Seasonal Allergies: How to Find Relief and Breathe Easier

Seasonal allergies, also known as allergic rhinitis or hay fever, can significantly affect your quality of life. Common symptoms include sneezing, nasal congestion, itchy or watery eyes, runny nose, and fatigue. These symptoms are triggered by the body’s immune reaction to airborne allergens like pollen, mold, and dust. Avoiding allergens can help reduce symptoms, but many people find the most relief with medical treatments. Here’s a guide to the most effective ways to manage seasonal allergies, including tips to reduce allergen exposure and common treatments to relieve symptoms.

Reduce exposure to allergens

Understanding your allergy triggers and how to manage them can greatly improve your comfort year-round. Common seasonal allergens include pollen from trees, grass, and weeds, as well as mold, humidity changes, and air pollution. Indoor allergens like pet dander, dust mites, and pollen brought in on clothing can also worsen symptoms, especially in poorly ventilated spaces. Reducing your exposure to allergens is one strategy that can help to avoid severe symptoms.

TIPS FOR LIMITING ALLERGEN EXPOSURE

• Stay indoors during high pollen times, especially early morning (5–10 a.m.) and on windy days.
• Keep windows closed in your home and car; use air conditioning with a clean filter.
• Shower and change clothes after spending time outdoors to rinse off pollen.
• Use a mask when doing yard work or gardening.
• Dry laundry indoors during high pollen days to prevent pollen from settling on clothing and bedding.
• Track pollen levels using apps or websites like Pollen.com or local weather services to monitor daily pollen counts and plan accordingly.
• Try nasal irrigation with a saline rinse to flush allergens and irritants from nasal passages.
• Vacuum with a HEPA filter.
• Use air purifiers in bedrooms and living areas.

Medications can help prevent or relieve symptoms

ANTIHISTAMINES

There are several antihistamine options available over the counter. They work by blocking the effects of histamine, a chemical your body releases during an allergic reaction.

Oral antihistamines are often the first choice for mild or occasional symptoms.¹ Avoid first-generation antihistamines like diphenhydramine (Benadryl®) or chlorpheniramine, especially in older adults, due to side effects such as drowsiness, dry mouth, blurred vision, urinary retention, and confusion.² Second-generation antihistamines are less sedating and include cetirizine (Zyrtec®), levocetirizine (Xyzal®), fexofenadine (Allegra®), and loratadine (Claritin®).

The FDA recently issued a warning about rare but severe itching that can occur in some people after stopping long-term use of oral antihistamines like cetirizine and levocetirizine. This reaction is most likely in individuals who have taken these medications daily for years.³

Nasal antihistamines like azelastine (Astepro®) or olopatadine (Ryaltris®) can be added for stubborn nasal symptoms, and antihistamine eye drops (like Ketotifen® or Pataday®) can help relieve itchy, red eyes.^1,4

NASAL CORTICOSTEROIDS

Nasal corticosteroids are considered the most effective treatment for moderate to severe, persistent seasonal allergy symptoms.^1,2 They work by reducing inflammation inside the nasal passages, which helps relieve nasal congestion, sneezing, runny nose, and itching. Unlike antihistamines, which primarily block histamine after it’s released, corticosteroids help prevent and calm the entire allergic inflammatory response.⁵ These medications are most effective when used consistently rather than just as needed, and they may take a few days to reach full effect. They are safe for long-term use in most people and have minimal systemic absorption, meaning they act locally in the nose with a low risk of side effects when used as directed.

DECONGESTANTS

Over-the-counter decongestants can also help relieve symptoms. Oral decongestants like pseudoephedrine (kept behind the pharmacy counter) can help reduce nasal swelling but should be used with caution in people with heart disease, high blood pressure, or glaucoma.^1,2 Oral phenylephrine has been found to be not effective.⁶ Nasal decongestant sprays like Afrin® should be limited to 3 days to avoid rebound congestion.

OTHER TREATMENT OPTIONS^1,2

• Cromolyn (NasalCrom®) is an over-the-counter mast cell stabilizer and a safe option for children or for prevention before known allergen exposure. It decreases inflammation in the nose and reduces substances in the body that cause allergy symptoms.
• Montelukast (Singulair®) is a prescription leukotriene receptor blocker that may help with both nasal and asthma symptoms but should be used cautiously due to potential mental health side effects.
• Oral corticosteroids are prescribed by doctors during flare-ups but are reserved for short-term use because of serious long-term side effects.

When to see a doctor

You should contact a healthcare provider if:

• You have a fever over 101.5°F
• Symptoms get worse or don’t improve with over-the-counter treatments
• You have chest pain, shortness of breath, or other signs of serious illness
• You have chronic lung or heart conditions like asthma, COPD, or CHF
• There is thick, colored mucus or signs of infection
• A child under 2 years old needs treatment

Managing seasonal allergies can take some trial and error, but with the right combination of allergen avoidance and medication, most people can find lasting relief. Understanding your triggers and using treatments consistently can help reduce symptoms and improve your daily comfort. If symptoms persist or worsen, seek guidance from a healthcare provider.

References

1. Bernstein, J. A., Bernstein, J. S., Makol, R. & Ward, S. Allergic Rhinitis: A Review. JAMA 331, 866–877 (2024).
2. Dykewicz, M. S. et al. Rhinitis 2020: A practice parameter update. Journal of Allergy and Clinical Immunology 146, 721–767 (2020).
3. Research, C. for D. E. and. FDA requires warning about rare but severe itching after stopping long-term use of oral allergy medicines cetirizine or levocetirizine (Zyrtec, Xyzal, and other trade names). FDA (2025).
4. Leonardi, A. et al. Allergic Conjunctivitis Management: Update on Ophthalmic Solutions. Curr Allergy Asthma Rep 24, 347–360 (2024).
5. Sousa-Pinto, B. et al. Intranasal antihistamines and corticosteroids in allergic rhinitis: A systematic review and meta-analysis. J Allergy Clin Immunol 154, 340–354 (2024).
6. Meltzer, E. O., Ratner, P. H. & McGraw, T. Phenylephrine hydrochloride modified-release tablets for nasal congestion: a randomized, placebo-controlled trial in allergic rhinitis patients. Ann Allergy Asthma Immunol 116, 66–71 (2016).