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How To Treat Seasonal Allergies

For millions of allergy sufferers, spring and summer mean sneezing, runny noses and itchy eyes. Plumes of pollen from trees,…

For millions of allergy sufferers, spring and summer mean sneezing, runny noses and itchy eyes. Plumes of pollen from trees, grasses and plants (such as ragweed) get released into the air and trigger seasonal allergies — also referred to as hay fever and allergic rhinitis — for nearly 1 in 4 American adults and nearly 1 in 5 children.

With experts expecting a longer, more severe allergy season this year, many people are looking for allergy relief. Here's what you need to know about seasonal allergies and how to manage your symptoms.

[READ: When Allergy or Cold Medicine Makes You Drowsy.]

When Is Allergy Season?

In the U.S., May is typically the worst month for allergies due to the increase in pollen counts from trees and grass across the country. However, seasonal allergies can occur year-round, depending on where you live, where certain plants grow and when they bloom and release pollen.

Summer allergies are typically triggered by grass pollen and generally start in June and go through September. During the winter months, cedar trees release plumes of pollen in the South, giving rise to "cedar fever." In the Midwest, birch, oak, pine and elm trees start pollinating in the early spring followed by a heavy grass pollen season. Timothy and Bermuda grasses are two major allergy-triggering culprits in the spring and early summer. Ragweed releases its pollen in the fall.

"There are hundreds of different weeds, trees and grasses that all produce pollen," explains Dr. David Corry, professor of medicine in the section of immunology, allergy and rheumatology at Baylor College of Medicine in Houston. Therefore, the timing and location of the allergy season, he explains, "is an issue of botany."

[READ: How Seasonal Allergies Can Impact Mental Health]

Seasonal Allergy Symptoms

Common allergy symptoms include:

— Sneezing

— Runny nose

— Itchy, watery eyes

— Sore, scratchy throat

— Coughing

— Sinus congestion

— Fatigue

Allergies can also cause coughing, shortness of breath and wheezing in people with asthma.

"These symptoms are actually very bothersome and can affect not only your nose and your lungs, but they can affect your daily life and quality of living," says Dr. Anju Peters, an allergy and immunology specialist at Northwestern Medicine in Chicago. "It can definitely affect your overall school performance, work performance and mental well-being in general."

[READ: Allergies or Cold: What's the Difference?]

Seasonal Allergy Causes

Seasonal allergies occur when an allergen — such as pollen from trees, grass and weeds or mold spores — enters the body. In response, the immune system overreacts and produces antibodies, called immunoglobulin E (IgE), that signal to cells to release histamines, a chemical that fights off invaders, causing allergy symptoms.

The most common allergens include:

— Alder

— Ash

— Birch

— Cedar

— Elm

— Grass

— Maple

— Mugwort

— Mulberry

— Oak

— Pine

— Ragweed

— Sagebrush

— Mold

Treatments for Allergies

There is a wide variety of over-the-counter medications, as well as prescription drugs, that can help you manage your symptoms and keep hay fever at bay.

Allergy medications

There are several over-the-counter allergy medications that can safely and effectively treat symptoms for most people with mild or moderate allergies.

— Oral antihistamines: While diphenhydramine (Benadryl) and hydroxyzine are common antihistamines, they are considered older, first-generation allergy medications that tend to have a long list of side effects, such as sedation, drowsiness, fatigue and impaired alertness. Instead, experts recommend second-generation antihistamines — including cetirizine (Zyrtec), loratadine (Claritin) and fexofenadine (Allegra) — to treat seasonal allergies because they are longer lasting and more effective with minimal side effects.

— Nasal corticosteroid sprays: Fluticasone propionate (Flonase Allergy Relief), nasal triamcinolone (Nasacort AQ) and budesonide (Rhinocort AQUA) are safe and effective intranasal treatments for seasonal allergies. In contrast, OTC decongestant nasal sprays such as Afrin, Sinex and Neosynephrine should only be used a few days for congestion, or you can develop "nasal rebound" and worse congestion. Unlike nasal decongestant sprays, such as Afrin, nasal steroid sprays are not habit-forming and can be used regularly. Saline nasal sprays and gels can also be effective for flushing out pollen from your nose and sinuses. Make sure you get the right nasal spray.

