Many people enjoy the cool weather and colorful foliage autumn brings. But for those with fall allergies, the season also comes with watery eyes, itchy throats, and stuffy noses. Fortunately, there are ways to alleviate these symptoms and appreciate the change of season.
Rachel L. Miller, MD
In this Q&A, Rachel L. Miller, MD, Chief, Division of Clinical Immunology, and The Dr. David and Dorothy Merksamer Professor of Medicine (Allergy and Immunology), Icahn School of Medicine at Mount Sinai, explains what could be triggering your fall allergies and how to treat them.
What causes fall allergies?
The most common causes are weed pollens, especially ragweed, and outdoor molds. Ragweed is a very robust urban weed that is common in the New York City area—it grows in Central Park, along roadsides, and in sidewalk cracks, starting middle to late August through the fall. Outdoor molds, also prevalent during this time, are produced by decaying leaves and other organic matter.
How can I know if my symptoms are from fall allergies or non-allergies such as COVID-19 or a cold?
Allergies are more likely to trigger symptoms such as a stuffy nose, itchy throat, and teary eyes. If your throat is actually painful or you have a fever, that is more likely to be a virus. A cough can be caused by either.
What are the most effective over-the-counter treatments for fall allergies?
The first line of therapy is nasal steroids. Some effective over-the-counter nasal steroid sprays include:
- Fluticasone (Flonase®)
- Budesonide (Rhinocort®)
- Triamcinolone (Nasacort® Allergy24HR)
These work by reducing inflammation in your nasal passages that trigger symptoms such as a runny nose.
Antihistamines also can be helpful to alleviate allergic symptoms like eye irritation and sneezing. Over-the-counter antihistamines include:
- Oral treatments such as cetirizine (Zyrtec®) and loratadine (Claritin® and Alavert®)
- Nasal medications such as azelastine (Astepro®)
- Eye drop medications also with azelastine (Optivar®), ketotifen (Alaway® and Zaditor®), and olopatadine (Pataday®)
Higher strength treatments are available with prescription. An allergist can determine which options are best for your symptoms. You can also use over-the-counter sinus rinses, such as neti pots (NeilMed® and SinuCleanse®) and saline solution sprays, to cleanse your nasal passages of allergens and other particulates several times per week. Be sure to use distilled or sterilized water.
What medical interventions can reduce my symptoms?
The first step to seeking any allergy treatment is to schedule an appointment with an allergist. We can provide tests to determine if you have ragweed, mold, or other allergies. Based on the results, we may recommend certain allergy shots or prescribe daily sublinguals (under-the-tongue tablets). The latter is effective for treating ragweed allergies. For the sublingual tablet to be effective, you need to start the medication a few months in advance of allergy season and continue it during the season.
What else can I do?
In general, you want to reduce the amount of allergens you come in direct contact with. When you are outside, wear a head covering and sunglasses, so the pollen and mold spores don’t get in your hair and eyes. Take your shoes off when you are get home so you’re not tracking the allergens inside. Keep windows closed, and use an air purifier to reduce pollen and other allergens in your home. Shower and shampoo your hair before bed to remove allergens from your body and pillow.