Why are my allergies so bad in spring? It’s the number one question we are asked when it comes to allergy season.
Is it spring and you have a runny nose, nasal congestion, sore throat, or red, itchy, watery eyes? Are you coughing and sneezing? These types of allergic reactions are typical for people with spring allergies or seasonal allergic rhinitis (also called hay fever).
A person with an allergy has an overactive immune system. An allergic reaction occurs after exposure to a typically harmless substance (a “trigger).
For people with spring allergies, the primary trigger is pollen. During spring, tree pollen and grass pollen are released into the air, causing the pollen count to rise. Breathing in pollen from trees, grasses and weeds can trigger spring allergy symptoms. Outdoor mold spores are also common spring allergy triggers.
Common myths about spring allergy season
Allergies affect as many as 60 million people in the United States every year. There are 7 million doctor’s office visits every year due to allergy symptoms. Given how common seasonal allergies are, it’s easy to understand why there are a lot of myths about spring allergies and how to manage seasonal allergies.
Let’s explore some of the more common myths so that you can better control your spring allergies – rather than spring allergies controlling you.
Myth: I only need to take my allergy medication when I’m feeling really bad.
Fact: Most allergy medications work best if taken daily, beginning about 1-2 weeks before your allergy season starts. When the medicine is already in your body, it can work more effectively when you are exposed to an allergen. So managing grass pollen allergy or other spring allergy symptoms means understanding the timing of your allergy symptoms. That allows you to start your medicine early.
We developed a helpful weather tool. This will help you monitor the pollen count in your community. By understanding when the pollen count is on the rise, you can more effectively plan when to start medications for your symptoms.
Myth: Moving to a drier climate – the U.S. Southwest, for example – will cure my spring allergies.
Fact: There really is no allergy-free zone. Pollen allergies can occur anywhere. Deserts have plenty of plants that produce pollen, such as sagebrush, cottonwood and olive trees. When pollen counts are high, you may experience symptoms.
Relocating may offer temporary relief. But allergies to local plants could develop before long. The timing of your seasonal allergies and your allergic symptoms may vary in a different climate, but they may not vanish altogether.
Before you consider moving to help manage your pollen allergies, talk to a healthcare professional about treatment options. Travel may also affect your allergies, so read about our tips for spring travel.
Myth: Allergy medications make me sleepy, so I just tolerate my symptoms because there’s nothing I can do to stop them.
Fact: Non-sedating allergy medications are available and effective for relieving symptoms. These include antihistamines and corticosteroid nasal sprays. Many people also find effective relief from nasal washes.
If you purchase a medication over the counter, be sure to read and follow the dosing and safety instructions printed on the medication label.
Talk with an allergy specialist about treatment options including allergy immunotherapy (also called allergy shots). There is no reason to suffer when there are lots of different choices for treating allergy symptoms.
Myth: All I need to control my allergies indoors is an air cleaner.
Fact: An air cleaner or purifier will only remove allergens floating in the air. These include They do nothing for pollen and mold spores on your clothes, shoes, or hair that you bring in from outside.
Air cleaners are one part of an overall strategy to reduce indoor allergies. Health tips include making sure you’re air filters are replaced regularly. Keeping windows shut when pollen levels are high is essential. Showering after being outside, and regular dusting and vacuuming may also help control allergy symptoms.
Myth: I’ve never had allergies before, so this runny nose must be a cold.
Fact: You can develop new allergies at any time, even as an adult. Are your eyes, nose and throat are itchy? Do you have a stuffy nose, inflamed nasal passages, or a runny nose with clear and thin nasal drip? Have your symptoms lasted more than two weeks? These are signs of seasonal allergies or allergic rhinitis. See an allergist for testing and to discuss treatment options, including allergy immunotherapy.
Spring allergens can really zap the joy out of spring with bothersome symptoms. During the COVID-19 pandemic, even a runny nose can have you wondering if you have seasonal allergies or COVID-19.
How to Treat Spring Allergies
Short of living in a bubble, most people find exposure to outdoor allergens extremely difficult to avoid. It’s just not realistic to avoid spending time outdoors at any time of year, let alone spring allergy season.
