AARP Smart Guide to Seasonal Allergies

15. Gum disease

There are two ways allergies can lead to dry mouth, which is when your salivary glands fail to produce enough saliva to keep your mouth moist. One, if your sinuses are congested, it’s likely that you’re breathing through your mouth more often. And second, a dry mouth can be a side effect of taking antihistamines (which is why people who take antihistamines might also suffer from bad breath). When there’s no saliva to wash away food and bacteria from your teeth, it can result in cavities and gum disease. If you experience seasonal allergies, tell your dentist to look at your mouth carefully.

16. Eye infections

Untreated allergic symptoms in your eyes — also called allergic conjunctivitis — can cause a serious condition called keratoconus. “It’s very severe inflammation in the cornea of the eye” and can lead to visual impairment, Louisias says. Check in with your health care provider if you have red, watery or itchy eyes, or swelling in your eyelids, which could indicate allergic conjunctivitis.

 

PREVENTION

17. Irrigate your sinuses

Congested? Use a bulb syringe, neti pot or sinus rinse kit to help clear mucus from your nasal passages with saline water. “If you can tolerate it, a nasal saline rinse is really good as a nonmedicated way to flush out anything that sits in your nose,” Rubin says. “And I typically have people do that at nighttime.” Always use distilled, filtered or cooled-down boiled water to prevent spreading bacteria to your nasal passages, and avoid tap water, which can cause an infection, says William Berger, M.D., medical director and allergist with Allergy & Asthma Network. Thoroughly wash your neti pot with antibacterial soap and water after use. “You can develop irritation in your nasal passages if you overuse it, so I recommend once or twice a day as needed,” says Mili Shum, M.D., an allergist and immunologist with U Health in Utah.

18. Allergy-proof your home

Do your best to keep allergens out of your home during allergy season. Sanjay C. Patel, D.O., an allergist and immunologist at Desert Center for Allergy and Chest Diseases in Phoenix, suggests keeping windows shut, and if you’ve spent a lot of time outside, change your clothes and take a shower before sitting down on furniture or lying in bed. Putting on fresh clothes after being outside or exercising outdoors can help to remove allergens from your skin and hair and minimize symptoms.

19. Check the weather

A pollen count is a real-time measurement of the pollen grains in the air per cubic meter, and a pollen forecast is a prediction of future pollen counts based on historical data and weather forecasts. Pollen counts of 50 or less are considered low, while 1,000 or more is considered very high. Many free weather apps, including My Pollen Forecast, Allergy Plus and WebMD Allergy App (iOs, Android), include pollen counts, air quality and humidity levels — which can all make allergy symptoms feel worse. Shum says pollen is usually worse on dry and windy days, but people notice improvements when it’s rainy, because the precipitation pushes pollen to the ground.

20. Wear a mask

Windy, cold or dry weather can trigger or worsen symptoms. Consider wearing a mask or bandanna to prevent the inhalation of allergens. If you’re also going into fragrant stores, like Lush, Bath & Body Works and Sephora, it might be beneficial to keep the mask on to not trigger a reaction. “Fragrances can irritate anyone. Not everyone who has seasonal allergies are bothered by fragrances, but not everyone who is bothered by fragrances have seasonal allergies,” Rubin says.

21. Plan outdoor time strategically

Pollen counts are typically higher in the early morning and late afternoon, Berger says. So if you take a daily walk or want to work in the garden, plan those activities for other times of day. If your activity’s not flexible or you’re still irritated, wearing a mask may help control your allergy symptoms.

22. Stop using essential oils

Mint, lavender and eucalyptus essential oils may smell good — and even seem as though they are opening your nasal passages — but they can be very irritating to the nose, eyes and lungs, Rubin says. On your skin, they can cause contact dermatitis — an itchy, red rash that may lead to blistering and peeling. “Even if you feel better temporarily, in the long run, it’s not treating the underlying problem,” Rubin says. “I really don’t find significant benefits from them.” Bonus: They aren’t good for your pets, either, so everyone will be breathing easier in your home by nixing them.

23. Skip scented products too

Many scented bath and cleaning products — especially ones that list “fragrance” as an ingredient — include pollen, which may irritate your allergies. Plus, people with allergies are generally more sensitive to chemicals, says Hariri. Air fresheners and scented candles are the biggest no-no’s. Scented candles can irritate the nasal passages, sinuses, airways and skin, leading to increased allergy symptoms, sinus problems, breathing problems and rashes. “I generally recommend people to avoid these products if they bother them,” Rubin says.

