Seasonal Allergies Causes, Symptoms, and Testing


What are seasonal allergies?

A seasonal allergy, often called allergic rhinitis or hay fever, is an allergy that occurs during a specific time of the year. Seasonal allergies are most often caused by three types of pollen: grass, tree, and weed.

Seasonal allergies can have a significant impact on a patient’s quality of life and are a significant burden on the healthcare system.1,2  Approximately 600 million people are thought to be affected by rhinitis, and there is evidence showing that those numbers are on the rise.3,4

Rhinitis is generally divided into two groups: allergic and non-allergic. Differentiating between allergic and non-allergic rhinitis is critical, as half of patients prescribed antihistamines for their reported allergic rhinitis have symptoms that are not due to allergy.

Combatting Seasonal Allergies: Tommy's Story

It’s vital to identify underlying allergic triggers. Track your symptoms.



Common Seasonal Allergens

Click on a seasonal allergen to learn more about the specific allergy, including where it can be found, common symptoms, testing information, allergy management, and symptom relief. 
 

Grass Pollen
Tree Pollen
Weed Pollen

Are you a healthcare provider looking for a comprehensive list of pollen allergens and associated symptoms? 

Explore our fact sheets, an easily sharable, patient-friendly resource that includes cross reactivities, component names, and management plans.

Seasonal Allergy Symptoms

Common seasonal allergy signs and symptoms include:

  • Stuffed-up nose
  • Itchy nose 
  • Runny nose
  • Sneezing 
  • Watering eyes
  • Red, itchy eyes and/or swollen eyelids 
  • Itchy throat
  • Swelling of the mouth/airways 

If someone is experiencing wheezing and shortness of breath in addition to the symptoms above, allergies may be triggering asthma.

Symptoms such as sleep disturbance and daily fatigue, along with inappropriate use of antihistamines, can result in impaired performance at school and work.1-3

For a better consultation with a healthcare provider, it’s helpful to keep track of the types of symptoms experienced and when they occur.

Allergic rhinitis affects physical and psychological wellbeing by reducing sleep quality that in turn negatively impacts work performance and productivity, school attendance and concentration, and social life.6,7

Is it seasonal allergies or something else? 

Approximately 65 percent of patients diagnosed as having allergic rhinitis and prescribed a nonsedating antihistamine are not allergic.4,8 As allergic rhinitis and non-allergic rhinitis have such similar symptoms but different management, it is imperative to correctly diagnose the cause and select the correct management.9 A blood test can help detect sensitization to hundreds of potential allergic triggers, including pollen, mold, food, and animal dander.

Frequently Asked Questions About Seasonal Allergies

Symptoms can change from day to day, depending on the weather. For example, high humidity can make mold grow quickly, while pollen counts can surge when it’s warm and windy. Other allergic triggers may be involved, too. Learn more about the symptom threshold.

Allergy season depends on where a person lives and what he or she is allergic to. For example:

  • Spring allergies: In some parts of the United States, spring allergy season can start as early as February and last through the summer. It all depends on geographic location and when grasses, trees, and weeds begin pollinating. March and April tend to be known as high spring allergy season months when most people experience the worst of their symptoms.

  • Summer allergies: Spring allergy season can continue into the summer months, as grasses and weeds continue to produce pollen. 

  • Fall allergies: The fall season can be especially difficult for people who have allergic sensitizations to mold, as mold spores thrive in damp locations such as fallen leaves, dirt, and rotting wood.10 This time of year is also challenging for those with ragweed sensitization, as ragweed usually begins to pollinate in mid-August and may continue until a hard freeze.11 

  • Winter allergies: Winter allergies can occur if a person is allergic to indoor allergens, such as mold, dust mites, and animal dander, and may worsen during the months of November through January due to increased exposure to these indoor allergens. 

A common cold has similar symptoms to seasonal allergies. However, a reaction to a cold is caused by a virus while a reaction to an allergen is the result of the immune system responding to a substance it has deemed a threat. Learn more about head, eyes, ears, nose, and throat symptoms

Five ways to tell your seasonal allergies from a cold:12

  1. Colds can produce a fever; allergies cannot.  
  2. Colds typically don’t cause itchy, watery eyes. Allergies typically do. 
  3. Cold symptoms aren’t likely to last more than two weeks, but many people with seasonal allergies will experience symptoms for six weeks at a time.  
  4. Sore throats can accompany colds but rarely occur with allergies. 
  5. Colds can occur during any season, while seasonal allergy symptoms will likely appear at the same time each year. 

