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Mustaches serve as reservoirs from which impacted pollen grains are
inhaled. The resulting increase in seasonal allergic rhinitis symptoms
can be ameliorated by mustache washing.
Introduction
Several patients with seasonal allergic rhinitis and mustaches noted
symptom improvement after mustache washing, suggesting that mustaches
serve as reservoirs from which impacted pollen grains are inhaled. Nasal
vibrissae trap particles larger than 15m in diameter.1 If
mustache hairs serve a similar function, they trap airborne pollen grains
(14-60m),2 specifically oak (32m)3 and grass (20-25m).3
Methods
All male patients with mustaches seen between April 1 and June 30, 1996,
who had at least three of four symptoms of seasonal allergic rhinitis
(nasal obstruction, rhinorrhea, sneezing, nasal or palatal pruritus)
and positive skin tests to the major spring allergens of oak and grass
mix in the Washington, D.C. area were included in the potential study
population. After three weeks of stable avoidance and nasal steroid
use (four also using nasal cromolyn regularly and four also were receiving
maintenance immunotherapy for longer than 18 months), we suggested that
patients also shampoo their mustaches BID with a liquid soap or shampoo
for two weeks.
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The study group consisted of eight patients 35-50 years old who met the
inclusion criteria and for whom there was no significant change in the
counts for the pollens to which they reacted between the standard treatment
period and the period during which mustache washing was added. Six had
positive skin tests to oak and grass mix, one to oak mix, and one to grass
mix. Four of the study group were also using nasal cromolyn regularly,
and four were also receiving maintenance immunotherapy for longer than
18 months. Because record analysis was done retrospectively for patients
seen in a clinical office, there was no control group studied.
Results
After two weeks of mustache washing, the eight patients reported less
frequent use of oral antihistamines and decongestants and decreased symptoms
(8/8 with less obstruction, especially nocturnal; five with less rhinorrhea;
and three each with less sneezing and pruritus).
Discussion
This small study suggests that mustaches serve as first a filter and then
a reservoir from which pollen grains are inhaled, increasing rhinitis
symptoms. Mustache washing was added after three weeks of stable avoidance
and nasal steroid use, making it unlikely that the symptom reduction seen
with mustache washing was due to standard treatment. Pollen counts were
stable for the five study weeks, so the symptom reduction was not from
a decreased allergen load coincident with the end of the season but probably
from mustache washing. The symptom most reliably reduced was obstruction,
probably by decreasing the persistent antigen load driving this late phase
response.
Studies using a control group with unwashed mustaches correlating mustache
allergen levels with rhinomanometry, nasal lavage volume and analysis,
and symptoms could confirm our observation that pollen grains filtered
by mustaches are later inhaled, increasing symptoms of seasonal allergic
rhinitis.
References:
1. Druce HM. Allergic and nonallergic rhinitis. In: Middleton E, editor.
Allergy: Principles and Practice. 4th ed. St. Louis: Mosby; 1993:1434.
2. Platts-Mills TAE, Solomon WR. Aerobiology and inhalant allergens. In:
Middleton E, ed. Allergy: Principles and Practice. 4th ed. St.
Louis: Mosby; 1993:481.
3. Gutman A, Bush RK. Allergens and other factors important in atopic
disease. In: Patterson R, editor. Allergic Diseases: Diagnosis and
Management. 4th ed. Philadelphia: Lippincott; 1993:107-9.
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