— Antihistamine eye drops: Allergy eye drops deliver antihistamines to your eyes to help relieve redness, itchiness and wateriness.

For kids and adolescents who suffer from seasonal allergies, there are several options for children's allergy medicine.

It's best to start taking antihistamines before you have symptoms, say experts. That's because by the time histamine (a chemical that's part of the immune response) is released and a person has symptoms such as nasal congestion, itching and sneezing, histamines are already present. If you start taking antihistamines before symptoms appear, they can block histamine before it has an effect on you.

If your allergy symptoms have a pretty consistent seasonal pattern, it's best to start taking antihistamines on a daily basis a week or two before the offending type of pollen emerges. Since the release of pollens can vary from year to year, allergists often recommend starting your medication regimen in early February if you're allergic to trees, early June if you're allergic to grasses and early August if you're allergic to ragweed.

Keep in mind, though, that while antihistamines help with sneezing and itchiness, they usually don't help with nasal stuffiness, which is better relieved by using a nasal steroid spray along with an antihistamine. Since nasal steroid sprays take a week or two to have the desired anti-inflammatory effects, you should also start using these before symptoms appear.

Can honey cure your allergies?

Eating local honey won't control your spring allergies.

"This myth comes from the idea that, since bees carry pollen, some of that pollen would get into the honey they make," explains Dr. Michael Blaise. "The theory is that by eating local honey, you're consuming pollen grains — which in turn 'desensitize' you to your allergies. It's a good thought, but the pollen that triggers allergy isn't transported by bees. It's the wrong type of pollen. Feel free to eat local honey because it tastes good, but it won't help your spring allergies."

Immunotherapy

Those who have moderate to severe or very severe allergies that do not respond to over-the-counter remedies should meet with an allergist or another health care professional who is equipped to conduct allergy tests in order to identify exactly what you're allergic to. Based on those results, experts may recommend allergen immunotherapy, more commonly referred to as allergy shots.

Allergy shots are essentially a "very slow, long-term form of vaccination," Corry explains. This treatment consists of injecting a very low dose of the allergen under the skin, then gradually building up the dosage over a period of days, weeks or months to train your immune system. Allergen immunotherapy can also be administered in tablet form, known as sublingual immunotherapy. The tablets, which are placed under the tongue and swallowed, are approved by the Food and Drug Administration for ragweed, grass pollen and dust mites.

"The goal and the intent of immunotherapy is to change how your immune system responds to whatever you're allergic to," Corry says. "The immune system essentially removes these irritants from your system, degrades them and expels them from your body without you experiencing any symptoms."

Allergies and asthma

Seasonal allergies can also trigger asthma flare-ups. Sometimes this phenomenon is referred to as allergic asthma, which means that allergens trigger asthma symptoms such as coughing, wheezing, chest tightness or shortness of breath. An injectable drug called Xolair (omalizumab) is designed to treat moderate to severe persistent allergic asthma.

Lifestyle changes to minimize allergies

In addition to medications, there are lifestyle strategies you can use to minimize the unpleasant effects of seasonal allergies.

— Monitor pollen counts. No one wants to be stuck indoors to avoid pollen. Instead, monitor your local pollen and mold levels and allergen forecast through weather apps or the American Academy of Allergy, Asthma and Immunology's National Allergy Bureau website. Plan to spend time outdoors when allergen counts are low.

— Wear a mask. The masks we used to protect against the spread of COVID-19 are also effective for preventing pollen from getting into your airways. If you know you'll be outside during peak pollen time or gardening, wearing an N95 mask will keep the allergens at bay.

— Don't wear shoes in the house. Taking your shoes off before entering the house is a common Asian practice. While the tradition is believed to protect against bringing bad luck into the house, it is also an effective way to maintain good hygiene and clean floors, as your shoes can track outdoor dirt, bacteria and pollen into the house.