24. Watch what you eat

Some proteins in fruits and vegetables are similar to the ones in pollen. If your body thinks the food is the pollen you’re allergic to, you may experience oral allergy syndrome, which is characterized by an itchy mouth. “As the protein gets altered through normal digestion, this changes the food protein so it no longer resembles the pollen protein,” Chinthrajah says. Typically, only raw foods trigger symptoms; if the food is cooked or canned, people usually don’t notice symptoms, Chinthrajah says. (You can learn more about cross-reacting foods through the American Academy of Allergy, Asthma & Immunology.)

25. Add friendly bacteria to your gut

If you don’t already take probiotics, consider starting now. Multiple studies identify a connection between gut and immune health. A 2017 study, for example, found healthy bacteria in the GI tract from probiotic supplements can help alleviate allergy symptoms. Patients who took probiotics reported fewer allergy-related nose symptoms and overall better quality of life during allergy season than those taking a placebo. Even if probiotics don’t cure your allergies, they have plenty of other well-studied health benefits and few risks.

26. Use an air purifier

Studies suggest air purifiers equipped with high-efficiency particulate air (HEPA) filters can trap allergens and reduce symptoms. Only purifiers labeled “HEPA-certified” — not HEPA-style or HEPA-like — are shown to be effective and safe, Hariri says. In general, you get what you pay for: More expensive models are usually more effective and require less upkeep (for example, you’ll have to change the filter less frequently). If you have an air purifier in your bedroom, turn it on at least an hour before bedtime; it can take that long for the machine to effectively clean your air.

27. Prioritize purifying air in common spaces

Effectiveness with air purifiers is limited to the room you’re using it in, rather than the whole home. “Air purifiers work, but they filter for such a small area that it has to be right by your head to remove enough,” Altman says. If you can afford more than one air purifier, Hariri suggests prioritizing spaces you spend the most time in, such as your bedroom or living room. In that case, you’ll probably want to choose a quiet air purifier, but avoid ozone air generators, which have been associated with lung damage and other health risks.

28. Pay heed to your humidifier

Adding moisture to the air with a humidifier can help cough and congestion, but too much humidity can have the opposite effect for some people. Dust mites thrive in moisture, Shum says, so if you have a known allergy, skip the humidifier. (And be careful not to overmist or water your houseplants.) Humidifiers can also increase the risk of mold in a home, especially if you don’t follow the manufacturer’s instructions to clean yours properly. If you need a humidifier, Shum recommends investing in a hygrometer, a tool that measures humidity. Ideally, your home humidity should be lower than 50 percent at all times. (A dehumidifier can help regulate moisture levels if needed.)

29. Honey for coughs, not for allergies

The old adage about eating local honey at the start of allergy season to stave off symptoms is not completely sound. Moss says honey typically contains microscopic grains of pollen from surrounding plants, but it’s probably not enough to change how your immune system responds to allergens. Honey, on the other hand, has been shown in studies to control cough as effectively or better than cough suppressant medications in some people, so it may be worth adding some to your tea or eating a teaspoonful if you’ve got postnasal drip. “Honey is something that helps with a cough — there’s no doubt about that,” Rubin says. But as far as taking local honey to help with allergies, that contention was based on one very small study and hasn’t been proven. Another small, similar study found no difference for those who took honey or a placebo. “[It’s] a complete myth,” Rubin says.

30. Bathe your pet more often

Even if you don’t have a pet dander allergy, your pet can carry pollen from outdoors to indoors and worsen your symptoms. Patel suggests bathing your pet more frequently during allergy season to prevent worsening symptoms. The Humane Society of the United States recommends talking to your vet or other animal care professional to see what they recommend for shampoo and soap. Keep Fido off your bed and couch if you’re concerned about pollen (or pet dander) on your furniture.

31. Leverage your washer and dryer

Hariri suggests washing your clothes and bedding in the hottest water possible to kill dust mites and remove pollen and other allergens. And don’t hang anything out to dry on a clothesline, Berger adds, or it’ll collect pollen. Dryer sheets can be potentially irritating to those with allergies, asthma or skin issues, Rubin notes. Instead, use wool dryer balls or spritz white vinegar on a washcloth and put it in the dryer.

