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Seasonal Allergies

Seasonal allergies are caused by allergens in the air, like pollen and mold. They cause sneezing, watery eyes, sore throat and can make you feel terrible, but there are ways to prevent and reduce your symptoms.
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Written by David Lee, MD.
Clinical Fellow, Pediatric Otolaryngology, Children's Hospital of Philadelphia
Last updated July 15, 2022

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Care Plan

1

First steps to consider

  • Mild to moderate seasonal allergies can often be treated at home.
  • Can be treated with OTC antihistamines and decongestants and avoiding allergens.
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2

When you may need a provider

  • Symptoms have not improved with OTC medications
  • Moderate to severe symptoms that affect your daily life for more than 4 days a week and more than 4 weeks in a year.
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What are seasonal allergies?

Seasonal allergies (also called hay fever) are caused by your immune system reacting to a foreign substance in the environment, including pollen from flowering trees, grass, weeds, and flowers. Your body produces antibodies against these pollens, which triggers a chain reaction that leads to allergy symptoms like runny nose, sneezing, sore throat, and itchy eyes. Your symptoms may be mildly annoying or so intense that it feels like a bad cold.

Seasonal allergy symptoms

When allergy season hits, it can seem like you’re coming down with a cold or flu. Though symptoms can mimic those of a cold or flu, they usually don’t cause fever, chills, or body aches. Seasonal allergy symptoms include:

Pro Tip

An important question to ask your doctor is, When should I get allergy testing? Many people don’t realize how helpful allergy testing can be. It may sound too simplistic, but if you can avoid exposure to the allergens you’re allergic to, you won’t have any allergy symptoms! —Dr. David Lee

How long does hay fever last?

Seasonal allergies in the U.S. begin in the spring with the flowering of trees, then grass and weeds in the early summer, and generally end in the fall with ragweed season.

Each allergen generally lasts 2 to 3 months, peaking for about 2 to 3 weeks—when symptoms are at their worst. The timing depends on both the allergen and where you live.

For example, pine pollen is released from April to July, with a peak generally in late May. Elm pollen is released from February to April, with a peak in March.

Some people may be allergic to only one type of pollen, while others are allergic to several allergens.

Some people have allergy symptoms to dust mites and mold spores. These are indoor allergies and are not seasonal. Usually, symptoms are worse during the cold months when people spend more time indoors.

Pro Tip

Each person’s allergy symptoms are different. This is for many reasons, but the biggest is that not everyone is allergic to the same types of pollen (of which there are many types) and everyone’s immune response is a little different. In addition, geographic location plays a large role in allergic responses. —Dr. Lee

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Can you outgrow allergies?

Most seasonal allergies develop during childhood or early adulthood. Some people may outgrow allergies over time, while others first develop allergies later in life. Changes in sensitivity to a specific allergen can be from many causes. It may simply be from changes in the environment, such as moving to a different location. Or the specific response to the allergen may have changed.

Seasonal allergies treatments

There are many approaches to treating seasonal allergy symptoms. It usually requires a combination approach: avoiding allergens when possible, taking medications to prevent the symptoms, and treating symptoms when they occur.

Medications

If you are taking several types of medications, review them with a doctor to avoid cross reactions of the medications or accidentally taking too much of one type.

  • Antihistamines: These block histamine, a compound released by the immune system during an allergic response. Some people find it helps to start these medications a week or two before allergy season, while others may only need to take them when their symptoms worsen. These are available over the counter or by prescription as pills (Zyrtec, Allegra, Claritin), eye drops (Zaditor, Patinol, Visine), or nasal sprays (Azelastine, Patanase).
  • Decongestants: These decrease nasal congestion and open up clogged nasal passages. They can be either nasal sprays (like oxymetazoline, or Afrin) or oral decongestants (pseudoephedrine) and are available over the counter. Decongestants should not be taken for more than 3 or 4 days in a row.
  • Nasal saline sprays: These can clear congestion from the nasal passages and help the body get rid of inhaled allergens.
  • Corticosteroids: These are prescription medications that stop inflammation caused by allergies. They should only be used for very severe symptoms.

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Immunotherapy

Immunotherapy is a treatment that trains your body to stop reacting to an allergen by exposing you to very small amounts of the allergen. Over a period of months to years, you are given increasingly higher doses of the allergen. Eventually, you are switched to a maintenance dose. Types of immunotherapy include allergy shots, sublingual (under your tongue) immunotherapy, and some types of biological medications.

Dr. Rx

There has been so much improvement in types of allergy immunotherapy. Many people have had incredible resolution in their allergy symptoms with allergen-directed immunotherapy. This can be in the form of injections (allergy shots, which are the most common) to drops that go under the tongue. —Dr. Lee

Lifestyle approaches

For seasonal allergies, limiting outdoor exposure during peak pollen seasons may reduce symptoms.

  • A good time to go outside is after it has rained because there will be fewer allergens in the air.
  • Avoid dry, windy days when allergen counts are high.
  • After you have been outside, change out of your clothes as soon as you can and take a shower to remove allergens that are on your skin and hair.
  • Find a source for getting your area’s pollen count so you know when it’s at a high level. On days with high pollen counts, limit time outdoors and keep windows and doors closed.
  • When pollen counts are expected to be high, you may want to take allergy medication before symptoms start so they hopefully won’t be as bad.
  • HEPA (high-efficiency particulate air) filters in heating and cooling systems reduce indoor allergies like dust and mold.
  • Keep indoor air dry with a dehumidifier to decrease mold and mildew.
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Clinical Fellow, Pediatric Otolaryngology, Children's Hospital of Philadelphia
Dr. Lee is a board-certified otolaryngologist and medical consultant for Buoy Health. He completed his undergraduate degree in Biochemistry and Spanish at the University of Arkansas (2011) and went on to complete medical school from the University of Arkansas for Medical Sciences (2015). He completed his residency training in Otolaryngology - Head and Neck Surgery at the University of Cincinnati (...
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