— Change your clothes. Similar to removing your shoes, changing your clothes when you get home will reduce the amount of pollen that you introduce into the house.

— Wash your bedsheets regularly. Hypoallergenic bed sheets and pillow cases can help with dust mite and mold allergies, but when it comes to reducing pollen, your best bet will be to wash your bedding often. This is especially important if you have pets that like to sleep in bed with you. Because pollen, along with dirt and other allergens, can stick to their coat, your furry friend is likely bringing in particles that may aggravate allergies.

— Use air filters. Portable air purifiers with high-efficiency particulate air (HEPA) filters can help remove 99.97% of pollen, dust, dander and other allergens circulating in your bedroom. For your whole house, consider installing an air filter in your central heating, ventilation and air conditioning (HVAC) system. The American College of Allergy, Asthma and Immunology encourages using an air filter with a minimum efficiency reporting value (MERV) rating of 11 to 13.

[READ: When to See an Allergist.]

Long-Term Effects of Seasonal Allergies

In addition to physical discomfort, seasonal allergies can be disruptive to your daily life and health if left untreated. The congestion and sneezing can disturb your sleep, which — in turn — sets off a chain reaction of detrimental health effects. Sleep deficiency is associated with an increased risk of heart disease, high blood pressure, stroke, diabetes, obesity and depression. In older adults, sleep deficiency can affect balance and lead to a greater potential for falls.

"Taking care of allergies is very much an important issue to gain that quality of life that we all need and deserve," Corry says. "Getting good quality sleep is actually a matter of life and/or death, literally. You can get into a chronic deficit of sleep that can absolutely impair your quality of life and lead to serious health problems that can be fatal over years of sleep deprivation."

Bottom Line

Ultimately, pollen is a fact of life. You can only avoid it for so long, but thankfully, you can nip pesky allergy symptoms in the bud.

"You don't have to suffer," Peters says. "We have good treatment options, so you can try over-the-counter medications or go see an allergist … to tailor your treatment based on what you're allergic to."

Westfield Health Bulletin: Gesundheit! Good Health Includes Managing Seasonal Allergies

God bless you. Gesundheit. Spring is here along with red, watery eyes, the sounds of sneezing, and whistling, sniffing noses. Allergies are blossoming along with the beautiful flowers and trees with radiant blooms and vibrant green leaves. Allergic rhinitis or seasonal allergies can occur seasonally or all year round. Symptoms can be mild to debilitating. Studies have shown allergies, for most, are worse than ever.

The most common cause of allergy symptoms is pollen. Pollen is the fine powder produced by trees, flowers, grasses and weeds one finds all over parked cars and patio furniture. There are hundreds of plants and trees that release pollen. The most common tree offenders are birch, oak and maple trees. The most common grasses to cause symptoms are perennial rye, bluegrass and Bermuda grass. Overall, ragweed is the most common allergen.

The immune system defends the body from viruses and bacteria. With allergies, some immune systems incorrectly identify pollen as harmful. The body then produces histamines and other chemicals to fight against the pollen. Approximately one quarter of the U.S. Population have seasonal allergies. It is thought that genetics may play a role.

Most common seasonal allergy symptoms are watery eyes, sneezing and stuffy nose. Other symptoms include sinus pressure, facial pain, sore throat, post-nasal drip, cough, wheezing, headaches, hives and swelling beneath eyes. Allergies exacerbate asthma and other respiratory diseases. Untreated allergies can become more severe, lead to chronic inflammation, damage tissue and organs, weaken immune system, cause fungal and bacterial infections of the sinuses, lungs, ears or skin, severe fatigue, sleep issues, structural changes of the sinuses and decreased quality of life.

Minor allergy symptoms can be treated with over-the-counter non-drowsy antihistamines (Claritin, Zyrtec, Allegra and others) and drowsy antihistamines (Benadryl), along with OTC nasal steroid sprays such as Flonase and others, and Sudafed. Herbal medications butterbar or spirulina have been recommended for allergies. As with any herbal remedy, check with your medical provider to avoid interactions with other medications. Afrin is often used or recommended. It is very important to know that using Afrin for more than two to three days can cause severe rebound nasal congestion.

