Spring Allergies:
Symptoms, Treatment & Relief

Every spring, millions of people wake up congested, itchy-eyed, and exhausted — not from a cold, but from the invisible cloud of pollen that blankets the country from March through June. If you have been sneezing your way through the season wondering whether to tough it out or finally do something about it, here is what you actually need to know.

Spring allergies — technically called seasonal allergic rhinitis — are triggered by pollen from trees, grasses, and weeds. In Maryland, Washington, and Delaware, tree pollen season typically begins in late February and peaks through May, with grass pollen following close behind. The good news: most cases respond well to treatment. The challenge is choosing the right one.

What Causes Spring Allergies?

Spring allergies are driven by pollen — tiny particles released by trees, grasses, and weeds that are carried by wind and inhaled. When pollen enters the airways of a sensitized person, the immune system misidentifies it as a threat and releases histamine and other inflammatory chemicals. That immune response is what causes every symptom you associate with allergy season.

The main culprits vary by region:

• Maryland and Delaware: Oak, birch, maple, and cedar pollen are the primary triggers from March through May, followed by ryegrass and bluegrass pollen in late spring.
• Washington State: Alder and birch are among the most potent spring allergens in the Pacific Northwest, often beginning as early as February in western Washington.

Pollen counts are highest on warm, dry, and windy days. Rain temporarily suppresses counts. If you notice your symptoms worsen in the morning and on breezy days — and improve after rain — seasonal pollen is almost certainly the cause.

Spring Allergy Symptoms vs. a Cold: How to Tell the Difference

This is the question most people get wrong, especially in early spring when temperatures and a stuffy nose go hand in hand. The symptoms overlap significantly, but the pattern tells you everything.

If your symptoms appear every spring, improve when you stay indoors with windows closed, and have never included fever, you almost certainly have seasonal allergic rhinitis. A telehealth provider can confirm this and help you build an effective treatment plan.

Over-the-Counter Allergy Treatments That Actually Work

The allergy aisle can feel overwhelming, but the evidence is clear on what helps. Here is a practical hierarchy:

1. Nasal Corticosteroid Sprays (Most Effective)

Fluticasone (Flonase), budesonide (Rhinocort), and triamcinolone (Nasacort) are now available over the counter and are consistently rated as the most effective single treatment for seasonal allergic rhinitis by the American Academy of Allergy, Asthma & Immunology. They reduce inflammation in the nasal passages, improving congestion, runny nose, and post-nasal drip. They take 1–2 weeks to reach full effect, so start them before pollen season peaks.

2. Second-Generation Antihistamines

Loratadine (Claritin), cetirizine (Zyrtec), and fexofenadine (Allegra) are non-drowsy options that work well for sneezing, itching, and runny nose. Cetirizine is slightly more sedating than the other two for some people. These work within one to two hours and are most effective when taken consistently rather than only when symptoms spike.

3. Antihistamine Eye Drops

For itchy, watery, or red eyes — a symptom that oral antihistamines sometimes under-address — ketotifen drops (Zaditor, Alaway) are available OTC and provide rapid relief specifically for ocular allergy symptoms.

What to Skip

Decongestants like pseudoephedrine can help short-term but are not recommended for long-term use and can raise blood pressure. First-generation antihistamines like diphenhydramine (Benadryl) cause significant sedation and are generally less appropriate for daily allergy management than the options above.

When OTC Treatments Are Not Enough

Over-the-counter options work for most people with mild to moderate seasonal allergies. But certain situations call for a clinical evaluation:

• OTC medications are not controlling symptoms after two weeks of consistent use
• Allergies are triggering or worsening asthma symptoms
• You are developing frequent sinus infections
• Allergy symptoms are significantly disrupting your sleep or ability to work
• You are pregnant or have a medical condition that limits your medication options

A telehealth provider can prescribe prescription-strength nasal sprays, the leukotriene modifier montelukast (Singulair), or a short oral steroid course for severe flares. They can also provide a referral for allergy testing and immunotherapy if your symptoms are persistent year after year.

Managing Pollen Exposure Day to Day

Medication is one part of the equation. Reducing pollen exposure is the other. Practical steps that make a meaningful difference:

• Check daily pollen counts before planning outdoor activities. Apps like the Weather Channel and IQVIA's pollen tracker provide local data.
• Keep windows closed on high-pollen days and use air conditioning with a clean HEPA filter.
• Shower after being outdoors to remove pollen from hair and skin before it transfers to pillows.
• Time outdoor exercise strategically: Pollen counts peak in the morning (5–10 AM) and are lower in the late afternoon and after rain.
• Wear sunglasses outdoors to reduce pollen contact with the eyes.
• Change clothes when you come inside on high-count days.

Frequently Asked Questions