Common, and often in families
In 2021, 31.8% of U.S. adults had a seasonal allergy, eczema or food allergy, including 25.7% with a seasonal allergy.1 Among children, 27.2% had at least one.2 Allergies often run in families.5 Breathing in pollen, mold, dander or dust makes the body release chemicals that cause symptoms.3
U.S. adults with a diagnosed allergic condition, 2021
Percent of adults, National Health Interview Survey
Survey estimates for the U.S. population, not a measurement of any patient or of a ProperHealth or Clarkson service.
Reduce exposure first
The best treatment is to avoid the pollens that cause your symptoms; you may not avoid them all, but you can reduce exposure.6 Hot, dry, windy days carry the most pollen,4 and showering before bed removes allergens from skin and hair.16 Allergy testing can show what triggers your symptoms.7
Reduce exposure before reaching for a medicine
An illustration based on MedlinePlus and FDA advice.
Choosing and using a medicine
Nasal steroid sprays are the most effective treatment for allergic rhinitis and work best used every day.8 Some antihistamines cause less sleepiness than others.12 Decongestant nasal sprays should not be used for more than 3 days,9 because longer use can make congestion rebound.10
Allergy medicines, side by side
| Medicine | Good for | Know this |
|---|---|---|
| Less-drowsy antihistamines (cetirizine, loratadine, fexofenadine) | Sneezing, itching, runny nose.12 | No alcohol; check how it affects you before driving.13 |
| Steroid nasal sprays | The most effective treatment for allergic rhinitis.8 | Work best used every day; can cause stinging or nosebleeds.811 |
| Decongestant nasal sprays | Short-term stuffiness. | No more than 3 days, or congestion rebounds.910 |
| Pseudoephedrine tablets | Stuffiness. | Tell your doctor first if you have high blood pressure or heart disease.15 |
Allergy shots can build tolerance over months to years.18
Sinus infections and rinsing
Viruses cause most sinus infections, and most get better on their own without antibiotics.19 When antibiotics are not needed they will not help, and their side effects can still harm.20 A warm compress and steam can ease pressure.23 See a provider for severe facial pain or symptoms lasting more than 10 days without improving.21
Most sinus infections clear on their own
Based on CDC guidance.
If you rinse your sinuses, use only distilled, sterile or previously boiled water; tap water is not safe.25
Rinsing your sinuses safely
Safe water
A historical perspective: Dr. Majid Ali
“Allergy is a great masquerader of the immune system.”
— Dr. Majid Ali, 8 July 2014
Dr. Ali argued that allergy was widely under-recognized and put reducing exposure ahead of medicines. That is consistent with current sources: allergies affect about a quarter of adults,1 and reducing exposure is the best first treatment.6
He also wrote that many unrelated diseases are "in reality" caused by undiagnosed allergy, explained through his own oxygen model. The sources used here do not support those claims; allergy testing and diagnosis belong to a clinician.7
What to do this week
Name your trigger
Cut exposure
Shower before bed and stay in on bad days.16
Use a steroid spray every day
It is the most effective treatment.8
Limit decongestant sprays to 3 days
Rinse only with safe water
Distilled, sterile or boiled and cooled.25
When to get help now
Each warning sign cites the official guidance behind it. The wording still needs pharmacist sign-off.
- Trouble breathing, throat tightness, swelling of the face or lips, or collapse after a sting, food or medicine — use epinephrine if available and call 911.32
- Severe headache, a stiff neck, swelling or redness around the eye, or confusion with sinus symptoms — seek emergency care.3334
- Severe facial pain, or sinus symptoms lasting more than 10 days without improving — see a provider.35
- Wheezing or asthma that is getting worse during allergy season — contact your provider right away. Severe shortness of breath at rest, drowsiness or confusion — call 911.3637
- Fever, nosebleeds or headaches while using a nasal rinse — see your provider.38
Every numbered marker links to the exact passage it rests on. Check the sources.