Niti Chokshi, MD

A Stronger, Longer Allergy Season Is Here

, the spring season brings more than just blooming flowers and warmer days—it also means itchy eyes, constant sneezing, and a steady stream of over-the-counter (OTC) allergy medications.

 With that being said, this upcoming allergy season has started earlier than usual, and its impact is stronger, while its duration is projected to extend through the summer months.

Allergy season doesn’t just have a single underlying cause—several environmental factors are driving this shift. Warmer global temperatures have led to earlier plant blooming and longer growing seasons, especially for high-pollen culprits like trees, grasses, and weeds.

At the same time, increased levels of carbon dioxide in the atmosphere are causing plants to produce more pollen, and that pollen is more allergenic. Combined with fluctuating weather patterns, heavier rainfall in some regions, and poor air quality, these conditions create the perfect storm for prolonged exposure to airborne allergens.

The current allergy season is producing worse and longer-lasting symptoms, which affect numerous people compared to previous years. The prolonged environmental exposure to rising pollen counts has resulted in the highest number of patients visiting both pharmacies and medical offices to ask their usual and bothersome question: 

“Why aren’t my antihistamines working?”

While many people turn to antihistamines for relief, as they have in the past, this season’s intense and prolonged pollen exposure may require additional strategies to fully manage symptoms. As a result, patients may switch brands, increase dosages, or consult their clinicians for stronger options.

In addition to pharmacological management of symptoms, it’s increasingly important to consider what’s driving these reactions in the first place. Understanding the specific allergens at play can help patients make more informed choices about both prevention and treatment.

Antihistamines function as primary medications for treating allergic rhinitis with other IgE-mediated allergic conditions. The main mechanism of antihistamines involves blocking histamine H1 receptors to decrease symptoms like sneezing, rhinorrhea, nasal itching, and conjunctival irritation. Antihistamines succeed in treating light seasonal allergy symptoms, but they might not fully manage symptoms for patients who have moderate to severe or multiple allergies.

Patients who live in urban areas or high-humidity regions tend to show multiple sensitizations with multiple allergen exposures. The inability to determine exact allergenic triggers makes symptom management a trial-and-error process and often insufficient. The result of this situation creates treatment fatigue with polypharmacy and ongoing impairment of quality of life.

In this context, specific IgE testing plays a critical role. Clinicians can create individualized, evidence-based treatment plans by identifying the precise allergens that trigger patient sensitization. The diagnostic-first approach enhances treatment effectiveness while following the principles of precision medicine, which are becoming more prominent in allergy care.

When individuals have allergies, their treatment process starts by focusing on relieving their symptoms. The standard medical approach involves using OTC antihistamines together with other medications to treat sneezing, runny noses, and itchy eyes. But this symptom-focused strategy overlooks a critical first step: identifying the specific source of the allergic reaction.

Is it tree pollen? Mold spores? Dust mites? Pet dander? Environmental allergens create different biological responses because they exist in a wide range of types.

While pollen allergies tend to be seasonal, perennial allergens, such as dust and mold, can lead to allergy symptoms year-round. Often, having allergies to both can cause even more significant symptoms. The success of allergy treatment depends on identifying the precise allergen or allergens sooner rather than later.

Histamine serves as the primary target of antihistamines, yet allergic reactions typically involve more responses from the immune system than just histamine release. Cytokines and leukotrienes, along with additional mediators from the immune response, produce persistent symptoms that antihistamines fail to adequately treat on their own.

Different immune system responses result in the possibility that seasonal allergies consist of multiple triggers, which may also be a persistent yearly problem that environmental changes intensify. The patient who attributes their symptoms to pollen may actually experience reactions from dust mites, which exist throughout the year and become more evident during spring when windows open and new allergens can enter the home.

Identifying the specific trigger(s) behind an allergic reaction can dramatically shift the course of treatment. For instance, knowing that dust mites are the primary culprit could lead to recommendations for allergen-proof bedding, air purifiers, and additional pharmacotherapies like nasal corticosteroids or leukotriene inhibitors.

By moving beyond symptom suppression and getting to the root cause, patients can benefit from a more comprehensive management approach. This combines the preventative medicine approach of allergen exposure reduction with appropriate pharmacotherapies to allow for maximum symptom control with the lowest effective medication dosages.

Accurate identification of trigger substances stands as a fundamental requirement for effective allergy management. The process of testing becomes essential because specific IgE blood testing provides crucial results.

Specific IgE testing detects the IgE antibodies produced by one’s immune system specifically against individual allergens.

Blood tests through standard collection procedures provide essential information about allergic sensitizations through their results. Test results enable patients to move beyond just medications by identifying sensitizations to multiple allergens, especially when persistent triggers like dust mites or pets are present year-round or overlap with other seasonal allergens.

When specific allergens are identified as triggers, treatment plans should incorporate exposure reduction strategies that decrease exposure to sensitized allergens. The exposure reduction strategies should particularly be completed in locations where patients spend prolonged periods of time, like the bedroom, and may also include allergen immunotherapy (AIT).

Collaborative Approach to Allergy Management

The most effective allergy treatment plans are often the result of a partnership between the patient and provider. Allergy management requires more than symptom response because it involves both symptom prevention and anticipation. Patients will be able to reduce exposure, adjust routines, and treat symptoms early and effectively with accurate information.

While spring allergies may feel unavoidable, managing them effectively doesn't have to be a constant struggle. When antihistamines fail to provide adequate relief, it's important to investigate the underlying causes of a patient's symptoms. Specific IgE blood testing can help pinpoint the allergens responsible for triggering these reactions.

Identifying precise allergen sensitizations enables the development of a more targeted and effective treatment plan. This spring, there’s an opportunity to shift from symptom-based management to evidence-driven strategies supported by accurate diagnostics.

Pollen Seasons Are Longer and More Intense, Affecting Millions. Asthma and Allergy Foundation of America. March 18, 2025. 

https://aafa.org/pollen-seasons-are-longer-and-more-intense-affecting-millions/#:~:text=%E2%80%9CIncreased%20pollen%20exposure%20can%20make,Allergy%20Capitals%20ranking%20this%20year

The Most Challenging Places to Live with Allergies. 2023 Allergy Capitals. 

https://aafa.org/wp-content/uploads/2023/03/aafa-2023-allergy-capitals-report.pdf

ImmunoCAPTM Specific IgE Tests. ThermoFisher Scientific. 

https://www.thermofisher.com/phadia/us/en/our-solutions/immunocap-allergy-solutions/specific-ige-single-allergens.html

Articles

The current allergy season is more intense and prolonged due to environmental factors like warmer temperatures and increased carbon dioxide levels, leading to higher pollen production. Antihistamines, while effective for mild symptoms, may not suffice for severe cases, necessitating additional strategies. Identifying specific allergens through IgE testing is crucial for effective management, allowing for targeted treatment plans. Understanding the root causes of allergies, such as perennial allergens, can improve symptom control. A collaborative approach between patients and providers enhances allergy management by combining prevention and pharmacotherapy.