The arrival of spring may feel like a distant reality depending on where in the U.S. you live, but experts say now is the time to think about taking medications to protect against spring allergy symptoms.
Seasonal allergies, also known as seasonal allergic rhinitis or hay fever, are incredibly common in the US – the condition is estimated to affect more than 19 million adults and more than 5 million children. And while the worst season for allergies depends on what each person is allergic to, early spring can bring heavy levels of pollen that are hard for some people to handle.
“I always tell patients, ‘Start by taking your over-the-counter allergy tablet [on] Valentine’s Day,” Christina Cruz, MD, an allergist and immunologist at Tufts Medical Center, told me Health. “It gives you a few weeks before the pollen starts to build up to have a little basic protection.”
Here’s what experts had to say about why now is a good time to start taking allergy medications, how to know if someone is taking the right one, and other ways to best prepare for this spring’s rising pollen levels.
Seasonal allergies are caused by the body’s immune system overreacting to something it shouldn’t. For people with seasonal allergies, their bodies mistakenly identify pollen as a threat and send chemicals into the nose that cause symptoms such as a runny or itchy nose, sneezing, coughing, or watery, itchy eyes.
That’s where allergy medications — antihistamines, decongestants, or steroids — come into play. These drugs work to reduce the severity of that immune system response.
“[Antihistamine] just basically stabilizes those cells responsible for releasing histamine in response to some of this irritation or inflammation that allergies cause on the body,” explained Dr. Cruz.
The same is even more true of nasal spray steroids, noted Stanley Schwartz, MD, PhD, chief of the division of allergy, immunology and rheumatology at the University at Buffalo Jacobs School of Medicine and Biomedical Sciences.
“That particular drug takes a little bit of lead time to become effective — by that I don’t mean months, I mean maybe a few weeks,” Dr. Schwartz. Health. “Even though the symptoms aren’t there, it’s preparing for the onset of symptoms.”
While it’s smart to start taking steroid medications a few weeks before spring, antihistamine pills may not even need that long of a prep period, added Dr. Schwartz to it. Those usually start working right away, he said.
While a few weeks before spring is the general rule of thumb to start taking allergy medication, there are a number of factors that can change when that ideal start date might be.
Dr. Cruz recommends starting around Valentine’s Day, but Dr. Scwartz said people don’t have to start their over-the-counter allergy medications until mid-March. This is largely because seasonal allergies can look very different depending on a person’s specific allergy and location.
The spring allergy season is primarily driven by trees, which pollinate earlier in the year. For people living in the northern US, this can make this time of year “inconvenient” for people, Dr. Cruz out. She is based in the Boston area.
“In our region [the Northeast]Just the sheer volume of pollen released in the spring, along with those kinds of winds — the pollen would travel enormous distances,” she said. “It almost feels like a body overload. Your body is overstimulated.”
But tree allergies aren’t just a problem for people living in the northern US — some of the worst species for allergy sufferers are the maple, oak, cedar, and willow, which can be found across the country. In the South and other regions where temperatures are warmer, spring allergy season can begin as early as January.
And tree pollens aren’t the only cause of allergies — grass pollens can trigger symptoms in late spring and summer, and people allergic to ragweed or similar plants can have symptoms that begin in late summer and last until the first frost, Dr. Schwartz said.
So if a person usually has no symptoms in early spring, it’s entirely possible that their hay fever is being caused by grasses or weeds rather than trees, meaning February or March is definitely too early to start medication.
Like spring allergy season itself, the treatments available to manage hay fever symptoms can vary and often involve a fair amount of “trial and error,” noted Dr. Cruz up.
“The nice thing about all these allergy medications that are available to people is the flexibility it allows,” said Dr. Cruz. “Depending on the intensity of your allergy symptoms, you may choose to just try treating it with a tablet or maybe a nasal spray.”
If a person’s symptoms don’t improve after taking the medication, they switch to a different kind of drug or even a different brand, she added.
There is currently no evidence that the effectiveness of antihistamines decreases over time. But anecdotally, Dr. Cruz, some of her patients tell her they feel they get better results if they switch brands or medications during allergy season.
“One brand can work particularly well on them for a period of time. But then it loses its efficacy the longer they use it. So it’s not like a permanent tolerance develops,” she said, “your body gets used to it a bit and it needs a break.”
But if changing them doesn’t work, it’s probably time to ask an allergist about allergy shots. These essentially remove allergy symptoms altogether, Dr. Schwartz explained, but they can take three or more years to be fully effective.
“They’re great, but the stakes are significant,” he said. “You don’t cure allergies with all the drugs we’re talking about — you just manage them.” But this is the potential for complete healing, but [it’s] a big commitment.”
In addition to medication, people with hay fever should close windows and doors to prevent pollen from entering, especially on high pollen days. This would ideally prevent the allergic reaction from happening in the first place.
It’s also important to think about the more secretive ways pollen can get into someone’s home, Drs. Schwartz and Cruz added. That could be brushing or bathing pets when they come in, or wearing a hat or washing your hair after walking around outside.
People may even consider wearing a mask outside during the worst of their allergy symptoms. Some air filters may be able to remove some of the pollen from people’s homes, but Drs. Cruz and Schwartz said they wouldn’t recommend relying on them alone.
With a variety of drug options and pollen avoidance strategies, allergy season can feel confusing or even oppressive. But the key is to plan ahead of time for allergy season, listen to your body so you can change medications, and seek advice from an allergist if things don’t get better. These are good hay fever prevention measures, but people also need to find a way to live their lives, said Dr. Cruz.
“You know, it’s always easy to say, ‘Well, just avoid the allergen,'” she said. “But I’m a big believer in being able to enjoy the outdoors even if you’re allergic. And that’s why [you should] see your allergist to see if we can optimize that for you to do these things if you are a severe allergy sufferer.