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What an immunologist wants you to know about spring allergies

Don't fall victim to high-pollen counts. Here's what you can do to ease symptoms — and even prevent them altogether.
Image: Spring allergies
According to the Asthma and Allergy Foundation of America, more than 50 million Americans experience various types of allergies each year — and spring allergies make up a significant chunk of that.South_agency / Getty Images

If you’ve spent the last few weeks sneezing, rubbing your eyes and going through boxes of tissues at your desk, you’re not alone.

According to the Asthma and Allergy Foundation of America, more than 50 million Americans experience various types of allergies each year, and those that are prevalent during the spring make up a significant chunk of that. Seasonal allergic rhinitis (or hay fever) — an allergic reaction to pollen from trees, grasses and weeds — affects 6.1 million children and 20 million adults nationwide.

And if your symptoms seem worse than previous years, it’s not all in your head.

“It is a bad pollen season, and part of the reason is progressively, year to year the pollen season has been getting worse due to climate change,” says Dr. Purvi Parikh, an adult and pediatric allergist and immunologist with Allergy and Asthma Associates of Murray Hill in New York City, and spokesperson for the Allergy & Asthma Network. “We are having rising carbon dioxide levels in our atmosphere and plants feed off of that, so we’re producing these super-high pollen plants; the pollen is more potent and it’s in the air for much longer. The season is much longer, too.”

Fifty million Americans experience various types of allergies each year.

Not to mention that year-round allergens like dust mites, mold and animal dander are still wreaking havoc. “People are still reacting to those year-round allergens in the pollen season, but now there’s extra allergen in the air, which can make their reactions even worse; it’s potentiating an already ongoing allergic reaction,” says Dr. Parikh.

If you are suffering from spring allergies, when can you expect some relief?

“That depends on which exact pollen you’re allergic to, because there are different pollens that come in at different months,” says Parikh. “Tree pollen is the first one, it usually starts in late March/early April, then this goes down and grass pollen is in the air May and June. Then late summer/early fall we see weed pollens, as well as ragweed. Some people may be unlucky and allergic to all of them and they are suffering a lot of months out of the year, or they might just be allergic to one and it’s a few weeks.”

It seems that some of us may want to order that jumbo pack of tissues and hide indoors for the next few months. But taking the time to understand exactly what is going on inside your body — and how you may be able to combat it — may help you find some relief this season.

Your body on allergies

So what exactly is happening in your body when you’re exposed to an allergen like pollen (and instantly feel your eyes well up and throat start to get scratchy)?

“Essentially what happens is your immune system decides that it wants to become hyper-sensitive, or allergic, to something. So your immune system recognizes pollen [or another allergen] as foreign and it releases a big amount of a chemical called histamines into your blood stream. What the histamine does is triggers this whole immune, or inflammatory, cascade of itchy, watery eyes and stuffy or runny nose. Some people are unlucky and it can be even more severe where they can have breathing problems, asthma attacks, and even bad skin reactions, like flare-ups of eczema, hives or rashes from it as well, because we have histamines and allergy cells throughout our entire body.”

So why are you dying a slow death at your desk, while your co-worker just has the sniffles?

The severity of the immune response, and triggered symptoms vary from person to person. “Just like any medical illness it’s a spectrum, where some people have a very severe, strong reaction where more body systems are involved and some people have it milder,” says Parikh. “Even within the same body system: For one person the itching in their eyes may be very mild, but I’ve seen patients come in where their eyes are swollen shut.”

Is it allergies or a cold?

When you’re allergies flare up, you may be quick to assume it’s a cold, which is a logical assumption, since they present similar symptoms.

“A lot of the symptoms are almost identical: very bad nasal congestion, coughing, wheezing, watery noes and eyes,” says Parikh. “But generally colds shouldn’t last you more than a week — 3-5 days on average — whereas allergy symptoms can last weeks to months at a time.”

