How to Manage Allergy Symptoms This Season

Springtime comes with an uptick in stuffy noses and scratchy throats, and for many it has nothing to do with Covid-19. There are 19.2 million adults and 5.2 million children in the United States who suffer from seasonal allergies, also called hay fever, according to the Centers for Disease Control and Prevention.

Some of the symptoms of allergies, like congestion, coughing and a runny nose, overlap with warning signs of Covid-19, but if your nose turns into a leaky faucet every spring, then allergies are the likely culprit.

Unfortunately, that’s where the good news ends. Several studies show that pollen seasons are getting longer and more intense across the country. Climate change and rising carbon dioxide emissions are expected to boost the growth of trees and grasses in many areas, which will mean higher pollen concentrations.

“For people who have been managing seasonal allergies for a long time, they may have already noticed allergy symptoms starting earlier, lasting longer and being more intense than even a few years ago,” said Kenneth Mendez, the president and chief executive of the Asthma and Allergy Foundation of America.

In the Southeast, pollen counts start rising as early as January for some trees, including cedar and juniper. Elm, maple and oak trees have pollen seasons that can run from March to May. And in the northern United States, several types of grasses also start releasing pollen in late spring or early summer, according to the A.A.F.A. (Though flowers are often blamed, they don’t usually trigger seasonal allergies because their pollen is large and sticky, designed to attract insects rather than float through the air.)

You cannot avoid pollen entirely, but there are ways to prevent or reduce symptoms. And you may just have to take these steps a little earlier every year, Mr. Mendez said.

Several over-the-counter and prescription medications can help with allergy symptoms. Many doctors recommend nasal steroid sprays like Nasonex (with a prescription) or Flonase as the first line of treatment, said Dr. Sandra Hong, an allergist at the Cleveland Clinic.

But they may take a few days or weeks to provide relief from stuffiness and sneezing, so it is best to begin using them early in the season, before your symptoms become severe. Antihistamines — whether sprays like Astelin; pills like Allegra, Claritin or Zyrtec; or eye drops like Optivar — are other alternatives to take when needed, because they have a more immediate effect, she said.

Decongestants like Afrin or Sinex can also come to the rescue in a pinch. But Dr. Hong recommended these drugs last because they can have a rebound effect. After a few days of using decongestants, the blood vessels in your nose become less responsive to the medication and you may feel severe congestion again. So limit these medicines to no more than three days in a row.

It takes some trial and error to find the best medication regimen. “If patients have tried one medication and it doesn’t seem to be working for them, they should absolutely try other types to see if they’re more effective,” Dr. Hong said.

You should also talk to your doctor about prescription options if you have already tried several over-the-counter allergy medicines. An allergy specialist can help you formulate a plan for your specific allergies ahead of time.

For a medication-free option, consider nasal irrigation. The practice traces back thousands of years to the Ayurvedic medical traditions of India and its effectiveness is backed by research. To try it yourself, use a neti pot, bulb syringe or squeeze bottle and pour a saline solution in one nostril, letting it drain out the other.

“It seems like a simple concept, but it helps flush out mucus, pollen and other allergens in your nasal cavity,” said Dr. Laura Chong, an allergist at the Oklahoma Allergy & Asthma Clinic in Oklahoma City.

The result is that you feel less congested and you may need less allergy medication, Dr. Chong said.

Many popular weather apps and websites provide “allergy forecasts” or pollen counts. On the National Allergy Bureau website there is a list of more than 80 stations throughout the United States that provide more detailed daily pollen updates based on different species of plants. You can select the station closest to you and receive notifications for the particular pollen allergy you have.

Pollen counts tend to be at their highest between early morning and midmorning, as well as on hot, dry, windy days, Dr. Chong said. If you can exercise indoors during those times or run errands later in the evening, you will reduce the amount of pollen you inhale, she added.

If you are prone to allergy symptoms and have to go out in the morning or do yardwork, wear a high-quality N95 mask — the kind you may already have for protection against the coronavirus. This will help filter out pollen.

Avoid bringing pollen back inside after you’ve been outdoors. Take your shoes off and change your clothes when you get home. Shower before going to bed to remove pollen from your body. And don’t have your furry pets sleep with you, Dr. Hong said. “Even if you’re not allergic to your pets, there is pollen on their coats.”

In order to sleep better, you can try zipping up your mattress and pillows in hypoallergenic encasements, washing bedding in hot soapy water once a week and using a dryer instead of a clothesline.

Dr. Hong also recommended cleaning and replacing your air-conditioner filter with one that has a Minimum Efficiency Reporting Value (MERV) of 11 or higher. These filters are capable of capturing tiny pollen particles. If you have severe allergies, you may even want to splurge for a professional-style HEPA (high-efficiency particulate air) filter in your bedroom. HEPA filters typically have a MERV rating of 17 or higher and remove 99 percent of pollen, as well as animal dander, dust and other particles.

If allergies are taking a toll on your everyday life, you may want to talk to your doctor about immunotherapy for long-term relief.

After confirming exactly which types of pollen you are allergic to with a skin prick exam or blood test, your doctor may recommend subcutaneous allergy immunotherapy, or allergy shots. This involves a series of injections given every week or every month containing minuscule amounts of the pollen you are allergic to. The dose is gradually increased, helping your immune system become less sensitive to the allergen over time.

In the last decade, the Food and Drug Administration has started to approve another form of immunotherapy, known as sublingual immunotherapy. Here, tiny amounts of pollen come in tablet form, placed under the tongue for one to two minutes and then swallowed as they dissolve. Currently, the only approved tablets are for allergies to dust mites, ragweed and northern pasture grasses like timothy, although more tablets are being tested in clinical studies.

Both types of immunotherapy require patience. It may take six months or a year to see a reduction in symptoms, Dr. Hong said. Still, you may need to stay on the treatment for three to five years before your body can reliably ignore your triggers.

When it works, immunotherapy can be amazing, Dr. Hong said. People who once suffered yearly stuffy noses and itchy eyes can, after successful treatment, enjoy the spring again.

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