32. Keep the dust under control

For people allergic to dust mites or concerned about pollen from outside, vacuuming more frequently can help. Fabric upholstery, rugs and carpet can harbor dust mites, so design and clean your space accordingly. But using a vacuum without a HEPA filter can make allergies worse by kicking up the dust. A vacuum with a HEPA filter contains the allergens more efficiently. Another spot that collects dust you may not always see — your plant leaves. Clean them periodically to help them continue to absorb the light they need to grow. And change your home’s air filter regularly, or if your furnace can handle it, use an allergy furnace filter.

33. Drive allergy-safe

In your vehicle, keep windows closed during allergy season. Rubin recommends using your air conditioning on warm days instead, but always choose the setting that circulates cool air rather than bringing it from outside. Next time you get your vehicle serviced, ask to have your AC system checked for excessive dust or pollen accumulation (and cleaned, if necessary). If you’re in the market for a new vehicle, leather car seats are better than upholstered ones, which can harbor allergens.

34. Don’t clean with a dry rag

When you’re cleaning a dusty area, avoid using a dry cloth. “A damp cloth will pick up the allergens, whereas a dry cloth will just move around the allergens,” says Payel Gupta, M.D., clinical instructor at Mount Sinai Hospital and medical director of allergy, asthma, immunology and ENT at LifeMD. Consider wearing a mask when you dust, too, to prevent allergy symptoms.

35. Swap your contacts for glasses

If you have the option to wear glasses instead of contacts, consider doing so when you go outdoors during allergy season. “Glasses act as a barrier to prevent allergens from getting into the eye and settling on the conjunctiva,” Gupta says. “The longer an allergen sits on the surface, the more inflammation it will cause.” Clean your glasses regularly as directed after you go inside. If you ride a bike, Gupta suggests wearing goggles, as they can protect your eyes from allergen-filled wind.

36. Zero in on your bedroom

Altman usually suggests people with dust mite allergies take additional steps to allergy-proof their bedroom. Change your bedding frequently, and consider investing in dust mite encasements for your pillows and mattress. “These products are tightly woven fabric that’s too small for dust mites to fit through,” he says. Look for bedding, mattress covers and box springs that are feather-free, down-free and include “dust mite protector” and “allergen barrier.” And wash all bedding in hot water at least once a week.

37. Design an allergy-friendly space

Any fabric in your home can collect dust or other allergy-causing debris, which is why Berger recommends leather furniture over upholstered alternatives and tile or wood floors rather than carpet. Try to minimize drapery and rugs to avoid indoor allergens, and declutter your home, as stacks of books, magazines and knickknacks can collect dust. Berger says you can also purchase inexpensive vent covers that filter dust and other allergens from your home’s air.

38. Maintain your HVAC

Change the filter on your heating and air conditioning system at least twice a year to avoid blowing dust and other allergens into your home, Berger says. If you see dust blowing from your vents, you can clean them with a wet rag. But if the problem doesn’t resolve, Berger says it may be beneficial to hire a professional air duct cleaning service. “We know that there can be a lot of dust and mold inside vents, and cockroaches can die inside them, which is a major allergen for people,” he says.

39. Consider moving

It’s a drastic decision but one that may bring relief. Moving to a region with different plant species may also change your symptoms. “Everybody’s pollen season is different depending on where you live. So it starts earlier in the South and starts later as you go further north,” Rubin says. According to Patel, it usually takes two full seasons to develop a new allergy. “Beware of the honeymoon period, that first two years where you think your allergies are better,” he says. This can also happen on vacation — you might not have any allergy symptoms during a time your allergies are usually high. But if you visit that location frequently, your body might develop an allergic response.

 

TREATMENT OPTIONS

40. Treat individual symptoms as needed

Only have eye or nose symptoms? Local treatments are your best bet. Moss recommends over-the-counter allergy eye drops for relief of itchy, watery eyes. Corticosteroid nasal sprays, or steroid nasal sprays, such as Beconase, Flonase and Nasacort, can reduce sneezing, runny nose and congestion by decreasing inflammation in the nasal passages. But these take longer to work. “I recommend starting a nasal steroid spray about two weeks before allergy season commences, and then starting oral antihistamines and eye drops when people start to notice symptoms,” Moss says. Rubin agrees that you’ll need to use these regularly to see results: “It’s not something that you can take for a day and expect it to work well, because steroid medications take a while to work, because they’re actually trying to change how the cells operate. That takes time. So usually, you’re not going to see an effect for anywhere between three to up to seven days or so.” Always consult with your physician and mention these types of medications when you talk to your doctor.

