Temperatures are starting to rise and pollen is in the air, which can mean only one thing: Spring allergy season is here. And thanks to a mild winter and more precipitation, this year's pollen season is shaping up to be rough. So, if you aren't already taking the allergy medications you typically rely on, now is the time to start, experts say.
With allergy season picking up earlier than in the past, starting your medications even earlier can make a huge difference in keeping your symptoms under control. Letting them go untreated, however, can leave you feeling miserable — and make it harder to treat your runny nose, sneezing, fatigue and itchy, watery eyes.
“The longer you have symptoms, if they’re not treated well, it builds up so that your symptoms can get worse and worse,” Dr. William Reisacher, an otolaryngic allergist at Weill Cornell Medicine, tells TODAY.com.
That means the key to keeping your symptoms at bay all spring (and summer and fall) is figuring out what types of pollen you're allergic to, learning when they tend to spread and starting your over-the-counter medications early in the season for your set of allergens.
How severe will this allergy season be?
Also, allergy season may be more challenging in some areas of the country than others. For instance, the worst city for people with pollen allergies is Wichita, Kansas, followed by Dallas, Texas and Scranton, Pennsylvania, according to the 2023 Allergy Capitals report from the Asthma and Allergy Foundation of America.
The report ranked cities in the U.S. based on the amount of pollen that's likely to be in the air this year, as well as allergy medication usage and the local availability of board-certified allergists.
On the other hand, people living in Buffalo, New York, as well as Seattle, Washington, and Cleveland, Ohio, are likely to have an easier time with pollen allergies this season, the AAFA report explains.
And with climate change causing milder winters, allergy seasons may be getting more severe, too, Dr. Michelle Pham, allergist and immunologist at UCSF Health, tells TODAY.com.
With milder winters, “you don’t get the benefit of the frost, so you have a longer growing season,” Dr. Tanya Elliott, a board-certified allergist at NYU Langone Health, explained during a March 9 segment on the TODAY Show.
But we’re also seeing more precipitation, she says. “So you have more rainfall and warmer weather, (which is a) perfect storm for allergy season to start sooner,” Elliott explains.
While that’s frustrating news for anyone with seasonal allergies, it’s especially dangerous for those who have asthma that’s triggered by allergies, the AAFA report says. Asthma can cause symptoms such as shortness of breath, chest discomfort, wheezing and coughing, the AAFA explains. And that's on top of the usual congestion and itchy eyes and throat that pollen allergies can cause.
Is it seasonal allergies or a cold?
If you start to feel congested and fatigued, you could be dealing with a cold or your usual seasonal allergies. So it's important to figure out what's really going on before trying to treat it.
"Itchy eyes, runny nose, congestion and facial pressure are consistent with allergies, but you also see that when you have a cold," Elliott says.
First, remember that allergies never cause a fever or swollen lymph nodes, she explains. So if you have those symptoms, it's more likely that you're dealing with another illness, such as a cold or COVID-19.
Second, think about the timing of your symptoms and how long they've lasted, Elliott says. If you're feeling those symptoms around the time you normally experience allergies, that suggests your runny nose is due to allergies. Also, colds usually last seven to 10 days, whereas allergy symptoms can persist for much longer.
When should you start taking your allergy medications?
If you get spring allergies, you should start taking your medications and getting your allergy management plan in motion starting around Valentine’s Day, Feb. 14, experts say. But even if you missed that date, it’s still important to start taking them as early in the season as possible.
“It’s hard to be motivated (to start taking your medication) when you feel well,” Pham says. “But the whole idea of starting it beforehand is so that you don’t get any symptoms, and you continue to feel well throughout your season.”
That’s why she recommends her patients start using corticosteroid sprays, such as Flonase, about four weeks before the start of their allergy season. “And with oral antihistamines, we have patients start about two weeks before,” she adds.
Oral antihistamines begin to work quickly (usually within 15 minutes to two hours), so it’s not the worst thing to start taking them once your symptoms start to come on, Dr. Sandra Hong, an allergist at the Cleveland Clinic, tells TODAY.com. But if you can avoid getting your symptoms in the first place by pre-treating, that’s even better. To get the most out of your allergy medications, you'll want to start taking them before the allergens that you're sensitive to begin to appear.
While fluctuating temperatures can cause intense pollen spikes on an unusually warm day in the winter, seasonal allergies typically kick off in March with tree pollen, Reisacher says. That's followed by grass pollen around June, and then weed pollen in late August and September, which continues generally until the first frost, he says.
