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By Whitney Salinas, M.D.

Internal Medicine - Allergy and Immunology, UT Southwestern Medical Center

Spring means blooming trees and newly green grasses. But if you have seasonal allergies, it also means dealing with congestion, sneezing, a runny nose, and itchy, watery eyes.

More than one in four adults and one in five children in the U.S. have seasonal allergies (allergic rhinitis). And North Texas has a perfect climate for producing allergy-inducing pollen.

Along with the more well-known spring oak trees and fall ragweed allergies, our region is known for high pollen counts of the mountain cedar (Juniperus ashei) evergreen tree, which causes “cedar fever” – nasty allergy symptoms – in the winter.

Anyone can develop new or worsening seasonal allergies, even well into adulthood. Moving to a new state or geographic area can introduce new-to-you blooms. And seasonal allergens often stem from wind-pollenated plants, such as trees, grasses, and weeds. So, warmer temperatures and windier weather can infiltrate your neighborhood with new plants that may produce more pollen longer into the season.

Allergies are among the most common health problems. When you’re allergic to something like pollen, your immune system sees it as a threat and triggers a response. Antibodies in your nose, eyes, or lungs stimulate the release of chemicals like histamine, which cause symptoms such as sneezing, runny nose, congestion, and itchy, watery eyes.

Left untreated, seasonal allergies can cause miserable symptoms and even chronic sinusitis – long-term sinus inflammation, congestion, and recurrent sinus infections. Seasonal allergies can also trigger or worsen asthma symptoms.

But you don’t have to lock yourself indoors until fall! Allergy experts in the UTSW  can walk you through three solutions that have helped thousands of Texans manage unruly seasonal allergy symptoms each year.

Most challenging allergy areas in Texas

With all that pollen swirling in the air, it’s no surprise that a  (AAFA) ranks six Texas cities in the top 50 most challenging metro areas to live with pollen allergies:

• Dallas at No. 13 – up from No. 16 in 2020
• Houston at No. 26
• McAllen at No. 27
• San Antonio at No. 37
• Austin at No. 45
• El Paso at No. 50

Ways to manage seasonal allergies

1. Reduce exposure to pollen

While you can’t totally avoid the great outdoors, you can minimize your exposure to the pollens that trigger your symptoms:

• Stay indoors as much as possible on dry, windy days.
• Keep your windows closed when pollen counts are high.
• Avoid mowing the lawn, pulling weeds, or gardening chores that can stir up allergens.
• After you’ve been outdoors, change your clothes and shower to rinse allergens from your skin and hair.
• Wear a face mask outdoors if it’s windy or you are doing yard work.

2. Use medication

Several types of over-the-counter medications can help ease seasonal allergy symptoms. These include:

• Antihistamines: Use daily to help relieve sneezing, stuffy or runny nose, and itchy, watery eyes. Examples of these are cetirizine, fexofenadine, and loratadine.
• Corticosteroid nasal sprays: Use daily to help prevent seasonal allergy symptoms. A common example of this is fluticasone propionate.
• Antihistamine sprays: Use as needed to relieve congestion, runny nose, and sneezing. The most common example of this is azelastine.

Some allergy medicines, such as diphenhydramine, can cause mild side effects like drowsiness and are generally not recommended for daily use. Read the label carefully and talk with a pharmacist or health care provider about which type of medication is right for you.

Nasal sprays are often most effective for people with seasonal allergies. Using a saline sinus rinse once or twice a day as well can rinse pollen out of the nose, help medicated nasal sprays get deeper into the nose, and thin out secretions so they’re easier for the sinuses to clear.

If your child has allergies, talk with their pediatrician or a  about which medications are safe to take regularly.

Decongestant medications

Some allergy medications combine an antihistamine with a decongestant. While these can relieve stuffiness, long-term use can cause complications with certain health problems, such as high blood pressure.

Avoid cold and flu medications that have extra ingredients you don’t need for allergy relief, such as acetaminophen to reduce fever.

Decongestant nasal sprays that use oxymetazoline hydrochloride should only be used for a few days in a row. Long-term use can increase your blood pressure and make you more stuffed up, leading to an ugly cycle of continuous use.

Talk with a doctor before taking any type of decongestant for more than a few days. If over-the-counter medications don’t do the trick, prescription oral or nasal spray medications can be effective.

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3. Consider immunotherapy

If you’re miserable with seasonal allergies and medication hasn’t helped or you want to minimize medication use, your allergist may recommend immunotherapy. This treatment involves getting regular injections of allergy serums of the environmental aeroallergens you’re allergic to.

To learn what you are allergic to, we perform an allergy skin test where we scratch the skin with different allergy serums. We take the things you are allergic to and mix them into a vial individualized for the patient. Treatment starts with tiny doses, and we gradually increase the amount over several months. You continue to receive monthly injections for three to five years to build immunity. Allergy shots are not a quick fix but can be very effective. AAFA reports that many people get complete relief within one to three years of starting immunotherapy, and the benefits last several years after stopping the shots.

Sublingual immunotherapy can be effective for ragweed, grass pollen, and dust mite allergies. You’ll place a dissolvable tablet under your tongue daily to expose your immune system to the allergen. Similar to allergy injections, this therapy takes a few months to show improvement and you would be on the therapy for three years. Talk with a doctor about which immunotherapy is the best choice for your allergies.

Related reading: 

4 seasonal allergy myths – debunked

As with many health conditions, there are many myths surrounding seasonal allergies. Let’s debunk a few that we discuss most often with patients.

Myth 1: Eating local honey helps relieve seasonal allergies.

Truth: In general, the pollen collected by bees is not the same pollen that is triggering your seasonal allergies. That’s because the pollen from flowers that bees like is often too heavy and sticky to be carried by the wind and cause your allergy symptoms. So, the pollen in local honey likely isn’t the same type of pollen you’re allergic to.

Myth 2: Moving to the desert will cure your allergies.

Truth: In the U.S., there is no allergy-free zone. Many types of desert plants produce pollen, and when pollen counts are high, you can have allergy symptoms.

Myth 3: I only need to take allergy medication when I feel bad.

Truth: Most allergy medications work best if taken daily, ideally starting a couple weeks before allergy season starts. For some people, this approach can prevent symptoms or minimize them from the start of allergy season.

Myth 4: I’ve never had seasonal allergies before, so I can’t have them now.

Truth: You can develop new allergies at any time, even in adulthood, more commonly if you move to a new location. If you’re unsure whether you have allergies or a recurrent cold, talk with an allergist about testing and treatment options.

Seasonal allergies are no fun, but effective treatments are available. If allergy symptoms disrupt your life, talk with a board-certified allergist to develop a long-term plan that can help you get back to the great outdoors.