41. Find the right antihistamine for you

Antihistamines, available over the counter, work by blocking histamine, a chemical that triggers allergic inflammation. Moss suggests taking one as soon as you notice allergy symptoms; you may feel better within an hour or two. “You may need to take [them] for a few days to notice the full effect, but that depends on how severe your allergies are to begin with,” Shum says. Either way, she says antihistamines are safe to take for the entire allergy season, as long as you’re aware of side effects. Diphenhydramine (Benadryl) was once the gold standard antihistamine, but Moss says doctors don’t recommend it as much now because it’s sedating and can cause unwanted psychiatric effects, especially in higher doses, and it may increase the risk for dementia and Alzheimer’s disease if taken long term. Now, the most commonly recommended antihistamines are cetirizine (Zyrtec), loratadine (Claritin) and fexofenadine (Allegra). Shum generally recommends Allegra for older adult patients, because it’s the least sedating (followed by Claritin and then Zyrtec). If your antihistamine makes you sleepy, she recommends taking it at night. Xyzal, another over-the-counter antihistamine, is related to cetirizine and is associated with equal effectiveness and less drowsiness.

42. Use nasal sprays the right way

Nasal sprays, whether antihistamine- or steroid-based, can help reduce eye and nasal symptoms. But make sure you’re using your spray correctly. Hariri suggests blowing your nose first and, if needed, irrigating your sinuses, which can ensure the medication absorbs. Angle the spray bottle away from your septum, or the middle of the nose, when you spray. Spraying in the middle of your nose can increase the risk of nosebleeds or even damage to your septum, Berger says. And you don’t need to snort or tilt your head back, which will only cause the medication to drain down your throat. Berger recommends tilting your head down toward the floor when you spray and gently sniffing in each nostril: “I like to tell patients ‘nose to toes’ when they administer their nasal spray.”

43. Have someone help you with eye drops

If itchy eyes are your primary symptom, antihistamine eye drops can help. If you struggle getting eye drops in, have someone help you administer them. Rubin suggests lying down with your eyes closed and having someone place the drop in the inner corner of your eye. When you open your eye, the drop will distribute throughout your eye. To make your artificial tears eye drops more effective, try keeping them in the refrigerator. The colder temp, Rubin says, can make the drops more soothing while also helping relieve inflammation in the eyes.

44. When to use decongestants

Decongestants — available as tablets or nasal spray — can help relieve nasal congestion due to allergies, but they don’t treat the core problem of inflammation. So while Moss says you can try a decongestant, you’ll likely need other treatments. Decongestants can also cause significant side effects, like heightened blood pressure, rapid heart rate, feeling jittery and problems sleeping, according to Moss. David Corry, M.D., a professor of medicine-immunology, allergy and rheumatology at Baylor College of Medicine in Houston, warns: “Oral decongestants should not be used by anyone, hypertensive or otherwise, after about the age of 50 due to numerous potentially serious side effects.”

45. Take time off if you use nasal decongestants

Decongestant nasal sprays (oxymetazoline or xylometazoline) are known to cause dependence and worse congestion when you stop using them — that’s why Altman suggests using nasal sprays for no longer than three days. “Basically, you sensitize the cells responsible for congestion,” he says. “If you overuse them, the cells can become inert to it, and you need more and more.” If you’re having a hard time stopping your nasal decongestant spray, talk to your health care provider about how to do so safely. “Excessive use of nasal decongestant sprays causes rebound vasodilation that worsens the congestion that was the initial problem, producing the condition formally known as rhinitis medicamentosa,” Corry says. 

46. If you use montelukast, know the risks

Another oral allergy medication is montelukast (sold under the brand name Singulair and in generic form). Like antihistamines, this drug works by blocking inflammatory chemicals called leukotrienes. Moss commonly recommends montelukast for people who still have symptoms while taking other medications, but it’s important to know the risks. In 2020, the U.S. Food and Drug Administration warned consumers and health care providers of psychiatric side effects, including aggression, depression, agitation, sleep disturbances, suicidal thoughts and suicide. Moss says this effect is serious, but rare, and it should stop when you stop taking the drug. “Overall, montelukast is probably the most worrisome medication for use in allergies, especially in those over age 50,” Corry says. “If standard medications are not working so that you are thinking of trying montelukast, it is preferred to go to an allergist and try immunotherapy — allergy shots — before resorting to montelukast.”

