Seasonal Allergies: Symptoms, Triggers and When to Be Seen

What it involves

MedlinePlus describes allergic rhinitis as a group of nose symptoms that occur when you breathe in something you are allergic to, such as pollen, dust, mold, or animal dander. When pollen from trees, grasses, and ragweed is the trigger, it is commonly called hay fever or seasonal allergies. The body releases chemicals that cause the symptoms, which is why the reaction can feel like a cold without any infection.

Who this is for

• Patients whose sneezing, itching, and congestion come back at the same time each year
• Patients with a runny nose and watery eyes but no fever or body aches
• Patients whose over-the-counter allergy medicine has stopped working
• Patients with asthma or frequent sinus trouble who suspect allergies play a part

What to expect

• Questions about when symptoms start, which seasons are worst, and what pets or dust you live with
• A physical exam of your nose, eyes, ears, and throat
• A review of every allergy and cold medicine you already use, including nasal sprays
• A plan that may include avoiding triggers, medicine, or a referral for allergy testing

Symptoms that come right away and symptoms that come later

MedlinePlus lists the symptoms that appear soon after contact with the trigger:

• Itchy nose, mouth, eyes, or throat
• Runny nose and sneezing
• Watery eyes
• Problems with smell

What shows up later

MedlinePlus says symptoms that may develop later include a stuffy nose, coughing, clogged ears, a decreased sense of smell, sore throat, dark circles and puffiness under the eyes, fatigue and irritability, and headache. That later group is why allergies get mistaken for a long cold or a sinus infection. The sinus infection or cold guide explains how the two overlap and how a provider tells them apart.

Pollen, weather, and family history

MedlinePlus says the plants that cause hay fever are trees, grasses, and ragweed, whose pollen is carried by the wind, while flower pollen carried by insects does not usually cause it. Hot, dry, windy days tend to carry more pollen, and cool, damp, rainy days wash most of it to the ground. Hay fever also runs in families, and the chance is higher if both parents have allergies. The plants that bother you can differ from person to person and place to place. People with eczema often have seasonal allergies too, and the eczema guide explains how pollen, dust mites, and dry air can make skin flare.

How allergies are confirmed

MedlinePlus says a provider will do a physical exam and ask whether your symptoms vary by time of day or season and whether pets or other allergens are involved. Allergy testing may reveal the pollen or other triggers, and skin testing is the most common method. If skin testing is not possible, blood tests such as an IgE test or an eosinophil count may help. Skin testing may be arranged through an allergy specialist, so a primary care visit is often where the question starts, not where it ends. MedlinePlus says people with hay fever and other allergies often get hives, and the hives guide lists the triggers and what usually helps.

Treatment options your provider may discuss

MedlinePlus says the best treatment is to avoid the pollen that causes your symptoms, and that the medicine chosen depends on your symptoms, your age, and other conditions such as asthma. It describes antihistamines, nasal corticosteroid sprays as the most effective treatment, short-term decongestants, saline nasal rinses made with distilled or boiled water, and for hard-to-control cases allergy shots or under-the-tongue treatment. Nasal decongestant sprays should not be used for more than three days. Some antihistamines cause sleepiness, so read the label before driving. Red, itchy, watery eyes can also come from allergic conjunctivitis, and the pink eye guide explains how that type differs from viral and bacterial pink eye.

When allergies spill into other problems

Allergy symptoms do not stay in the nose. Postnasal drip can set off a lingering cough, which the persistent cough evaluation guide covers, and poorly controlled congestion can lead to headaches, as the headache and migraine page explains. Patients who also have wheezing or chest tightness should say so at the visit, because that points the conversation toward the lungs as well as the nose. Allergies can also swell the eustachian tubes, and the ear pain and ear infection guide explains how that can lead to fluid behind the eardrum and ear pain. Repeated sneezing and nose-blowing can irritate the lining of the nose enough to cause bleeding, and the nosebleeds guide explains how to stop a bleed and when it needs a visit.

Sources

• MedlinePlus — Allergic rhinitis (Medical Encyclopedia)
• MedlinePlus — Hay Fever (Health Topic)