So, most people who get spring seasonal allergies will be safe starting their medications around Valentine’s Day, Dr. Kathleen R. May, president of the American College of Allergy, Asthma and Immunology, tells TODAY.com.
"When you think of Valentine's Day, think of your allergist," Hong agrees.
But the exact timing — and the specific types of plant pollen you might be exposed to — are both "contingent on where (you live)," May adds. In Texas, for instance, mountain cedar pollen, a type of tree pollen, starts to pick up as early as December, May says.
Because the correct timing can be so individual, the experts suggest that people who get allergies see an allergist to learn what their triggers are and then keep an eye on local weather trends and pollen counts. In particular, Pham directs people to the American Academy of Allergy, Asthma and Immunology's website where they can look at data from pollen sampling stations in their area.
Why should you start taking allergy meds so early?
There are a few good reasons to start taking your allergy medications before you start feeling symptoms.
First off, if you're waiting to see leaves on trees before you start those medications, you'll be too late, May says. Pollen on trees may look like fuzzy buds, and it can appear before the leaves come back in the spring, she adds.
And some medications, particularly corticosteroid nasal sprays (commonly known by brand names Flonase and Nasacort), can take two to four weeks to build to their maximum effect.
There's a mechanical reason to start the sprays early, too: If your nose is already full of snot, it will be harder for the spray to get where it needs to go, May explains.
Antihistamine medications, including pills, nose sprays and eye drops, can typically be used on more of an as-needed basis than the steroid sprays, Reisacher explains. But if you know you're going to be exposed to your allergen (like at someone's house with a pet or outside on a hike, for instance), he recommends patients take their antihistamine medication the day before, the day of and the day after the exposure.
"Steroids can decrease inflammation overall," Pham explains, while antihistamines block histamines, the compound your body releases in response to allergens, from affecting the cells that cause allergy symptoms.
What's more, "during the initial part of the season, it takes less pollen to trigger you," May explains, which is another "reason we always tell people to do the medications in advance."
Other ways to combat allergy symptoms this season
As important as it is to take your medications early, don't forget to also start putting your other allergy management tactics into motion.
- Consider wearing sunglasses, a hat and a high-quality mask outside. If you're going to be at your child's baseball game or out gardening, for example, a high-filtration mask can help manage your symptoms, Hong says.
- Take a shower when you get home. Pollen can accumulate on your skin and especially your hair. "You can collect almost a tree's worth of pollen right on your own head if you have a lot of hair," Reisacher says. So it's important to rinse off when you come back inside.
- In addition to a shower, try using a saline nasal spray or a nasal rinse with purified water to flush pollen out of your nasal passages, the experts suggest.
- Close the windows (in your car, too!) and use a HEPA air purifier in your home, especially the bedroom, the experts advise.
- Keep an eye on pets that go outside. Pets can accumulate pollen from the outdoor environment, Hong says. So, if you can, try not to let them spread that pollen around in the house.
- Have a few indoor-only outfits. That way, when you come home and change into your indoor outfit, "you're not walking around the house depositing pollen into all the rooms," Reisacher says. In fact, Elliott recommends that patients keep a laundry basket right by their front door to drop their outdoor clothes.
- Try to avoid using hair spray when you'll be outside, Elliott says, because "pollen loves to stick to our hair."
When to see an allergist
Many people with run-of-the-mill seasonal allergies can manage their symptoms with over-the-counter medications. But there are a few important reasons to check in with your doctor or an allergist.
First, if your go-to medications aren't helping as much as they used to, go ahead and try another brand, Hong says. But if that's still not helping, it may be because your symptoms are simply getting worse, May advises. In that case, it's worth talking to an allergist about your options, which could include prescription medications or long-lasting treatments, such as immunotherapy.
Finally, if you think you might have asthma or another condition that can be worsened by seasonal allergies, you should talk to your doctor about the best ways to manage those issues.
"People who don't have allergies don't understand how disruptive it is your quality of life," May adds. "They don't quite realize the impact on sleep, the impact on your daytime alertness and function."
But addressing your allergies sooner rather than later can make your whole season much easier to deal with.
"It's really important to think about allergies before your season starts," Hong explained. "Getting the jump on your allergies will make all of your symptoms so much better for the entire springtime."