As the seasons change and warmer weather arrives, many people may experience nasal congestion, watery eyes, and an itchy throat because of seasonal allergies. About one in four adults in the U.S. suffer from symptoms of seasonal allergies, as well as one in five children.

Seasonal allergies are generally related to the life cycle of plants in the environment. In the spring, the pollen released from trees is the most abundant allergen. In the summer, grasses cause seasonal allergies, and in the fall, it’s ragweed.

“Spring allergies can significantly impact people’s quality of life,” says Dr. David A. Gudis, an otolaryngologist and chief of the Division of Rhinology and Anterior Skull Base Surgery at NewYork-Presbyterian/Columbia University Irving Medical Center. “When the weather is gorgeous and the trees are blooming and kids want to run and play, we all want to be outdoors. It’s much harder when suffering from allergies. Today, there are great treatment options to alleviate allergy symptoms.”

While seasonal allergy symptoms are typically associated with a stuffy nose and itchy eyes, Dr. Gudis says they can also affect sleep, attention and memory. To learn more about why people develop seasonal allergies, how to prevent them, and if allergy seasons are getting worse, Health Matters spoke to Dr. Gudis.

What are seasonal allergies?

Seasonal allergies are the immune system responding to something in the environment as though it were a threat. Everyone has immune cells throughout the body to protect us from infection — including on the surface of our eyes, our skin, and the lining of our nose, mouth, and airway. When something like pollen triggers one of the cells in an allergic patient, the body mistakenly treats it like a threat. The immune cells react with an inflammatory cascade as though they must respond, react, and fight. Thus, a massive and robust allergic reaction begins.

What are the seasonal allergy symptoms?

The allergic response, which is a form of inflammation, can cause lots of very uncomfortable symptoms for patients — itching, sneezing, watery eyes, nasal discharge, itchy throat, and eczema are common. People suffering from seasonal allergies can also feel fatigued and even notice difficulty focusing.

Do seasonal allergies have a mental health impact too?

Allergies are associated with changes in mood. When sleep is impaired, memory and attention can suffer as well. Allergic swelling in the nose can reduce the sense of smell, and believe it or not, a lasting poor sense of smell is associated with feelings of isolation and other mood changes. Lastly, allergies are associated with anxiety. All of these complex relationships can have an impact on mental health. 

Why do people develop seasonal allergies?

It’s not entirely understood. Seasonal allergies equally affect all socioeconomic groups, races, ethnicities, and demographic groups, but the climate and environment in which one grows up can significantly impact the risk of developing allergies. The type of inflammation that causes allergies can also run in families. If someone’s parents have allergies, the child is much more likely to end up with allergies as well.

Is it normal to develop allergies later in life, even if you’ve never had them before?

Yes.  A lot of patients say that they never had allergies until they moved to New York City, or a new apartment, and all of a sudden, things change. The immune system also changes over the course of our lives, and as a result, some people may become more symptomatic as they age.

Is allergy season getting worse?

Allergy seasons are getting longer, and they’re getting worse, likely secondary to changes in the climate and environment. Pollen counts and other markers of allergy triggers are higher than they used to be, and the duration of allergy season has increased. These changes could represent another reason that seasonal allergies are more common or affecting people more severely than they used to.

Are there ways to prevent seasonal allergies?

The first step is to try to avoid allergens. During those first few weeks of spring, when pollen counts are high, consider spending more time inside with air conditioning and an air purifier rather than keeping the windows open. It’s helpful to dust and vacuum regularly and make sure bedsheets are changed and washed regularly. I also tell patients always to shower before bed so that they’re not spending all night rolling around in the pollen and other allergens that they may have accumulated over the course of the day.

What medications can treat seasonal allergies?

Over-the-counter medications can significantly improve seasonal allergy symptoms. Nasal steroid sprays, nasal antihistamine sprays and oral antihistamines are very effective at helping patients feel better. For people who suffer every allergy season, I recommend starting the medications before symptoms begin, as it may be easier to prevent inflammation than try to treat it after it’s severe.

What if medications are not enough?

If allergies are significantly impacting your quality of life and over-the-counter treatments are not enough, it’s definitely worth seeing a doctor. Allergy testing and immunotherapy or allergy shots can significantly help with your symptoms.