table of contents
If you have any medical questions or concerns, please talk to your healthcare provider. The articles on Health Guide are underpinned by peer-reviewed research and information drawn from medical societies and governmental agencies. However, they are not a substitute for professional medical advice, diagnosis, or treatment.
You’ve got itchy, red eyes, and your nose won’t stop dripping. Is this a cold or just allergies? If these are seasonal allergy symptoms, it’s essential to treat your symptoms appropriately so that you can feel better faster. Learn all about how to treat your seasonal allergy symptoms—the right way.
What are allergies?
Allergies happen when your immune system becomes hypersensitive to substances in your environment that it interprets as harmful, even though they’re not. Some allergies, like food allergies to peanuts, seafood, and certain medications, can be very dangerous and may lead to life-threatening reactions. However, seasonal allergies to pollen, ragweed, or pet dander are typically more of a bother than anything else. We are going to focus on seasonal allergies and how to treat them.
Estimates say that up to 30% of the world’s population suffers from seasonal allergies (also known as allergic rhinitis or hay fever) (Akhouri, 2021).
While the name implies that the runny or stuffy nose, sneezing, and itchy eyes only happen seasonally, some people may be affected year-round. Symptoms of allergies such as these can range from mild to severe (Akhouri, 2021).
Choosing medications for your seasonal allergy symptoms
When choosing the best allergy medication for your symptoms, the last thing you want to do is play Goldilocks and hope you pick the best option the first time. We’ve broken down three factors to consider when choosing how to treat your allergy symptoms to help you get it right from the get-go so you can get back to tackling that to-do list free of watery eyes:
- What are my symptoms?
- How long do my symptoms last?
- Which side effects do I need to be concerned about?
What are my symptoms?
Some medications are better suited to addressing certain symptoms than others. The most common symptoms of seasonal allergies are sometimes confused with the common cold and include (Akhouri, 2021):
- A stuffy or runny nose
- Postnasal drip or frequent throat clearing
- Sinus congestion
- Watery or itchy eyes
- Itchy throat
You may opt for different over-the-counter (OTC) or prescription nasal sprays or oral pills, depending on your allergy symptoms.
- Mild allergy symptoms: If your allergies give you mild symptoms and excess mucus, saline nasal sprays may be helpful. Saline sprays are a combination of sterilized water and salt. They’re great for clearing your nose. Keep in mind that they only work in the short term and don’t address the underlying condition.
- Nasal congestion: If your allergy symptoms are mostly nasal congestion and swelling of the nasal passages, you can likely opt for either decongestants or corticosteroids.
- Nasal decongestant sprays are available over-the-counter and typically contain the active ingredients oxymetazoline or pseudoephedrine—brand names include Afrin, Dristan, and Neo-Synephrine. These medications work effectively and quickly because they temporarily shrink the blood vessels in the nose (vasoconstriction), improving your congestion. Unfortunately, you cannot use them for more than three days because of rebound congestion (more on that below) (Wahid, 2021).
- Nasal steroid sprays are considered the go-to treatment for allergic rhinitis symptoms. Over-the-counter options include fluticasone propionate (brand name Flonase) and triamcinolone acetonide (brand name Nasacort). You may need a prescription-strength option if you have severe symptoms (Sur, 2015).
- Itching, sneezing, and runny nose: Some people find that oral antihistamines, like loratadine (brand name Claritin), fexofenadine (brand name Allegra), and cetirizine (brand name Zyrtec), are excellent for alleviating these symptoms. You can even prevent symptoms from appearing in the first place by taking antihistamines daily during allergy season. Antihistamines work by blocking histamine, which is released in response to allergens like pet dander, dust mites, and mold spores; it leads to symptoms like sneezing, itching, and nasal congestion. In addition to the pill form, antihistamines are also available as nasal sprays, such as Astepro, Astelin, and Patanase (Akhouri, 2021).