Besides the length of time you’re suffering from symptoms, there are a few other key differences to look out for. “It’s likely allergies if you’re noticing a pattern to it; if you’re sick all spring or fall (even in the winter it’s still probably allergies if it’s lasting weeks and weeks),” says Parikh. “Allergies are also more associated with itching … itchy nose, itchy eyes … and also with colds, viruses and flus people get much higher fevers than you would with an allergy, so any temperature over 100 or 101 is more likely a virus or infection of some sort.”

How to survive allergy season

  • Don’t write off allergies if you’ve never had them. You can absolutely develop allergies as an adult, “especially the environmental ones,” notes Parikh. “Those tend to change and can come up in adulthood, especially if you’re moving to a new environment after a few years; if you’re moving into a city that has different air quality than where you were living before you can develop an allergy.”
  • But know they can also improve over time. “It can happen, due to environmental changes, but also hormones can have an affect," says Parikh. "So often after puberty, young boys will see their allergies and asthma get better, whereas the opposite happens with girls, unfortunately, because hormones also have an influence on the allergy cells in your body."
  • Get tested. “We recommend people see a board-certified allergist, and there are two options in terms of testing: Skin testing, where they would know within 15-20 minutes, and blood tests, where we can see what each specific allergen that they’re allergic to involves," says Parikh. "It's helpful because then we can predict which season of the year might be a problem for them. And for some people we are even able to desensitize them or cure their environmental allergies. We use that information to help manage the symptoms, and know when to start and stop medication, and for the desensitization treatment we target individual pollens as well as mold, dust mites, etc.”
  • Choose the right over-the-counter medications. "Generally, the over-the-counter options are a good start, especially the anti-histamine tablets and steroid nasal sprays, those are actually the safest over-the-counter options," says Parikh.
  • Consider medication or allergy shots. "You can start with over-the-counter, but if it's not improving and your symptoms are involving your breathing, like coughing or wheezing or chest tightness, then you really should see a doctor," says Parikh. "We get the people who we know are very susceptible started on preventative medication before the season starts because that way they're less reactive to their outdoor environment. The immunotherapy or allergy shots are very effective because even with the medications, it’s just suppressing the symptoms; what immunotherapy does, is over time, makes you less allergic, so you won’t even need the medications because you aren’t reacting as strongly anymore."
  • Allergy-proof your home. “The most important room in your house to keep allergy-free is your bedroom, because we all spend the most time at one there sleeping. If you’re allergic to dust mites, for example, we recommend having very little rugs or carpeting. There are also special encased covers for your mattress, box spring and pillows which have been shown to be the only effective measure against dust mites because it creates a barrier between you and the dust mites," says Parikh. She also recommends an air purifier if you have a pet or mold in your home environment. "And in the season, we always recommend to rinse your body and change your clothes when you come home from outside so you don’t track the pollen into the bed with you. Keep the windows closed, especially early in the morning, when the pollen counts are the highest.”
  • Know how to find temporary relief. “Wash out your sinuses with a Neti Pot or a saline solution with salt and water — that helps clear things out of your nose," says Parikh. "Hot showers do help, they open things up so you can breathe better and also wash off any pollen or things that are on your body.”
  • Adjust your exercise routine. Wearing sunglasses and a hat can help protect your eyes from pollen, but these are temporary measures and it’s very hard to avoid it; it’s all round you," says Parikh. If your allergies are severe, "avoid outdoor, early-morning exercise because that's when the pollen counts are the highest. You may want to do evening outdoor workouts or take it indoors, Parikh says.
  • Skip happy hour.Alcohol makes all allergic reactions worse," says Parikh. "It increases blood flow to those areas of the body that are already inflamed, and also causes inflammation. Anything that causes inflammation in your body can make it worse — junk food, excess dairy — but alcohol is the only one that we know for sure worsens allergies."
  • Pay close attention to breathing symptoms — and don’t take them lightly. “There is a peak in emergency room visits and hospitalizations during allergy season because some people get asthma attacks and have a lot of difficulty breathing," says Parikh. "We always stress not to take that lightly, even if it’s never happened to you before. You could of never had asthma before and have an asthma attack due to your allergies. A lot of times people think it’s only mild symptoms and it can be treated with over-the counter medication, but for some people it does create a large problem and we’ve seen the studies to support it with ER visits and hospitalizations."


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