47. Be skeptical of direct-to-consumer allergy tablets

Sublingual allergy tablets, which introduce allergens in oral liquid or tablet form, have been shown in a few small studies to improve allergy symptoms. But they’re not FDA approved, and according to the American Academy of Allergy, Asthma & Immunology, there’s not enough consistent evidence about their safety or efficacy. Allergy drops are typically sold from direct-to-consumer companies rather than prescribed by allergists, and the purchase process may involve customers pricking themselves to test for allergies. But relying on the consumer to take data can result in inaccurate treatment. “That’s really concerning,” Patel says. “You’re asking a consumer to do something, and their whole treatment is based on that.”

48. Talk to your eye doctor about using contacts with antihistamines

Johnson & Johnson received FDA approval in early 2022 for disposable contact lenses called Acuvue Theravision with Ketotifen, which delivers a well-known antihistamine (ketotifen) to the eyes to fend off allergy symptoms. The pros are that they are convenient and effective in controlling ocular pruritus (eye itch) due to allergies. But Corry says recent reports of blindness and death happening to those using eye drops contaminated with pseudomonas (a type of bacterium) is worrisome. “Putting anything in the eyes confers higher risks as compared to the application of medication to other organs,” he says. “The long-term safety of drug-eluting contact lenses is unknown, and it may be best to wait for postmarketing surveillance reports to begin accumulating in a few years.” Your eye doctor, Moss adds, is the best resource if you want to talk it over. You can also use allergy drops in your eyes before putting in your normal contacts, and again after you take them out at night. Wait at least 15 minutes after using allergy drops before putting in your contacts.

49. Be wary of alternative medicine

Alternative allergy treatments, including acupuncture and an herbal supplement called butterbur, have been shown in some studies to improve people’s symptoms. But according to Corry, research on alternative remedies is often not as robust or reliable as for mainstream treatments — plus, the FDA doesn’t regulate supplements for safety and efficacy — so he generally doesn’t recommend them. Instead, focus on treatments your health care provider recommends.

50. Consider immunotherapy

Immunotherapy is a treatment that desensitizes your immune system to allergens that affect you. Subcutaneous immunotherapy — or SCIT — involves getting injected with small amounts of allergens at an allergist’s office. Studies show it’s highly effective, and that people report decreased symptoms for years after therapy, but it’s a big time investment: Most people go every week for several months, and then receive monthly maintenance shots for three to five years afterward. “I’ll usually offer it to people who aren’t getting any benefit from over-the-counter drugs or prescription medications,” Louisias says. Some clinics offer at-home immunotherapy shots, but Louisias cautions against those.

Allergy shots can cause severe allergic reactions, so they’re best done in a doctor’s office. Because immunotherapy involves introducing actual allergens to your body, it isn’t a safe option for everyone. For example, Corry says allergists usually advise against allergy shots for people with lung or heart disease, and people prone to hives. People who take beta-blockers for high blood pressure may not qualify for allergy shots, because these drugs may lead to more severe (or even life-threatening) anaphylaxis that is difficult to treat.

51. Try sublingual immunotherapy (SLIT) if you have just one allergy

If you’d rather not spend years getting shots, sublingual immunotherapy — taking a dissolvable tablet at home — is an option. According to Patel, doctors may recommend SLIT to people who aren’t eligible for subcutaneous immunotherapy, such as patients on blood thinners who shouldn’t get shots due to bleeding risk, or people prone to swelling. While subcutaneous immunotherapy can introduce multiple allergens at once, the tablets only include one allergen. “This is a great way to get desensitized from grass, ragweed and dust mites and is safer and more convenient than SCIT,” Corry says. “Unfortunately, SLIT is only available for a few things and so is less effective for folks with multiple allergies. It’s also more expensive than SCIT.”

52. If all else fails, ask about biologics

Patients who aren’t candidates for traditional immunotherapy aren’t out of options. Xolair, a biologic drug, can alter people’s immune response to allergens without exposing them to the actual allergen. When you breathe in an allergen, your body releases an antibody called immunoglobulin E (IgE), which then attaches to the allergen and inflammatory cells. Biologic drugs like Xolair — typically administered as a shot — contain proteins that bind to the antibodies, so they can’t attach to inflammatory cells. Currently, the FDA has approved Xolair for allergic asthma but not seasonal allergies. Still, Corry says many allergists prescribe it “off-label” for patients who have severe allergies but can’t undergo immunotherapy.