Non-pharmaceutical fixes revolve around avoiding allergens. This can be done with masking outdoors, keeping windows closed, using air purifiers (preferably with HEPA filtering) or dehumidifiers, vacuuming the floors frequently, staying in on dry, windy days, avoiding yard work and gardening, and covering mattresses and pillows with allergen covers. Mind the pollen count. Local weather reports usually include the pollen count in their forecast.

Health experts and meteorologists agree that climate change contributes to longer and more intense allergy seasons. Growing zones are changing. Increased temperatures cause plants to bloom earlier and prolong the pollen season. Increased rainfall causes plants to release more pollen. More frequent thunderstorms make pollen grains burst, making them more irritating. Shifting wind patterns carry pollen more widely. Increased carbon dioxide makes pollen more potent. The number of allergens has doubled over the last 25 years.

It is important to manage allergies for general health and to avoid complications. If over-the-counter medications do not help, see a primary care provider. One may be referred to an allergist for allergy testing and treatment. Long-term management includes allergy shots or allergy drops. A newer treatment of three injections over eight weeks, called ExACT immunoplasty, is more convenient.

The tradition of saying "God bless you" when someone sneezes originated with the belief that one's soul could exit the body with a sneeze. "Gesundheit" actually means "health" or "wishing good health."

Manage your allergies. Do what you can to help protect this beautiful Earth from climate change for the sake of the Earth, its people and allergy sufferers. God bless you and gesundheit.

Take care of yourself and someone else.

Juanita Carnes is a Westfield resident and a nurse practitioner with 38 years of experience in a hospital emergency department and urgent care facilities. She served 30 years on the Westfield Board of Health.

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It's Not In Your Head: Doctors Say Allergy Season Is Getting Worse Every Year

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It happens every year. The weather warms up and flowers start to bloom, but, you can't stop sneezing, your nose is so stuffed up that you can't breathe and you feel like clawing your eyes out. Allergy season is here, and if it feels like your symptoms are getting worse and lasting longer than ever, you might not be imagining it.

"Indeed, allergy season is getting worse every year, and it's also starting earlier," Martin Smith, M.D., an allergist and immunologist and co-founder of Untoxicated Skincare. An analysis of pollen count data from 1990 to 2018 found that recent spring allergy seasons are kicking off about 20 days earlier, and pollen concentrations have increased by about 20%, especially in Texas and the Midwest.

Seasonal allergies are definitely no fun. They can affect your day-to-day habits and just make you feel miserable. The good news is there are several over-the-counter (OTC) allergy medications that can bring relief. The not-so great news is browsing the allergy medication aisle at your local drugstore can be daunting. There are so many options, from antihistamines to steroids to pills to nasal sprays — and, they all promise to unclog your nose, stop your sneezing and just make you feel better.

So, what OTC allergy medication should you choose? The best option depends on your symptoms, your individual needs and any medical conditions that you have, says Christina Aungst, Pharm.D., senior pharmacy editor at GoodRx. Talking this over with your doctor or a pharmacist can help you decide which medication is right for you.

To give you a head start, we spoke to a handful of allergists and pharmacists. Here's an overview of their suggestions of the best over-the-counter allergy medications.

Allergy Relief Nasal Spray

Steroid nasal sprays are one of the most effective medications for treating seasonal allergies, says Raphael Strauss, M.D., an allergist at Allied Physicians Group. A nasal spray enables you to get the medication into your bloodstream quickly to reduce inflammation. But, these medications aren't meant to be taken on an as-needed basis. Instead, they should be used daily to be effective, Dr. Smith says. Another thing: It can take up to two weeks to see the full benefit.

Shop Now

Allergy Relief Nasal Spray

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$15.60

Haleon US Services Inc. Adult 24Hr Non-Drowsy Antihistamine

When your body encounters an allergen, it releases histamine, a natural chemical, to help fight it off. Antihistamines block histamine and minimize symptoms, Aungst says. Allegra contains the active ingredient fexofenadine. Dr. Smith says he often suggests patients start with a steroid nasal spray, like Flonase, and then add an oral antihistamine. Allegra is usually his first choice for patients over other oral antihistamines.

