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Update: What You Need to Know About 2021 Spring Allergies

Update: What You Need to Know About 2021 Spring Allergies

A practice guideline points to new recommendations for managing hay fever

ARLINGTON HEIGHTS, Ill. (February 17, 2021) – Allergic rhinitis, more commonly called “hay fever,” has been around for hundreds of years, and the misery it causes has been around just as long. Occasionally, there is new information to be passed along regarding how to manage the symptoms that come with hay fever — namely sneezing, itchy nose, runny nose, and congestion.

Recently, the American College of Allergy, Asthma and Immunology (ACAAI) took part in publishing a practice guideline for allergists and other healthcare workers about the latest developments in understanding allergic rhinitis.

“The guideline highlights the fact that cough is a common symptom of hay fever,” says allergist Luz Fonacier, MD, ACAAI president. “Many people aren’t aware of that, and especially as we face another spring with COVID-19, people should be aware that a cough isn’t necessarily a COVID-19 symptom – it can just be part of allergies.”

Five additional recommendations highlighted in the guidelines included:

  1. Avoid first-generation antihistamines – If you plan to take an oral medication to treat your hay fever, think twice before using first generation antihistamines such as diphenhydramine (Benadryl) and chlorpheniramine (ChlorTrimeton). They can cause drowsiness and symptoms like dry mouth, dry eyes, and constipation. Look for non-sedating treatments such as cetirizine, levocetirizine, fexofenadine, loratadine or desloratadine instead.
  2. Intranasal corticosteroids are an effective treatment – Intranasal corticosteroids (fluticasone, mometasone, budesonide, triamcinolone) are the most effective treatment if you suffer from persistent allergy symptoms, especially if they are interfering with your quality of life. They may even help control the symptoms that accompany eye allergies.
  3. Pseudoephedrine is effective but has side effects – Many people use the oral decongestant pseudoephedrine to clear up a stuffy nose. Unfortunately, pseudoephedrine is the main ingredient in methamphetamine – commonly called “meth.” It is only available by prescription or by specially requesting it from a pharmacist, depending on what state you are in. Pseudoephedrine has many side effects including insomnia, loss of appetite, irritability, and heart palpitations. It should also not be taken if you are pregnant.
  4. No verdict on alternative treatments like acupuncture – In developing the guideline, the allergists did an extensive review of medical studies that examined the effectiveness and safety of alternative treatments such as acupuncture and herbal medications. Because there is a lack of adequate studies, they concluded that they could not currently recommend for or against the use of these treatments for hay fever.
  5. Food allergy testing should not be a part of testing nasal allergies – When patients get tested for allergic rhinitis (nasal allergies,) they often also get tested for food allergies. The guideline strongly emphasizes that food allergy testing should not be performed in the routine evaluation of allergic rhinitis because food allergies do not cause nasal symptoms. Occasionally patients have food-pollen cross reactivity.  Testing for hay fever should include sensitivity to pets, dust mites, trees, grasses, weeds, and mold as they are the most likely triggers for nasal allergies.

If you are suffering with nasal allergy symptoms and your regular treatments aren’t working, it’s time to see a board-certified allergist. Allergists are specially trained to help you take control of your allergies and asthma so you can live the life you want. Find an allergist in your area with the ACAAI allergist locator.


The ACAAI is a professional medical organization of more than 6,000 allergists-immunologists and allied health professionals, headquartered in Arlington Heights, Ill. The College fosters a culture of collaboration and congeniality in which its members work together and with others toward the common goals of patient care, education, advocacy and research. ACAAI allergists are board-certified physicians trained to diagnose allergies and asthma, administer immunotherapy, and provide patients with the best treatment outcomes. For more information and to find relief, visit Join us on FacebookPinterest and Twitter.

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