May 20, 2026
It doesn't seem fair — you wait all winter for the first signs of spring. But before you can bask in the warm, spring sunlight or appreciate the burst of color, you develop a drippy nose, scratchy throat and watering eyes. Seasonal allergies have arrived.
That's the story for approximately one in four adults in the United States. And in children ages 17 and younger, seasonal allergies are the most commonly diagnosed allergy. But just because seasonal allergies are common does not mean this is a normal response to nature or that you need to live with the symptoms.
"Seasonal allergies are not a typical immune response," says Christine Franzese, MD, an MU Health Care otolaryngologist (ear, nose and throat doctor) who specializes in allergy and immunology. "Your immune system is meant to attack threats, but in this case, it's attacking a harmless allergen, like pollen or grass, and that's not normal."
The good news is that there are many treatment options. You can get most of the recommended medicines, such as pills, nasal sprays and eye drops, over the counter (OTC) at your local pharmacy. But to find complete relief, it's critical to know what to expect, which treatment to use and when to ask for help.
Here are 5 things you should know about seasonal allergy treatment:
1. Allergy Testing Can Help Guide Treatment
You may think you have seasonal allergies, but do you know what exactly you are allergic to? Allergy testing provides that information so you can:
- Watch daily counts for your specific allergen to avoid dangerous days
- Reduce your medicine use so that you only take it when you need it
In some cases, allergy testing may also reveal that your symptoms are not caused by an allergy but may be a sign of an underlying condition such as non-allergic rhinitis or chronic sinusitis.
"For many older adults, allergies begin to fade because the immune system isn't as reactive as it used to be," Dr. Franzese says. "What seems like typical seasonal allergy symptoms may just be a nonallergic reaction to an irritant, such as smoke or a fragrance.”
Avoid online or at-home allergy tests — they don't offer the same level of testing as what you get through your doctor. They may be able to identify a "sensitivity," but cannot provide conclusive evidence about seasonal or year-round allergies.
2. The Response to Different Over-the-Counter Allergy Pills Is Personal
There are plenty of options for allergy pills, but don't assume they all work the same.
"The brands are equally effective, but many people will respond to one type of pill but not the others," Dr. Franzese says. "So, if one pill doesn't work, try something different. You may find something more effective for you.”
You can expect an antihistamine pill to reduce or eliminate your symptoms within an hour or two. If you are still sniffling or itching, assume that medicine doesn't work for you.
One allergy medicine to avoid, says Dr. Franzese, is Benadryl®, because it has a risk association with neurological issues. Other antihistamines do not cross the blood-brain barrier as much or at all, and don't affect the brain in any way.
3. All Allergy Nasal Sprays Are Not Created Equal
There are two categories of allergy nasal sprays:
- Steroid sprays, which come in different strengths
- Antihistamine sprays, which have a decongestant effect
"Be careful with decongestant sprays that are marketed for allergies but are not classified as a steroid spray or antihistamine," Dr. Franzese says. "They may contain an addictive chemical called oxymetazoline that is only safe to use for three to five days."
To assess the effectiveness of your nasal spray, make sure to set your expectations. Nasal steroid sprays will not be fully effective until they’ve been used for at least a week. Antihistamine sprays should start working in 15 to 20 minutes.
4. Seasonal Allergy Immunotherapy Doesn't Have to Involve Shots
For people with more bothersome symptoms that are not responding well to OTC medication, immunotherapy may be a good option. Immunotherapy gradually exposes your immune system to the allergen to desensitize it. As your immune system grows accustomed to the allergen, it no longer has the same reaction.
Most people think of immunotherapy only as "allergy shots," but it is actually offered in several different formats:
- Injections or shots (subcutaneous immunotherapy) administered weekly in your doctor's office
- Oral drops or tablets (sublingual immunotherapy) taken under your tongue daily at home
- Toothpaste (oral mucosal immunotherapy) used daily at home
To see if immunotherapy is an appropriate treatment for you, your doctor will assess your medical health and ability to commit to the treatment. If the treatment is effective during the first year, you will complete three to five years of therapy.
"Consider immunotherapy as an investment in yourself," Dr. Franzese says. "It's a long-term commitment, but the effects will last for many years, especially if you begin allergy therapy at a young age."
5. Reducing Your Exposure to Allergens Can Make a Big Difference
Seasonal allergy treatment can be very effective. But there are also several things you can do to reduce your exposure — and your symptoms:
- Cover your mouth and nose with a mask, bandana or gaiter when doing yard work, especially if you are allergic to grass.
- Keep your home free from allergens, if possible. Change your clothes and shower after being outside, keep windows closed and use an air purifier in the rooms you use the most.
- Know when your allergen is at its worst. Check daily pollen counts and learn which time of day the count is highest so you can avoid being outside.
- Use wraparound sunglasses if allergies affect your eyes. They may not be the most fashionable, but they have been clinically shown to help reduce eye allergy symptoms.
"Small shifts in your lifestyle can have a significant effect on symptoms," Dr. Franzese says. "For example, if you have spring allergies, tree pollen is worse in the morning. So, if you like to jog outside, try switching your exercise time to the afternoon or evening."
When to See a Doctor About Seasonal Allergies
If you have mild allergies that are completely controlled by OTC medicine, keep doing what you are doing. But consider seeing a doctor if you:
- Get side effects from allergy medication
- Take multiple medicines and don’t get complete symptom control
- Only have control of your symptoms because you take medicine every day
"If your allergy symptoms bother you enough that you find yourself looking for help from AI or TikTok, you should probably talk to a doctor," Dr. Franzese says. "It doesn't mean you have to get allergy testing, but we can provide treatment options and offer advice on medicines that seem more effective than others."
An allergy doctor can also:
- Prescribe stronger eye drop treatment for people with stubborn eye symptoms
- Provide information on the newest allergy treatments and research, such as MU Health Care's study focused on the effects of a novel injectable medication on year-round allergies
Dr. Franzese's final recommendation is to keep a diary of your allergy symptoms to bring with you to your appointment. Knowing more about your symptoms and the timing can be helpful for identifying the trees or grasses behind your allergy.
Next Steps and Useful Resources
- Want to discuss more with an allergy specialist? Schedule an appointment.