It’s been shown that uncontrolled allergic rhinitis can lead to:13-15

  • Increased risk of developing asthma
  • Poorer asthma control in people with asthma (wheezing, breathlessness, nighttime awakenings, limiting daily activities)

  • Reduced physical, mental, and emotional wellbeing

  • Reduced sleep quality (waking up at night)

  • Being constantly tired, and tiring easily, which leads to lowered concentration at work or school and needing more time off, all of which affects job performance or school work

  • Reduced quality of everyday life, including social life and daily activities

  • Irritability and social problems in children

It is important to consider testing for allergic rhinitis in people with asthma, eczema (atopic dermatitis), conjunctivitis, sinusitis, polyposis, upper respiratory tract infections, otitis media, and sleeping disorders, as well as in children with learning and attention impairments.

More than 80 percent of people with asthma also suffer from rhinitis, suggesting the concept of “one airway, one disease.”4,16,17 The presence of allergic rhinitis commonly exacerbates asthma, increasing the risk of asthma attacks, emergency visits, and hospitalizations for asthma. It is not clear whether allergic rhinitis represents an earlier clinical manifestation of allergic disease in atopic patients who will later develop asthma or whether rhinitis itself is causative for asthma.17-20

If a patient suffers from allergic rhinitis triggered by pollen and has an allergic reaction that typically occurs upon ingestion of certain foods, he or she may be experiencing Pollen Food Allergy Syndrome (PFAS), also known as Oral Allergy Syndrome (OAS).21

Depending on your unique symptom threshold, i.e., the point at which a person experiences symptoms after being exposed to multiple triggers, some allergy symptoms may occur only at certain times throughout the year. For example, common indoor allergens, such as animal dander and mold, may only trigger symptoms in the fall when a person is also exposed to a seasonal allergen, such as ragweed.

While an insect venom allergy  is not technically seasonal, there may be periods of higher exposure to stinging insects during certain times of the year in different geographical locations. It may take several uneventful stings from an insect—such as a bee, wasp, hornet, yellow jacket, or fire ant—for manifestations to appear.

After an initial sting, the immune system of an affected patient may respond by producing Immunoglobulin E (IgE) antibodies. Any subsequent stings can trigger a systemic inflammatory response.22 It is important to correctly identify the culprit insect, as patients can be allergic to one or several species of stinging insects.22Testing can be used to identify the insects to which a patient is sensitized, which will aid in the selection of the most appropriate treatment.23

Seasonal Allergy Testing and Management

It is important to use testing for allergen sensitization to identify the cause of seasonal allergies and help decipher allergic from non-allergic rhinitis. Test results, along with a physical exam and medical history, can ensure that people receive appropriate treatment sooner, as well as helping to reduce avoidable antihistamine use.21,24

The management of allergic rhinitis consists of three major categories of treatment:

  1. Allergen avoidance and environmental control measures
  2. Pharmacological management
  3. Immunotherapy

A blood test—together with an allergy-focused medical history—may help identify underlying allergen triggers. 

Approximately 65 percent of patients diagnosed as having allergic rhinitis and prescribed a nonsedating antihistamine are not allergic.4,8 As allergic rhinitis and non-allergic rhinitis have such similar symptoms, but different management, it is imperative to correctly diagnose the cause and select the correct management.9

Practice Parameters and Guidelines for Allergic Rhinitis 


Guidelines provide a foundation for the process of diagnosing allergic rhinitis, which starts with a physical examination and an allergy-focused patient history.1,21 Guided by the findings of an allergy-focused patient history, a healthcare provider can continue to work through the most appropriate next steps, which may include specific IgE tests. Skin-prick testing and specific IgE blood testing can help determine allergen sensitization, which may give the ability to correctly diagnose and improve clinical management.25,26 Patient medical history should be supplemented by allergen testing for accurate results.27 

Practice parameters have been developed to classify and manage treatment of allergic rhinitis, and guideline-directed management has been shown to improve disease control.6,7 

 

Explore practice parameters and guidelines.

Tools for Understanding Allergies

 

Track allergy symptoms and prepare for a visit with a healthcare provider.

Learn about specific allergens, including common symptoms, management, and relief. 

Are you a healthcare provider? Get comprehensive information on hundreds of whole allergens and allergen components.

Related Content

Want to learn more about allergies? Explore a range of topics.