So you venture outside where you may inhale pollen and mild spores. Or they attach to your hair or clothes and you bring them indoors where you inhale them later, resulting in allergies.
Keeping a watch on pollen counts is recommended. But to ease symptoms, we often turn to medications. Which are most effective? Here are some treatment guidelines to discuss with your healthcare provider:
Adults and children ages 12 and older with mild, moderate or severe intermittent allergy symptoms can be treated with second-generation oral antihistamines or antihistamine nasal sprays as needed.
Second-generation antihistamines include cetirizine (Zyrtec®), levocetirizine (Xyzal®), fexofenadine (Allegra®) or loratadine (Claritin®). These antihistamines tend to cause less drowsiness and fewer side effects than first-generation diphenhydramine (Benadryl®).
Taking an antihistamine and decongestant combination may help relieve nasal congestion, but it’s not recommended to use these medications longer than three days.
Nasal sprays can be difficult to use for some patients. Learn how to use a nasal spray correctly so you get the relief you need from bothersome symptoms.
Corticosteroid nasal sprays
If allergy symptoms linger or worsen, the next step is a corticosteroid nasal spray. These are prescribed to adults and children with allergic rhinitis. In addition to nasal symptoms, they can provide relief to eye, throat and ear symptoms.
Corticosteroid nasal sprays are extremely effective, widely available, relatively inexpensive and don’t have a lot of side effects. For best results, these medications should be taken daily, beginning seven days before your allergy season begins and lasting throughout.
People who want to treat both nasal and eye allergies together can talk with their doctor about a new combination corticosteroid nasal spray and eye medication. The mometasone furoate monohydrate and olopatadine hydrochloride (Ryaltris®) combination is available by prescription only. It treats red or itchy eyes (allergic conjunctivitis) in addition to nasal allergies.
People who don’t find relief from a corticosteroid nasal spray alone may benefit from adding an antihistamine nasal spray. This is not for everyone, however. Discuss with your healthcare provider whether the benefits outweigh the costs. You can take two separate nasal sprays or use a medication that combines both ingredients in one device.
Keep in mind there is no extra benefit from combining an oral antihistamine with a corticosteroid nasal spray, unless your doctor advises it.
People who do not relieve symptoms with antihistamines or corticosteroids may consider a leukotriene modifier such as montelukast (Singulair®). This medication may be particularly helpful for people who already use montelukast to treat asthma.
Talk with your doctor about montelukast’s side effects, which may include behavioral changes such as depression, mood swings and suicidal thoughts in some people.
Intranasal Cromolyn Sodium
Another treatment option is intranasal cromolyn sodium (Nasalcrom®), a mast cell stabilizer medication. This sodium nasal spray helps prevent and relieve allergic rhinitis and common allergy symptoms like runny nose, itchy nose or stuffy nose.
Sodium nasal spray medications are less effective than corticosteroid nasal sprays. They have minimal side effects.
These oral medications treat seasonal allergic rhinitis and help relieve nasal symptoms. They work by minimizing the formation of mucus and drying out the nasal passages and airways. Side effects may include dry mouth and urine retention.
People who know their allergy triggers should consider allergen immunotherapy. Allergy shots or tablets can build resistance to a wide range of allergens including grass pollen and ragweed pollen. They help decrease severity of symptoms by making your immune system less allergic. Immunotherapy is the closest thing we have to an allergy cure.
If allergies are disrupting your life, it’s time to see a board-certified allergist. Undergo an allergy test to find out exactly what you’re allergic to and develop a long-term treatment plan.
Don Bukstein, MD, FACAAI, is a board-certified allergist and immunologist and pediatric pulmonologist. He serves as Medical Director for Allergy & Asthma Network. He is the former Director of Allergy and Asthma Research at Dean Medical Center in Madison.
Purvi Parikh, MD, FACAAI, is a board-certified allergist and immunologist at Allergy and Asthma Associates of Murray Hill in New York City. She is on faculty as Clinical Assistant Professor in both departments of Medicine and Pediatrics at New York University School of Medicine.