22-05-2025
This Is Why Your Allergy Meds Aren't Helping
May 22, 2025 – One in four Americans face an annual showdown with the air they breathe. Pills and sprays are their traditional weapons against seasonal allergies.
But is this battle plan all wrong? That's a crucial question right now as the air warms and the changing climate supercharges pollen production.
Doctors say too many people still use their allergy medications incorrectly – they wait until symptoms appear (too late!) or they rely too much on nose sprays and decongestant pills.
Here's a guide to help you breathe easier this year.
Why Is Your Body Reacting Like This?
A seasonal allergy is just an overreaction to pollen. Call it hay fever or allergic rhinitis – it's your body treating as dangerous threats these basically harmless reproductive particles of plants, distributed by the wind. It's literally in the air you breathe, so it's hard to escape.
Tree pollen is worst in the spring, grass pollen in the summer, and weed pollen in the fall. Indoor allergens like mold spores, pet dander, or dust mites can trigger hay fever as well. Your body releases histamine, molecules that trigger inflammation as a defense. This widens blood vessels and produces mucus to trap invaders.
Hence: a runny nose, sneezing, itching, watery eyes, coughing, a sore throat, clogged ears, even tiredness and headaches.
So you, understandably, try to get rid of this congestion. But Levi Keller, MD, an allergist and immunologist at UCHealth, says about a quarter of his patients misuse decongestants. Surveys have shown that many people still rely on decongestant pills, though doctors recommend nasal steroids and antihistamines as first treatment options.
Follow these guidelines instead:
1. Don't Wait for Symptoms
Many people wait for that first sniffle or throat itch before using meds, which makes them less effective, according to a survey published in The Journal of Allergy and Clinical Immunology: In Practice. Instead, beat allergies to the punch.
"Start prior to allergy season and continue through the season to prevent the development of symptoms, rather than treating symptoms reflexively," Keller said.
Starting antihistamines early gives the medication time to block histamine receptors before allergens hit. This helps your body stay ahead of flare-ups instead of working extra hard to relieve symptoms after they strike.
Aim to start one to two weeks before your first pollen exposure. For most people, that means setting the clock around February-April for tree pollen, April to early June for grass pollen, and from August onward for weed pollen.
2. Make Sure You Have the Right Meds
There's an allergy treatment for every symptom, from a clogged nose to watery eyes. But that doesn't mean you should grab one of everything from the allergy aisle. Research shows that a more targeted approach, tailoring treatment to specific symptoms, works better.
For best results, use:
Decongestants for a stuffy nose
Antihistamines for sneezing and itching
Steroid nasal sprays to relieve inflammation in the nasal passages
Some treatments can work better together. "For moderate to severe symptoms, combining non-sedating antihistamines with nasal corticosteroids is effective," said Brian Greenberg, MD, an allergist and immunologist at Pediatric Group of Southern California. He also recommends combining nasal steroid sprays and nasal antihistamines to relieve symptoms.
But Greenberg added that the specific symptoms you get and how hard they hit can depend on genetic, environmental, and immune factors.
3. Spray the Right Way
Do you tilt your head back when using nasal spray? Many do – but the correct move is to lean slightly forward when spraying. This helps the medication remain in the nose to work its magic, instead of dripping down the throat.
That fast relief is great, right? But don't go overboard. Decongestant sprays like oxymetazoline (Afrin) shouldn't be used for more than three days in a row – any longer and you risk rebound congestion that makes your symptoms worse.
4. Be Consistent
It's tempting to stop allergy meds when you start feeling better. But that can let inflammation creep back in. Be sure to use daily meds like antihistamines or nasal sprays as recommended by your doctor, including taking them for the time advised.
That said, don't go overboard. "Increasing antihistamines like cetirizine, fexofenadine, or loratadine beyond once-daily dosing likely won't make much of a difference," said Keller.
Maybe try this: Take daily antihistamines like loratadine or cetirizine at night, especially if they make you drowsy, Greenberg suggests. Some people prefer nighttime dosing to stay ahead of morning symptoms – though he notes there's little solid evidence that it works better than daytime use.
And if you're worried about side effects, don't be – Greenberg said that antihistamines are generally well tolerated with few serious concerns.
5. Don't Put Those in There!
Keep your allergy meds in a dry place, like your bedroom. Bathroom humidity can trigger chemical reactions in pills that weaken the active ingredients.
For liquid medications, such as antihistamine syrups, avoid storing them in the fridge unless the label says otherwise. Cold air can change their structure, causing ingredients to crystallize or separate, which may make them less effective or make dosing less accurate.
6. Try These Prevention Tricks
The best way to manage allergies is to stay two steps ahead of potential triggers. "Proactive management is key," Greenberg said. "Monitoring local pollen counts … using HEPA air purifiers, installing allergy-proof mattress and pillow encasements can help reduce exposure."
If you're doing yardwork, consider wearing a mask to limit pollen exposure, said Keller. Showering and changing clothes afterward can limit exposure to lingering pollen, he said.
Pets can bring allergens in too, he said. Before letting them back indoors, wipe down their coat with a damp towel to reduce the pollen they may have picked up outside.
7. Go to an Allergist
Over-the-counter meds can be a big help when allergies hit. But if you're battling problems – sinus infections, constant congestion, or hay fever – that last for months, it's worth checking in with an allergist.
These experts do more than treat symptoms – they dig deep to figure out what's causing them. Through testing, allergists can pinpoint triggers and build a customized plan for you, including strategies for avoiding those triggers and keeping flare-ups in check.