Shop Now

Adult 24Hr Non-Drowsy Antihistamine

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$17.96

Allegra 24 Hour Allergy Relief Tablets

Some people prefer Zyrtec over Allegra, but the medications work similarly to block histamine and minimize symptoms, like sneezing, runny nose, itchy eyes and hives, says Mohammad Younus, M.D., an allergist and immunologist at Hackensack University Medical Center in New Jersey. Zyrtec contains the active ingredient cetirizine, which, according to one study, was more effective for allergy symptoms than fexofenadine, the ingredient in Allegra.

RELATED: Which Works Better for Allergy Relief — Zyrtec or Claritin?

Shop Now

24 Hour Allergy Relief Tablets

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$23.77

Zyrtec Nasal Spray

This nasal corticosteroid contains the active ingredient triamcinolone to relieve nasal congestion, sneezing, runny nose and itchy nose. It's also scent- and alcohol-free. Dr. Younus says corticosteroid nasal sprays are safe and effective for long-term allergy management. One Amazon reviewer noted that the spray "really does last 24 hours."

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Nasal Spray

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$32.55

Nasacort Allergy Nasal Spray

Until recently, this antihistamine nasal spray was only available by prescription, Dr. Smith says. It's steroid-free and takes effect more quickly than other nasal sprays, often within about 30 minutes. It's designed to relieve nasal congestion, runny nose, sneezing and itchy nose. What's more, Dr. Strauss says it can be combined with a nasal corticosteroid for a stronger effect.

Shop Now

Allergy Nasal Spray

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$39.99

Bayer Healthcare LLC Antihistamine Eye Drops

If itchy, watery eyes are a major allergy symptom for you, these antihistamine eye drops directly target them, and offer quick and long-lasting relief. Dr. Strauss says they can be used along with corticosteroids and antihistamines as an additional treatment.

RELATED: Best Air Purifiers for Allergies

Shop Now

Antihistamine Eye Drops

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$9.95

Zaditor What are allergies?

Allergies are a chronic condition where your immune system reacts to a typically harmless substance, known as an allergen, according to the American College of Allergy, Asthma & Immunology. Common allergens are pollen, dust, pet dander or food. When your immune system encounters the allergen, it reacts to try to ward it off, and that causes symptoms like sneezing, rashes, coughing or nasal congestion. In severe cases, allergies can cause anaphylaxis, which is a life-threatening condition.

Seasonal allergies only occur during certain times of the year, usually from February to early summer in the U.S. When trees, grass, ragweed and other plants pollinate. About a quarter of adults experience seasonal allergies, according to the Centers for Disease Control and Prevention. However, you can develop allergies at any age.

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What are the types of allergy medicine?

These are the three main types of OTC allergy medications:

Antihistamines block histamine, a natural chemical that the body releases when it encounters an allergen, Aungst says. It's the histamine release that causes allergy symptoms, so antihistamines are effective at relieving itching, sneezing and a runny nose, Dr. Smith says. Oral antihistamines include Allegra, Claritin, Zyrtec and Xyzal, says Robert Hostoffer, D.O., an osteopathic physician specializing in allergy and immunology. Recently, Astepro, an antihistamine nasal spray, became available OTC, Dr. Smith says.

Nasal corticosteroids, including Flonase or Nasonex, reduce inflammation and swelling directly in the nasal passages, says Dr. Younus. "The anti-inflammatory effect leads the mucus-secreting cells to calm down and reduce blood flow, which makes your nose feel less blocked," Dr. Smith says, adding that these medications also help with dry, itchy eyes. Nasal corticosteroids can take a couple of weeks to kick in, however, so Dr. Strauss recommends combining them with an antihistamine for "maximal effect." That said, nasal sprays shouldn't be considered an as-needed medication — you should start taking them daily in early March to get ahead of allergy season, Dr. Smith says.

