Allergy Season is Here

Columbia University Irving Medical Center

Seasonal allergies-also known as hay fever-are allergies that occur during a specific time of the year. Like other types of allergies, the seasonals develop when the body's immune system overreacts to something in the environment. Most seasonal allergies are caused by pollinating plants, typically grass, trees, and weeds.

"From spring through fall, I see everything from red, swollen eyes to difficulty breathing. Seasonal allergies can disrupt sleep and the ability to focus," says allergist Mervat Nassef, MD, associate professor of pediatrics at Columbia University Vagelos College of Physicians and Surgeons.

"You do not have to suffer, but you do have to find the treatment that's right for you and your symptoms. Getting the right treatment means you can enjoy the blossoming trees, not hide from them."

Nassef says controlling allergies is especially important in school-aged children. "Allergy seasons coincide with the beginning and end of the school year, when kids are adjusting to new classes and taking important exams. Controlling their allergies allows them to function at their best during these critical times."

The exact start, duration, severity, and end of allergy season varies with weather conditions.

"If we have a warm winter, as we did this year, the season may start up to two weeks early. In fact, some trees started blooming in the last week of February," says Nassef. "If we have a warm, wet spring, we can expect high levels of pollen leading to a bad allergy season."

We spoke to Nassef to help us understand what that means for our health and how to treat our runny noses, itchy eyes, and more.

How seasonal allergies happen

Seasonal allergies, like other types of allergies, develop when the body's immune system overreacts to something in the environment, usually during spring, summer, or fall when certain plants pollinate.

It is an exaggerated response to an allergen that triggers an inflammatory reaction, leading to symptoms of itchy eyes, sneezing, runny nose, congestion, etc.

Seasonal allergy signs and symptoms

  • Itchy nose
  • Runny nose
  • Congestion (AKA stuffy nose)
  • Sneezing
  • Watery eyes
  • Red, itchy eyes
  • Swollen eyelids
  • Itchy throat
  • Swollen mouth
  • Fatigue
  • Sleep disturbance

Allergy season

In many areas of the United States, tree pollination begins early in the year, followed by grass pollination in the summer and weeds in the fall.

Allergies vary by geography. In tropical climates, for example, grass may pollinate throughout a good portion of the year and create an extended allergy season.

Who gets seasonal allergies

Seasonal allergies can develop at any age, from children to adults. There's no way to know in advance if you'll get them, but seasonal allergies often run in families and are common in patients with asthma or eczema.

How to find the best seasonal allergy treatment

Fortunately for allergy sufferers, many safe and effective treatments are available. Some medications are used to relieve symptoms while others are used to prevent them. It is important to tailor the treatment to the symptoms as different medications work better for some symptoms than others.

Talk to your doctor. Allergy treatment is specific to each patient and what causes the allergy (seek allergy testing if you do not already know). Some people may be candidates for allergy shots or immunotherapy tablets.

Immunotherapy is the only treatment that can take away the allergy by changing the immune response to the allergens. Injection immunotherapy (allergy shots) has been around for a hundred years. A newer form of immunotherapy utilizes tablets containing the allergen; the tablets are placed under the tongue and lead to decreased reactivity over time. This type of sublingual immunotherapy is available for grass and ragweed allergies.

When to try OTC allergy medication

Try over-the-counter allergy medication if you notice symptoms. Each class of medication has different effects. For itching and sneezing, the second-generation non-sedating antihistamines are the best. Beware: Some older antihistamines can cause sleepiness and should be avoided. Oral decongestants can cause heart palpitations. For nasal congestion and postnasal drip, nasal steroids are most effective. Read the label. Talk to the pharmacist. Talk to your doctor if you're unsure.

When to see a doctor about allergies

If you are not sure whether your symptoms are due to allergies, see an allergist/immunologist for evaluation and testing, especially if symptoms affect your sleep, work, or schoolwork.

If you are sure that your symptoms are due to seasonal allergies, try OTC medications. If they do not control your symptoms well, or if you develop side effects, see an allergist/immunologist to discuss other therapeutic options.

How to know if your allergy treatment is working as well as it can be

If your treatment is working, you should see an improvement in your symptoms. If you continue to have symptoms despite medications, go to an allergist for further testing and guidance.


Mervat Nassef, MD, is a pediatric allergist and immunologist at ColumbiaDoctors, associate professor of pediatrics at Columbia University Vagelos College of Physicians and Surgeons, and director of resident and medical student education in the Department of Pediatrics' Division of Allergy, Immunology, and Rheumatology.

To schedule an appointment with a ColumbiaDoctors allergist, call 212-305-2300.

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