or do not respond to the above, it is time to see the doctor. An allergist can do testing for indoor and food allergies, as well as the outdoor allergens for your area. Sometimes it really helps to know the bigger picture! (What if it’s your cat??) The prescriptions the doctor can offer include the same types of medications as outlined above, perhaps at different strengths or in time-release formulations. The only completely different approach that the physician can offer is desensitization. Once your allergies are identified, a mixture of “your” allergens is prepared and injected regularly with the goal of “training” your body to deal with them. Treatment can last for several years. Sometimes it works!
- Lifestyle choices for the performing singer with allergies. If you are serious about your singing and you develop allergies, you will have to consider what lifestyle changes are necessary and worthwhile. Suffice it to say that you already need to live a healthy lifestyle, with appropriate diet, exercise, and sleep habits to help you perform well and consistently. To protect the mucus lining of the respiratory tract, you need to drink plenty of liquids and avoid substances that dry you out, such as caffeine and alcohol. You may find it helpful to rinse the nose morning and evening with saline solution (using a NeilMed bottle or Neti pot). When allergies strike, you might have to reduce your singing schedule or increase rest time. Certainly the day of a performance, and perhaps the day before, should be spent avoiding the allergens as much as possible. This may mean keeping windows closed and using air conditioning, air purifiers, humidifiers or dehumidifiers. Avoid smoke and any household chemicals that can irritate.
I could tell some hair-raising stories about traveling to distant places and having an unexpected allergic reaction. I carried salt whenever traveling and developed the skill of inhaling salt water (bottled water I bought on location plus salt I brought with me) from a drinking cup before going out on stage, and sometimes even at intermission. Even though I was taking a second-generation antihistamine, sometimes this was all that got me through a performance!
Thanks, Bonnie. Very helpful information.
I would add to your paragraph on nasal sprays that most of them are to be used only temporarily, as they often trigger a “rebound” – stopping their use causes INCREASED mucus. The one you mention, Flonase, doesn’t have that effect.
I remember the day I came into your studio unable to sing at all. I still don’t know what triggered that allergic response, but your understanding was much needed.