  1. Scadding GK, Durham SR, Mirakian R, et al. BSACI guidelines for the management of allergic and non-allergic rhinitis. Clin Exp Allergy. 2008;38:19-42. 
  2. Roberts, G, Xatzipsalti, M, Borrego, LM, Custovic, A, Halken, S, Hellings, PW, Papadopoulos, NG, Rotiroti, G, Scadding, G, Timmermans, F, Valovirta, E. Paediatric rhinitis: position paper of the European Academy of Allergy and Clinical Immunology. Allergy. 2013; 68: 1102– 1116. 
  3. Bousquet, J., Vignola, A. M. and Demoly, P. (2003), Links between rhinitis and asthma. Allergy. 58: 691–706. doi:10.1034/j.1398-9995.2003.00105.x. 
  4. Pawankar R, Holgate S, Canonica G, et al. World Allergy Organization. White Book on Allergy (WAO). 2011. http://www.worldallergy.org/UserFiles/file/WAO-White-Book-on-Allergy_web.pdf. Accessed December 2017.  
  5. European Academy of Allergy and Clinical Immunology; Global Atlas of Allergic Rhinitis and Chronic Rhinosinusitis, 2015. http://www.eaaci.org/globalatlas/ENT_Atlas_web.pdf. Accessed December 2017. 
  6. Scadding GK. Optimal management of allergic rhinitis. Arch Dis Child. 2015 Jun; 100(6): 576-582.   
  7. Seidman MD, et al. Clinical practice guideline: allergic rhinitis executive summary. Otolaryngol Head Neck Surg. 2015 Feb;152(2):197-206. 
  8. Szeinbach SL, et al. Identification of allergic disease among users of antihistamines. J Manag Care Pharm. 2004;10(3):234-238.   
  9. Smith P. Global Atlas of Allergic Rhinitis and Chronic Rhinosinusitis. 2015. http://www.eaaci.org/globalatlas/ENT_Atlas_web.pdf. Accessed December 2017. 
  10. American Academy of Allergy Asthma and Immunology. Outdoor Allergens. https://www.aaaai.org/conditions-and-treatments/library/allergy-library/outdoorallergens. Accessed September 2019.  
  11. American Academy of Allergy Asthma and Immunology. 4 Things You Might Not Know About Fall Allergies. https://acaai.org/news/four-things-you-might-not-know-about-fall-allergies. Accessed September 2019. 
  12. American Academy of Allergy Asthma and Immunology. Is It a Cold or Allergies? https://www.health.harvard.edu/diseases-and-conditions/is-it-a-cold-or-allergies. Accessed September 2019. 
  13. Del Giudice M, et al. Int J Immunopathol Pharmacol 2011;24:25-8. 
  14. de Groot EP, et al. Thorax 2012;67:582-587. 
  15. Asthma Control Questionnaire. Available from https://www.qoltech.co.uk/acq.html; last accessed November 2018. 
  16. Grossman J. One Airway, One Disease. CHEST. 1997:111:2:11S - 16S. 
  17. Bousquet J, et al. Allergic Rhinitis and Its Impact on Asthma. J Allergy Clin Immunol. 2001;108(suppl 5):S147–S334.  
  18. Thomas M, et al. Asthma-Related Health Care Resource Use Among Asthmatic Children With and Without Concomitant Allergic Rhinitis. Pediatrics. 2005;15:129-134.   
  19. Crystal-Peters J, et al. Treating allergic rhinitis in patients with comorbid asthma: The risk of asthma related hospitalizations and emergency department visits. J Allergy Clin Immunol. 2002;109(1):57-62.     
  20. Valovirta E. Managing Co-Morbid Asthma With Allergic Rhinitis: Targeting the One-Airway With Leukotriene Receptor Antagonists. World Allergy Organ J.  2012;5:S210-S211. 
  21. House of Lords, Science and Technology sixth report- the extent and burden of allergy in the United Kingdom. http://www.bsaci.org/pdf/HoL_science_report_vol.1.pdf. Accessed December 2017. Immunology. Allergy. 2013;68:1102-1116.
  22. Pawankar R, Holgate S, Canonica G, at el. World Allergy Organization. White Book on Allergy (WAO). 2011. http://www.worldallergy.org/UserFiles/file/WAO-White-Book-on-Allergy_web.pdf. Accessed December 2017.
  23. Biló B, Rueff F, Mosbech H, et al. Diagnosis of Hymenoptera venom allergy. Allergy. 2005; 60(11):1339-1349.   
  24. Pearce L. Managing allergic rhinitis. Nursing Times. 2012;108(17):20-22.
  25. Duran-Tauleria E, Vignati G, Guedan MJ, et al. The utility of specific immunoglobulin E measurements in primary care. Allergy. 2004;59 (Suppl 78):35-41. 
  26. Niggemann B, Nilsson M, Friedrichs F. Paediatric allergy diagnosis in primary care is improved by invitro allergen specific IgE testing. Pediatr Allergy Immunol. 2008;19:325-331. 
  27. Smith HE, Hogger C, Lallemant C, et al. Is structured allergy history sufficient when assessing patients with asthma and rhinitis in general practice? J Allergy Clin Immunol. 2009;123:646-650.