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Itchy, watery eyes and a stuffy nose? Smells like seasonal allergies.
About a quarter of U.S. adults deal with seasonal allergic rhinitis, or hay fever. The immune system reacts to the airborne pollen, causing the allergic symptoms. And warmer temperatures mean spring is coming earlier, resulting in longer pollen seasons.
But allergists and rhinologists said you don't need to suffer through the plume of pollen. Take your allergy medication such as a nasal steroid a few weeks before peak pollen counts to get ahead of symptoms.
"If you don't proactively treat your symptoms before a pollen allergy season starts, you are going to have a much more difficult time treating it," said Zachary Rubin, an allergist in the western suburbs of Chicago.
Rubin said he tells his patients with spring allergies to start taking their medication on Valentine's Day.
• What pollen am I allergic to?
There are three types of pollen people can be allergic to: grass, tree and weed. Your primary-care doctor or an allergist can order a blood or skin test to help determine what type or types you are allergic to, experts said.
Generally, tree pollen circulates in early spring, grass pollen spreads in the early summer and weed pollen is in the air late summer through the fall. Oak and sycamore trees are notorious for pollinating early in the spring, said Khaled Abdel-Hamid, an allergist at Washington University School of Medicine in St. Louis.
But the exact timing of seasonal allergies depends on where you live, experts said. Cedar trees in Texas pollinate in the winter, causing what's known as "cedar fever."
Patricia Lugar, an allergy and immunology specialist at Duke University School of Medicine, recommends that people follow pollen counts from local reporting stations. The American Academy of Allergy, Asthma & Immunology also has a map of certified pollen counting stations across the United States.
• What are the most effective treatments?
Treatment starts with avoidance, experts said. If pollen counts are high, close windows, consider using an air purifier, avoid yard work, and change your clothes and take a shower when you come inside.
There also are a number of over-the-counter and prescription medications people can take to mitigate their allergic reactions.
Nyssa Fox Farrell, an assistant professor of otolaryngology at Washington University School of Medicine in St. Louis, said she recommends patients take nasal sprays instead of oral tablets because the sprays provide treatment "at the source."
- Nasal steroid sprays take time to work but can effectively treat the "cascade of immune responses" caused by seasonal allergies, Lugar said.
- Antihistamine tablets and sprays "are add-ons" that don't require the same lead time as steroid sprays, Lugar said. Antihistamines can help people who have a constant runny, itchy nose and watery eyes.
- Saline sprays or saltwater rinses will thin out mucus and wash away allergens stuck in the nose to prevent some of the symptoms, Farrell said.
- Leukotriene antagonists, such as the brand-name Singulair, are prescription drugs for people with nasal congestion, a cough or other respiratory symptoms caused by their allergies, Lugar said.
- Allergy shots are the "gold standard" to manage seasonal allergies, Lugar said. A doctor injects small amounts of an allergen in the skin every week to train the immune system to the exposure. But it's a long process, generally, with injections once a week for seven months and then every month for another three years, she said.
"Within the first year, you can go from four medications to treat your allergies to zero," Lugar said. And, when you're done with the treatment, "you're off medications for decades," she said.
• What about decongestant sprays?
Nasal decongestant sprays such as Afrin "squeeze the blood vessels," shrinking the tissue in the nose, which allows for greater airflow, said Erich Voigt, a professor of otolaryngology and the division chief of general otolaryngology at NYU Langone Health.
But nasal decongestants aren't treating the root cause of the congestion, and after repeated use, the nose can require more of the drug to achieve the same effect. Voigt said this can lead to a "vicious cycle" where people use more of the drug, more frequently, to breathe better, and the nasal passage can end up even more swollen than when a person first started using it.
Use a nasal decongestant for only up to three days in a row, experts said. Voigt said he recommends people use it only to treat a nose bleed or to relieve nasal congestion before boarding a flight. A person with a stuffed-up nose can burst an eardrum while on a flight because of the change in pressure.
Farrell and other researchers at Washington University in St. Louis are studying whether decongestant sprays could be combined with a steroid to mitigate the potential side effects of long-term use.
• Can local honey alleviate seasonal allergies?
Despite claims online, there's no evidence a spoonful of local honey will treat your seasonal pollen allergies, experts said. The honey might help to soothe a sore throat or cough, but not treat the allergic reaction.
"The pollen that's actually in honey is not the pollen you're allergic to," Rubin said. "Plants you're allergic to are wind-pollinated, not insect-pollinated."
• Can I develop a seasonal allergy as an adult?
Many people develop allergies when they are children, Abdel-Hamid said, but he has seen patients well into their 50s and 60s with first-time allergies.
A person can develop allergic reactions after certain viral infections, even the common cold, and some women report a change in allergies after childbirth, he said.
• What if it's actually a cold?
Colds and allergies have similar symptoms but allergies don't cause fevers, experts said. If you have a fever, you may have a virus or infection.
Seasonal allergies also linger for weeks whereas respiratory illnesses such as the cold, flu or respiratory syncytial virus (RSV) will wax and wane over the course of a few days or a week, experts said.
But if you have a cold or allergies, you're at risk of developing a sinus infection, Lugar said. Sinus infections cause persistent headaches, or facial pain, with thicker, yellow or green mucus.
"It's fairly copious for most people," Farrell said. "Whereas with viral infections and allergies, the drainage tends to be more clear."
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