- Asthma: Mast cell stabilizers such as cromolyn may be an option for those whose wheezing and asthma worsen during allergy season. While antihistamines block the actions of histamine in the body, cromolyn acts on mast cells to reduce the release of histamine in response to irritants. Mast cell stabilizers are often combined with other treatment options, like antihistamines or decongestants (Minutello, 2021).
Seasonal allergies: how to prevent, spot, and treat symptoms
How long do your symptoms last?
If you’re someone who suffers from allergies year-round, you’ll need a different treatment than someone whose itchy eyes are limited to allergy season, when levels of airborne irritants or pollen counts are highest.
For seasonal allergies, treatment options include antihistamines, decongestants, or nasal corticosteroids.
For year-round allergies, targeted delivery of corticosteroids in the form of intranasal sprays are considered the best treatment for symptoms. In this form, the steroids affect only your nasal passages instead of your entire body, minimizing the risk of side effects. Keep in mind that it can take time for them to kick in; consistent use leads to the most effective relief from allergy symptoms.
What allergy medication side effects can you expect?
Some allergy medications can cause nosebleeds, headache, nausea, unpleasant taste in the mouth, and cough. But, from there, it gets more granular in terms of what to expect and how potential side effects may balance out with the benefits. Each class of medications has its own set of common side effects:
- Intranasal steroids: The most common side effects of nasal corticosteroid sprays are nasal irritation and nosebleeds (epistaxis).
- Antihistamines: The side effects of antihistamines depend on whether you’re taking a first-generation or second-generation drug. First-generation antihistamines like diphenhydramine (brand name Benadryl) are notorious for causing drowsiness, fatigue, and impaired concentration—so don’t operate machinery if you are taking these types of antihistamines. Second-generation antihistamines, like loratadine (Claritin), fexofenadine (Allegra), and cetirizine (Zyrtec), do not cause as much drowsiness (Kawauchi, 2019).
- Saline: Since saline nasal sprays only contain just salt and sterile water, they are generally well-tolerated. But as we mentioned, these options may not be as effective as other types of treatments since they are just rinsing out your nasal passages.
- Decongestants: Decongestants may cause rhinitis medicamentosa, also called rebound congestion. This condition can develop from the overuse of nasal decongestant sprays. When you stop using the sprays, your congestion generally comes back. You should not use nasal decongestants for more than three days (Wahid, 2021).
Which allergy treatment is right for you?
The best allergy medication for you is the one that most effectively improves your allergy symptoms with the fewest side effects. In some cases, that may mean taking targeted allergy medicine, such as eye drops for eye allergies, instead of more general treatments, such as antihistamine tablets.
If traditional treatments have failed, your healthcare provider may recommend that you try immunotherapy, such as allergy shots. These can be expensive and take longer to work initially. But immunotherapy can potentially help you avoid long-term use of medications while providing significant relief.
Talk to your healthcare provider to find the ideal combination of therapies for treating your allergies.
- Akhouri S, House SA. (2021). Allergic rhinitis. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan-. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK538186/
Kawauchi, H., Yanai, K., Wang, D. Y., Itahashi, K., & Okubo, K. (2019). Antihistamines for allergic rhinitis treatment from the viewpoint of nonsedative properties. International Journal of Molecular Sciences, 20(1), 213. doi: 10.3390/ijms20010213. Retrieved from https://pubmed.ncbi.nlm.nih.gov/30626077/
Minutello K, Gupta V. (2021) Cromolyn sodium. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan-. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK557473/
Sur, D. K., & Plesa, M. L. (2015). Treatment of allergic rhinitis. American Family Physician, 92(11), 985–992. Retrieved from https://pubmed.ncbi.nlm.nih.gov/26760413/
Wahid NWB, Shermetaro C. (2021). Rhinitis medicamentosa. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan-. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK538318/
Dr. Chimene Richa is a board-certified Ophthalmologist and Senior Medical Writer/Reviewer at Ro.