The Throat Doctorby Dr. Françoise Chagnon
/ September 1, 1997
I am a 30-year old soprano and in June and September my allergies
impair my singing. My symptoms are watery eyes, sinus irritation and
coughing 20 to 30 times in a row, causing voice fatigue and slight
dizziness. These symptoms usually last over a three to four-day
period. What treatments do you recommend for singers with allergies?
What are the side effects? Can I take anti allergy pills to prevent
the onset of symptoms before a concert? I have heard that some
anti-allergy pills can cause catastrophic reactions like liver
failure. Is this true? What about homeopathic or natural
The seasonal pattern of your symptoms suggests that you are
allergic to pollens, grasses and trees in the spring and to moulds
in the fall. Seasonal allergies can be treated by preventative
therapy with systemic antihistamines and, or, intranasal topical
It is best to begin treatment at the very beginning of the season
before symptoms appear. Thus, antihistamines will have a chance to
block the release of the biochemical mediators of inflammation when
exposure to the offending allergen occurs.
The severity and the sites of involvement of allergy symptoms
vary with the individual. For isolated nasal symptoms (congestion,
sneezing, runny nose) the use of intranasal topical steroid sprays
is ideal. The newer preparations are highly effective and deliver
micrograms of medication without systemic absorption and side
effects (such as fungus growth in the throat).
For symptoms such as dizziness, headaches, itchy throat, tearing,
a systemic anti-histamine and medication are recommended. There are
many anti-allergy pills available. They vary in onset and duration
of action, efficacy and potential side-effects. For example
Cetirizine has a rapid onset which may be helpful to the singer
about to perform. Certain antihistamines , such as Terfenadine,
should not be taken in association with other medication (including
antibiotics) or if you have pre existing heart or liver disease.
Your response to antihistamines may also change with time, thus
requiring different medication. The best therapies for allergies are
those which are custom-designed for your symptoms and their
fluctuations. You may require the assistance of an allergist,
otolaryngologist and pharmacist to guide you in choosing a
As for homeopathic medications, despite anecdotal claims, there
is no scientific evidence of their efficacy in treating allergies.
The successful management of your allergies depends on the
identification and control of the allergens in your environment.
Pollen allergies can be curred by immunotherapy ("allergy shots"), a
process by which your immune system is stimulated to produce
antibodies against allergens before the allergy season. Dr.
Françoise P. Chagnon is the Director of the Voice Lab at the
Montréal General Hospital
The Throat Doctor
Submit your questions about voice or
vocal ailments to Doctor Françoise Chagnon c/o La Scena Musicale,
5411 Waverly, Montreal, Quebec, CANADA, H2T