Allergy season is back — and if you're not already feeling the congestion, itchy eyes and constant sneezing, you might be soon.
If it seems like your allergies are getting more severe, you're not alone. One theory is that climate change may be playing a role in the worsening of allergy seasons, Dr. Mark Corbett, board-certified allergist based in Kentucky and president of the American College of Allergy, Asthma and Immunology (ACAAI), told TODAY.
"Pollen seasons are longer now, and things seem to be getting a little warmer," he said. "Also, as you put more CO2 in the air, that's what the plants live on. So with higher levels of CO2 in the atmosphere, that's increasing plant production and, potentially, increases pollen production."
Anywhere from 10 to 30% of the global population experiences allergies, Dr. Antoine Azar, clinical director for the division of allergy and clinical immunology and assistant professor at Johns Hopkins University School of Medicine, told TODAY. “It is definitely very common, and we do see more and more people every year.”
There is a genetic component to allergies, Corbett said. So, if you're an adult experiencing seasonal allergies for the first time, your parents may also also have allergies. Or maybe you recently moved to an area of the country where different types of pollen are more prevalent — and you just happen to react more to the ones around you now.
Whether you're an allergy season veteran or just learning about antihistamines for the first time, here's what you need to know about navigating these seasonal symptoms.
The most common seasonal allergy symptoms:
The experts told TODAY that some of the most common symptoms of seasonal allergies can include:
Itchy, watery eyes
Stuffy or runny nose
Tiredness or fatigue
How long do seasonal allergy symptoms last?
Different seasonal allergens spike at different times of the year, so when you can expect to feel your typical allergy symptoms depends on what you're allergic to.
Spring allergy symptoms usually start around March when tree pollen is the main offender, Corbett said. That season typically lasts through April, he said. Then comes grass pollen season, which goes from May through the summer. Finally, from late summer through October is prime ragweed season.
So, if you're someone who is allergic to more than one — or even all — of these pollens, you might experience so-called "seasonal" allergy symptoms for a large chunk of the year. "Some of our spring allergy sufferers really are having problems from late winter to early summer," Dr. Courtney Jackson Blair, past president of the Greater Washington Allergy, Asthma and Immunology Society and practice owner of Allergy and Asthma Associates, P.C., told TODAY.
But the exact seasonal patterns vary depending on where in the country you live. For instance, if you're in the South, you might experience spring and tree pollen season a little earlier than the rest of the U.S., Corbett said. And some allergens are known to be particularly severe in certain areas, like the "cedar fever" that plagues areas of Texas and Oklahoma, Blair added.
Contrary to popular belief, though, the colorful flower blossoms we see in the spring aren't a major cause of allergy symptoms. “Pretty things don’t typically produce a lot of airborne pollen,” Corbett explained. “That’s why they have the insects — the bees — that pollinate them.”
Do you have seasonal allergies or COVID-19?
Having seasonal allergies is annoying at any time, but it creates some challenges (and confusion) during the COVID-19 pandemic. "With COVID out there, differentiating between the two has been difficult," Corbett said, because there can be some overlap in the symptoms of allergies and a coronavirus infection.
“Some of the symptoms can be similar because, with a viral infection, you're going to have congestion and runny nose," Azar explained. But there are some ways to differentiate the two conditions, he said.
For instance, despite the nickname "hay fever," allergies don't typically cause a fever, Corbett said. So, if you're feeling congested and your temperature is up, that's a sign you might have something other than allergies.
Also, if you have systemic symptoms, like body aches or a general feeling of being unwell, that's another reason to think beyond allergies, Azar said. "Plus, with COVID, there's some significant problems with people having reduced sense of smell and taste."
If you have some ambiguous symptoms and you're not sure what you're dealing with, it's definitely worth taking a COVID-19 test just in case.
How to manage seasonal allergies at home
There are many over-the-counter medications you can use to treat your seasonal allergies at home. The most effective options on the market right now are nasal corticosteroid sprays, Azar said. These medications work by gradually reducing the body's inflammatory response to allergens.
Remember that steroid nasal sprays take a while (usually a week or two) to produce their maximum effect. So you should ideally start using them before your symptoms appear. "We remind people (to) think about Valentine's Day as the time to consider restarting your seasonal allergy meds," Blair said.
Even if you missed that deadline, those sprays are still, "in general, the most effective way to treat nasal allergy symptoms," Blair added. "But a head start could help a lot."
Starting early helps avoid another potential problem: clogged nasal passages. "Oftentimes, people will start medications like a nose spray, but by the time (they start), they're really congested and swollen," Blair said. "All the tissue within the nose is pretty blocked, and it's hard to get the sprays to where they need to go."
Other options include oral antihistamines, such as fexofenadine (Allegra), loratadine (Claritin), cetirizine (Zyrtec) and levocetirizine (Xyzal), as well as antihistamine eye drops and nasal sprays. Depending on which allergy symptoms you experience most, it may make sense to take more than one of those medications, like using a nasal spray or eye drops, as well as taking an oral antihistamine. (Be careful not to take more than one type of oral antihistamine or more than the recommended dose, which can cause severe side effects.)
You can also take other practical steps to reduce your exposure to allergens outside and in your home. Here's what the experts TODAY spoke to recommend:
Keep your windows closed at home to prevent pollen from getting inside.
Use an air purifier with a HEPA filter. You don't necessarily need to invest in an expensive air filtration system for your whole home, Blair said. "I actually recommend just having way less expensive, freestanding air filters that are designed for the cubic square footage of each room," she said.
Wear a mask and sunglasses when outside. Anything that puts a barrier between you and your allergens can help reduce your symptoms, Blair said. In fact, some of her patients have been wearing masks and even ski goggles while mowing the lawn since before the pandemic. "It's a look," she quipped.
Change your clothes and/or take a shower when you get home to get rid of any pollen you may have collected outside.
If you have to be outside, avoid the morning. "Pollen counts typically are higher in the morning," Corbett said. "If you're going to exercise, try to switch from early morning to later in the afternoon."
When should you see an allergist for your seasonal symptoms?
For many people with seasonal allergies, over-the-counter medications are enough to manage their symptoms. But if you find that those options aren't enough for you, that the side effects associated with those medications are too severe or that your symptoms are getting worse, you should consider talking to your doctor or a board-certified allergist, experts told TODAY.
Additionally, if your symptoms are particularly severe or you have other conditions that allergies may exacerbate, such as asthma, it's worth having an allergist in your corner to guide you through the options.
If you've already tried a bunch of over-the-counter medications, they may recommend prescription antihistamines or the asthma treatment montelukast. Or they might discuss the option of immunotherapy, which can be done with allergy shots or sublingual tablets that dissolve in your mouth.
The nice thing about allergy shots or tablets compared to other treatments for allergies is that "they don't just treat the symptoms, they actually treat the underlying disease," Azar said.
Immunotherapy treats allergies by exposing your body to small (but increasing) amounts of the compounds that you're allergic to, the ACAAI explains. Over time, you'll become less sensitive to that allergen — ideally permanently. But allergy shots are an investment in both time and energy because they require repeated trips to your allergist's office, likely for a few years.
The sublingual tablets can be taken at home (after the first dose), but can only address one allergen at a time, Blair said. So if you're only allergic to grass or ragweed, that might be an option for you.
Immunotherapy may also be a good option if you're just tired of taking daily allergy medications or finding that your medications just aren't doing enough.
"About 80 to 90% of patients who are appropriate for (allergy shots) will get about a 40% reduction in symptoms," Blair said, "which some people think is not enough. Some people think that's amazing. It kind of just depends on how someone's looking at it."