Pollen may be hanging around almost all year, but these steps can keep you comfortable.
Think your allergies are getting worse? If it seems like your itchy eyes, runny nose, and congestion are more severe and last for more days, it’s probably not your imagination. Thanks to climate change, there’s a lot more pollen in the air these days, and it’s hanging around for a longer time. That’s a problem for a lot of people: About 26 percent of adults and 19 percent of children have seasonal allergies, according to the Centers for Disease Control and Prevention.
Research has found that 80 percent of those with seasonal allergies report moderate-to-severe symptoms that significantly impair their quality of life.
But thanks to newer treatments and ongoing research, doctors have a variety of effective ways to help subdue symptoms. Today’s medications “are worlds apart from what we had 40 years ago,” says Richard Lockey, MD, director of the division of allergy and immunology at the University of South Florida College of Medicine. “There’s no reason anyone now needs to suffer unnecessarily—we can usually find some sort of treatment that works for everyone.”
Here’s what to know about the latest treatment recommendations and what you can do to keep your seasonal allergy symptoms to a minimum.
Pollen-Proof Your Environment
One of the most effective strategies is also one of the most straightforward: reducing your exposure to allergens. So monitor local pollen counts and try to stay indoors between 5 a.m. and 10 a.m. on days when counts are highest, recommends the National Institute of Environmental Health Sciences. Other smart steps:
- Take a bedtime shower. This helps wash off pollen that has collected on your skin and hair during the day so that you’re not literally sleeping with allergens.
- Use an over-the-counter (OTC) saline nasal spray. This helps clear a clogged-up nose and wash out pollen and other allergens that may have accumulated there. You can use these products as often as you want, says Sandra Hong, MD, an allergist at the Cleveland Clinic, but it’s a particularly good idea after you’ve been outdoors and before bed. (Skip nasal decongestant sprays, or use them only for a couple of days, because they can cause rebound congestion.)
- Banish Buddy from the bedroom. Even if you’re not allergic to your cat or dog, keep pets off your bed—and if possible, out of the room entirely—if they spend any time outdoors. Their fur can harbor pollen.
- Keep your lawn tidy. Short grass is less likely to release pollen than taller grass, so mow regularly. If possible, have someone else mow it. If you do it yourself, wear a face mask (like an N-95 filter mask) and sunglasses to prevent pollen from blowing into your nose, mouth, and eyes. Regularly clean your gutters and downspouts, too.
- Run the air conditioner. You may be tempted to throw your windows open, but those lovely breezes can carry pollen into your home. “You want to keep doors and windows closed, so no pollen can get in,” Lockey says. An air purifier might help, too: See our air purifier ratings and buying guide. And check out a couple of our highly rated air purifiers:
- Vacuum regularly. This can help pick up stray pollen particles that float into your home, as well as allergens such as pet dander and dust mites. CR’s tests found that some vacuums with regular filters sucked up similar amounts of dander and dust as those with high-efficiency particulate air (HEPA) filters, and some were just as good at keeping these small particles from blowing back into the air. Have someone else do your vacuuming, and avoid bagless vacuums, which can stir up dust when you empty them. Members can check out our full vacuum ratings. And you can check a couple of our highly rated vacuums:
Take the Right Meds at the Right Time
Allergen avoidance techniques might not always be enough. Here’s the rundown on common medications and when it’s appropriate to consider them.
Steroid nasal sprays: If allergen avoidance isn’t sufficient, a good place to start is to consider a steroid nasal spray such as fluticasone (Flonase), triamcinolone (Nasacort), or mometasone (Nasonex)—all available over the counter and also in generic form. Daily use throughout the allergy season can help reduce nasal inflammation and combat a runny or stuffy nose, says Amber Luong, MD, a professor of allergy medicine with the McGovern Medical School at UTHealth Houston. But this is best started a week or two in advance of the season because it can take time to begin working, according to the American Academy of Allergy, Asthma & Immunology. (If you have glaucoma, talk to your ophthalmologist first, because these medications may increase ocular pressure.)
Oral antihistamines: Rita Kachru, MD, an allergist and immunologist with UCLA Health, recommends OTC oral antihistamines like cetirizine (Zyrtec and generic), loratadine (Claritin and generic), and fexofenadine (Allegra and generic). These tend to cause less drowsiness than the older, short-acting products such as diphenhydramine (Benadryl and generic). Still, they can lead to sleepiness in older adults, so if you’re older you may want to take smaller-than-normal doses.
Though the newer antihistamines all appear to be equally safe and effective, some people may respond better to one than another. So if, for example, cetirizine doesn’t seem to help, try fexofenadine or loratadine, Hong says.
Note that you can also take an OTC oral antihistamine for a week or so while you wait for a steroid nasal spray to begin working, but after that there’s little reason to regularly take both an oral antihistamine and a steroid nasal spray.
“Research shows that it isn’t any more effective than using a steroid spray alone,” says Mark Dykewicz, MD, director of the allergy & immunology fellowship program at St. Louis University in Missouri and an author of practice guidelines for the treatment of seasonal allergies published in 2017.
Antihistamine eye drops: For itchy, watery eyes, OTC antihistamine eye drops such as ketotifen (Alaway) or olopatadine (Pataday) can help— and quickly—says Donald J. Dvorin, MD, an allergist with The Allergy and Asthma Doctors in Mount Laurel, N.J.
Antihistamine nasal sprays: If you’ve been faithfully using a nasal steroid for a couple of weeks and you’re still uncomfortable, the guidelines recommend adding in a daily prescription nasal antihistamine spray, such as azelastine (Astelin, Astepro, and generic) or olopatadine (Patanase and generic).
“A nasal antihistamine seems much more effective than taking a pill by mouth—it may be that since it goes directly into the nasal passages, the nose gets a much higher concentrated dose,” Lockey explains.
Reduce Your Reaction to Allergens
Still not finding sufficient relief from seasonal allergy symptoms, and/or have year-round allergies that are very bothersome? You might find immunotherapy useful.
This prescription treatment involves exposing you to ever-larger amounts of allergens, gradually increasing your tolerance.
Traditional immunotherapy is delivered via regular shots—often for three to five years—and can help with seasonal and year-round allergens. “Over 80 percent of the time, people experience relief,” Hong says. The shots carry a small risk of a severe allergic reaction, so you’ll need to have them in a doctor’s office.
If your seasonal allergies are to grasses and/or you’re allergic to dust mites, you might look into a newer prescription option: sublingual immunotherapy, or SLIT. Here, you typically place a dissolvable tablet containing purified extracts of allergens under your tongue.
Currently, four treatments approved by the Food and Drug Administration are available: Odactra, for house dust mite allergies; Oralair, for five different grass pollens; Grastek, for Timothy grass allergies; and Ragwitek, for ragweed allergies.
“This is a really good option for people who are allergic to these types of pollen but aren’t seeing improvement on nasal and antihistamine sprays, or develop other complications from these allergies, such as sinus infections or asthma,” Hong says.
For grass and ragweed, you’ll need to begin treatment about three months before these allergens pop up. If you’re using them to treat dust mite allergy, you’ll stay on them year-round. SLIT may cause mild side effects, such as itchy or irritated mouth and throat, and nausea or abdominal discomfort. Severe reactions appear to be quite rare.
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