It’s not just your imagination: Your allergies are getting worse.
Compared to 1990, pollen season today kicks off 20 days earlier and sticks around eight days longer, according to a 2021 study. And sneezin’ season is more severe: Plants, grasses, and trees spew 21 percent more pollen in the air than they did 30 years ago.
A funny thing happens when you turn up the temperature or increase CO2 concentrations in the air: Plants produce more pollen, explains William Anderegg, associate professor of biology at the University of Utah and the lead author of the study mentioned above. How bad it can get depends on where you live and the plant species that proliferate there. His study found that Texas and the Midwest were particularly bad pollen hot spots. “This is a crystal clear example of how climate change is not in the future — it’s here with every breath we take in the springtime,” he says.
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If we don’t slow the cycle, and current trends continue, concentrations of ragweed pollen could double by 2060; grass pollen will triple, notes research analyst Hannah Jaffee of the Asthma and Allergy Foundation of America (AAFA).
This is just unfair: As people get older, allergy symptoms tend to decline as our immune systems become less reactive with age. But our changing climate is robbing us of this natural protection, says allergist Neeta Ogden, M.D., spokesperson for the AAFA and a member of AAFA's Medical Scientific Councill. Not only will we continue to suffer symptoms, or even see them get worse, but ”with longer, more intense seasons, older adults can actually develop allergies for the first time in their lives,” she says. Currently, about 16 percent of adults over the age of 65 have been treated for hay fever, according to a 2019 CDC report, though there’s evidence it’s underrecognized and undertreated in those over age 60.
Don’t let allergy season catch you by surprise this year. Here are seven smart pieces of advice from experts about surviving the watery-eyes, stuffy-nose, congestion-filled months ahead.
1. Start treating allergies early in the season
If you can, start your allergy medications several weeks before you traditionally experience symptoms, advises Purvi Parikh, M.D., medical director at Allergy and Asthma Network in New York City. It’s easier to prevent your immune system from getting overly aroused than it is to calm it once it’s begun to react. To protect against spring’s pollen, you should start treatment now, if you haven’t already. For fall’s ragweed surge, start in August. The exact dates may differ depending on what part of the country you live in, so confirm with your allergist.
2. Manage your allergy symptoms
While there are changes you can make to your day-to-day activities to decrease your pollen exposure, medication remains a mainstay of allergy treatment. Still, the last thing you may want to do is to add another tablet to your pillbox. So it’s important to find the right medication strategy to manage your symptoms. Start with a nasal steroid spray, such as fluticasone (Flonase), triamcinolone (Nasacort) or (Rhinocort). These reduce nasal swelling and mucous to clear your sinuses, and are “known to stop the immune response called by allergies and prevent severe symptoms,” says Donald Dvorin, M.D., an allergist in Mt. Laurel Township, New Jersey. Ideally, they’re started in advance of when symptoms normally start, as they can take a week to work. Use these daily and as directed (keeping your head upright, spraying toward the outer wall of your nostril). Shooting this up your nose may not be the most pleasant sensation, but consistency is key.
As for which one to choose, Dvorin says that some sensitive patients find Flonase irritating because it contains alcohol, so try Nasacort first. One note (or point of confusion): These are different than oxymetazoline (Afrin), a nasal congestion spray. Nasal steroid sprays can be used long-term, whereas you should not use Afrin for more than three consecutive days, otherwise — rather paradoxically — congestion could get worse.
Still suffering? Steroid sprays may not be enough. Add in an antihistamine. Dvorin recommends trying over-the-counter antihistamines loratadine (Claritin-D) or fexofenadine (Allegra-D) first, both of which are nondrowsy. Cetirizine (Zyrtec-D) or levocetirizine (Xyzal) are sedating, so they should be taken only at night. If you need something stronger, ask your doctor about prescription antihistamines, some of which, like hydroxyzine (Atarax), could help you sleep better at night if symptoms keep you up.
3. Talk to your doctor about allergy medications
Like any drug, allergy meds can interact with others you’re on or cause side effects, including drowsiness, prostate problems, brain fog and heart issues, in certain underlying conditions, Parikh says. So, while there are a lot of good options available OTC, that doesn’t mean they’re automatically safe for you. “All these meds are not necessarily benign. I would not wing it,” Dvorin says. Chat with your doc first.
4. Don't forget to treat fall allergies
You’re still not in the clear even in late fall. “I take regular pollen counts March through October. I find that pollen is still in the air even on Halloween,” Dvorin says. Ultimately, microparticles of pollen could stick around into winter and induce off-season symptoms, he says. Ask your doctor about year-round treatment — it could stave off sickness, too. That’s because if you have allergies, your airways are more reactive to viral illnesses, research suggests. Suppressing allergic flare-ups may improve your overall immunity, potentially helping keeping your defenses up to fight off colds and flu.
5. Wear your face mask (Eh, you’re used to It by now)
You love to garden, but with all that pollen, gardening does not always love you back. There are a few preemptive steps the green fingered among us can take to spend more time outside, sans sneezing, says Dvorin. Take your medication before going out and mask up. (Medical face masks designed to keep out allergens are best; you can find these everywhere now, as well as order them in bulk on NatlAllergy.com.) Once you get back inside, change out of your shoes and outdoor clothing. If allergies are especially severe, you may want to shower and wash your hair, as tresses trap pollen.
6. Check the pollen count
You look at the weather before heading out on your morning walk; why not do the same with pollen counts? Pollen.com provides an allergy forecast by zip code; WeatherBug (WeatherBug.com, also available as an app) and The Weather Channel (Weather.com) show counts and ratings for the day. If it’s high, you may want to shift outdoor activities indoors, if possible. For example, do a mall walk instead of a neighborhood stroll. If those resources aren’t available to you, consider timing outside activities to avoid peak pollen release, especially on windy and warm days. Those are 5 to 10 a.m. and then after 4 p.m. to dusk, Dvorin says.
7. Eradicate indoor allergens too
Breathing in pollen and dust mites and dander and mold is a recipe for disaster. Nasal passages can only handle so much: The sheer load of allergens can make your symptoms worse, Parikh says. You’ll want to take indoor precautions, too: That means zipping up box springs and mattresses with dust mite covers, vacuuming carpets frequently, keeping windows closed, and setting up a HEPA air purifier if you’re allergic to your pet. Get roof leaks fixed promptly, Dvorin adds. “Mold and mildew are major hazards for indoor allergy sufferers.” Set your indoor humidity to 40 percent to reduce the mold in your home.