If you’ve been itchy, congested, and sneezy for months, you’re not alone. This year’s spring allergy season started early, broke pollen-count records in some parts of the country, and is still going strong in many areas.
Unfortunately, this year is unlikely to be a fluke. While pollen counts vary from year to year, recent trends suggest allergy seasons are, in general, getting longer and worse, says Dr. Kristine Vanijcharoenkarn, an assistant professor at Emory University School of Medicine who specializes in allergies and immunology. Patients started filling her office early this year, around the beginning of March, and she says “the trend will most likely continue.”
Here’s why—and how to prepare yourself for future intense allergy seasons.
Why allergy seasons are getting worse
Climate change plays a big part.
“We’ve known for a long time that higher [carbon dioxide levels] and turning up the temperature on plants in very controlled environments makes them produce a lot more pollen and start that pollen season earlier,” says William Anderegg, an associate professor in the School of Biological Sciences at the University of Utah who researches how climate change affects nature. Now, that’s happening at scale.
Anderegg’s research suggests that, from 1990 to 2018, North American pollen concentrations rose by about 20%, with allergy season starting about 20 days earlier and dragging on more than an extra week by the end of that time period. The effect is happening across the U.S., but parts of the Southeast and Midwest are particular hot spots, he says.
“Climate change isn’t something in distant decades or other countries; it’s with us here, in every breath we take in the spring,” Anderegg says.
How bad allergy seasons affect your health
Bad allergy seasons lead to bad allergy symptoms: itchy eyes, congestion, sneezing, fatigue, rashes, and so on. In addition to being unpleasant, these symptoms can make it hard to sleep and may negatively affect work or school performance, says Dr. Michele Pham, an allergist and immunologist at UCSF Health.
If allergies linger and remain untreated, they can also contribute to complications, says Dr. Caroline Sokol, a physician in Massachusetts General Hospital’s Allergy and Clinical Immunology Unit. “The longer you have uncontrolled inflammation, the more likely you are to have side effects,” Sokol says.
For example, when you’re chronically congested, fluid and mucus can’t drain properly. If a virus or bacteria gets into that fluid, it can lead to a sinus or ear infection. (With viruses like COVID-19, influenza, RSV, and others spreading widely this year, doctors have seen an uptick in ear infections among both kids and adults, Well + Good reports.) Persistent inflammation in the sinuses and nose can also increase your risk of contracting other respiratory infections, Pham says.
Allergens like dust and pollen can also exacerbate asthma symptoms such as wheezing and coughing, Pham says. While most people manage their asthma without serious issues, asthma attacks can be severe, or even fatal in rare cases, if not treated properly. Allergy-triggered asthma attacks may require more intensive treatments, such as steroidal medications or hospitalization, Vanijcharoenkarn says.
How to handle worsening allergy seasons
Get ready to medicate. “People who maybe were able to get away with not treating anything or [taking] one week of an antihistamine are now going to be stuck with a few weeks or months of medications,” Sokol predicts.
Vanijcharoenkarn suggests planning ahead now for the fall allergy season—and for next year’s spring season—as she’s seen an increase in patients who need prolonged treatments to keep up with the worsening pollen seasons. If you’re prone to fall allergies, start taking medications in August to ward off symptoms before they start, she recommends. (For the spring, start proactively treating around Valentine’s Day.) “If you start it once you’re symptomatic, we’re a little behind the eight ball,” she says. “Prevention is always easier.”
If you’re already symptomatic, you may need something stronger than an oral drug. Pham says you’re likely to see better results with targeted therapies applied directly to the area that’s bothering you, such as a nasal spray, eye drops, inhaler, or skin cream, depending on your specific symptoms.
If your symptoms are really bothersome, you may want to see a doctor, who can prescribe stronger medication or assess whether something else is going on. Some people with allergy-like symptoms actually have nonallergic rhinitis, a condition that can be triggered by changes in weather or irritants in the air, Sokol says.
If you have allergies that aren’t responding to standard medications, you may be a candidate for immunotherapy, or allergy shots. Patients undergoing this treatment receive numerous injections that contain small amounts of their allergen, and the goal is for them to become desensitized to it over time.
“Immunotherapy is the only thing that changes your immune response to allergens,” Pham says. She’s already seen an uptick in the number of patients starting new immunotherapy regimens—a trend that she says is likely to continue as allergy seasons continue to worsen.
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