Allergy treatment online in Puerto Rico

Allergic rhinitis is an allergy in the nose: your body reacts to something you breathe in. It can be seasonal (from tree, grass and plant pollen) or year-round. The most common year-round triggers are dust mites, mold, pet dander and cockroaches.

Allergies run in families: a child is more likely to have them if one parent does, and much more likely if both parents do.

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Allergies are handled in a US$79 doctor visit, the same price for every age, with no membership. You pay by card when you request the visit, and you get a full refund if the visit can’t take place. A doctor’s note after your visit is included at no extra charge.

We do not bill insurance; the pharmacy charges separately. See all prices. The service is run by The Health Initiative, a nonprofit.

Some symptoms start soon after contact with your trigger, and others develop later. Allergies do not cause fever:

• Sneezing
• Runny nose with clear mucus
• Stuffy nose
• Itchy nose, mouth, eyes or throat
• Watery eyes
• Dark circles or puffiness under the eyes
• Cough, sore throat or throat clearing
• Tiredness and poor sleep from congestion

The best treatment is avoiding your triggers, though that isn’t always possible. These are the most used treatments; the doctor will evaluate which is appropriate for you:

• Steroid nasal sprays: the most effective treatment, working best when used every day during your season. Several are sold over the counter.
• Antihistamines: as pills, liquids, nasal sprays or eye drops. Some cause drowsiness; others hardly do. If one makes you sleepy, don’t drive.
• Decongestants: ease a stuffy nose, but decongestant nasal sprays should not be used for more than 3 days in a row.
• Saline nasal rinses: wash mucus and allergens out of the nose.
• Other prescription medicines, such as leukotriene inhibitors, and immunotherapy (allergy shots) when symptoms are hard to control. If your symptoms are severe or don’t respond to treatment, the doctor advises you on allergy testing with a specialist.

A cold is caused by a contagious virus, comes on gradually, often brings thick mucus and sometimes fever and aches, and lasts 3 to 10 days. Allergies aren’t contagious, flare as soon as you meet your trigger, cause clear mucus and itchy eyes, never cause fever, and can last weeks or months.

A sinus infection causes facial pain or pressure, thick mucus and sometimes fever, and often follows a cold. Poorly controlled allergies can lead to sinus infections. If your eyes are red and itchy too, see pink eye. And because allergy irritation can cause nosebleeds, see also nosebleed.

In a warm, humid climate like Puerto Rico’s, two triggers deserve special attention. Mold grows wherever there is moisture, leaks or flooding, and can cause a stuffy nose, cough, burning eyes and skin rash. The CDC recommends keeping indoor humidity at 50% or lower with air conditioning or a dehumidifier, and fully drying anything wet from flooding within 24 to 48 hours, for example after a hurricane. More in mold exposure and health.

Cockroaches live year-round in warm climates and are hard to get rid of; the allergy is caused by their droppings and body parts, not the insects themselves. Having them doesn’t mean a home is dirty. If you have just moved to the island and your allergies changed, new triggers like these may be why.

The doctor evaluates your child by video with you on camera and, if appropriate, prescribes and we send the prescription to your pharmacy. Allergy medicines for children should be given only on a doctor’s advice, even when sold over the counter: each label says the minimum age, and the dose depends on the child’s age and weight.

According to the American Academy of Pediatrics (AAP), "old-generation" antihistamines cause drowsiness, so if used they are best given in the evening. Several steroid nasal sprays are approved for children as young as 2. Decongestants taken by mouth can make children jittery, give them a racing heart or trouble sleeping. The AAP does not recommend "cough and cold" products under age 4, and from 4 to 6 only if a doctor advises it.

If your child wheezes or is short of breath, tell the doctor: it could be asthma. Patients under 21 need a parent or legal guardian on camera with ID. See our online doctor for kids.

These signs can mean anaphylaxis, a severe allergic reaction. For your safety, call 911 and use epinephrine if it has been prescribed for you. See when to go to the ER.

• Swelling of the face, lips, eyes or tongue
• Trouble breathing, wheezing or a very hoarse voice
• Hives or itching all over with dizziness or vomiting
• Trouble swallowing
• Fainting, severe dizziness or slurred speech after contact with something you are allergic to