Decongestants, like Sudafed, can improve nasal congestion temporarily by shrinking swollen nasal passages, Dr. Younus says. However, doctors typically don't recommend them for seasonal allergies because they can cause side effects, like irritability, difficulty sleeping and increased blood pressure, adds Dr. Strauss. They're also not as effective for allergies as antihistamines and steroids. You should also avoid decongestant nasal sprays, such as Afrin, Dr. Strauss emphasizes. Using this medication for more than a few days can cause rebound congestion, which can make your symptoms worse.

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What should you look for when picking an allergy medicine?

"Everyone is different," Dr. Younus says. So, the best way to choose which medicine will work for you is to chat with your doctor about your symptoms and overall health.

Some ingredients that doctors recommend looking for in antihistamines include cetirizine (Zyrtec), fexofenadine (Allegra), loratadine (Claritin), and levocetirizine dihydrochloride (Xyzal), Dr. Smith says. For nasal sprays, seek out fluticasone (Flonase), budesonide (Rhinocort), and triamcinolone (Nasacort) or the nasal antihistamine azelastine (Astepro).

Decongestants, like pseudoephedrine (Sudafed), are best avoided since they don't offer long-term allergy relief, Dr. Smith says. These ingredients might be included in antihistamines — so, watch for products with a "D" in their name, such as Zyrtec-D or Allegra-D, which means they contain decongestants.

Be careful about allergy medications that cause drowsiness, too, Dr. Strauss says. Otherwise, you might struggle to get through your day, and they can affect your ability to drive or make decisions. Whether to opt for a nasal spray or a pill is up to you. For mild symptoms, an oral antihistamine alone may work, but if they're mild to severe, layer on a nasal steroid, Dr. Smith says. When congestion is your main problem, Dr. Strauss says a steroid nasal spray is your best bet.

Whichever OTC allergy medication you choose, Dr. Hostoffer suggests choosing a generic or store brand — a cheaper option that's just as effective.

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Which is best — Zyrtec, Claritin or Allegra?

These common medications are safe and effective for treating allergy symptoms and work similarly, Aungst says. It really comes down to which one best minimizes your symptoms and doesn't cause side effects. It might take some trial and error to find your favorite.

Zyrtec might cause drowsiness for some people, Dr. Younus says. Claritin is non-drowsy, but he says some people don't think it's as effective as Zyrtec. Allegra is also non-drowsy, but some might find Zyrtec and Claritin to be more effective. All three offer 24-hour relief.

"My favorites, in order of preference, are Allegra, Xysal, Zyrtec and then Claritin," Dr. Smith says.

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Who should avoid OTC allergy medications?

Patients with kidney disease, seizure disorders, heart conditions and high blood pressure should check with their doctor before taking OTC allergy medications, says Dr. Strauss. So should pregnant women and men with enlarged prostates. Older adults might also need to avoid the medications, as the drugs could cause drowsiness and increase the likelihood of falls, Aungst says. If you have a kid with allergies, it's also important to make sure to choose a medication that is appropriate for their age.

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When to see a doctor about your seasonal allergies

Tried several OTC allergy meds and still dealing with congestion, sneezing and other symptoms? See your family doctor or an allergist, Dr. Hostoffer urges. Also, make an appointment if you're not exactly sure what's triggering your allergies, or if your symptoms are getting worse and lasting longer, Dr. Younus says.

"A good barometer is when you notice that the over-the-counter options are not cutting it, and the symptoms start to affect your quality of life," Dr. Smith says. Doctors may prescribe stronger versions of OTC medications, allergy shots or the medication Singulair, which he says works a little differently than antihistamines by blocking inflammatory molecules called leukotrienes.

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How we picked the best OTC allergy medications

For this article, author Erica Sweeney interviewed four allergists and one pharmacist. She also researched seasonal allergies and the most common treatments for the condition. She then scoured the internet to read customer reviews about OTC allergy medications to learn which were most effective.

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Why you should trust Good Housekeeping

Erica Sweeney, the author of this article, is an experienced health writer whose work has appeared in The New York Times, Men's Health, HuffPost, Parade, and many other publications. She conducted interviews, researched allergies and allergy medications and read customer reviews to compile this list.

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