Itchy eyes. Irritated skin. Congestion that won’t clear. Allergy season arrived late this year, but it’s causing stronger and more intense symptoms than usual.
“It’s been a tough one,” said Dr. Caroline Sokol, a practicing allergist at Massachusetts General Hospital. “The pollen counts have been quite high.”
She explained that even people who don’t typically suffer from bad seasonal allergies are struggling this year.
Spring came a little late, but a wetter buildup followed by sunny, windy days created what Sokol described as “great conditions” for trees to produce and spread pollen.
Right now, the main offenders are trees like birch and oak, which release pollen in waves. As May unfolds, grasses begin to take over. Then ragweed surges through early fall.
The confluence of trees and grasses makes May an especially brutal time for allergies.
“It’s right in the peak of some overlap of different types of pollen,” said Dr. John Accarino, a clinical allergist and immunologist at Mass. General. “We’ve got two main triggers, grasses and trees ... the earliest weeds can also start in May as well. So May is really the biggest overlap between seasonal [allergens].”
Doctors say that although the pattern isn’t new, it is getting more intense. Dr. Trisha Ray, clinical director of allergy at Beth Israel Deaconess Medical Center, said that in the last few years, pollen counts have been high and have lasted longer.
“The hypothesis is that this is probably a result of climate change and global warming,” Ray said.
Research published earlier this year suggests that higher temperatures and increased carbon dioxide levels can extend growing seasons and increase pollen production. The result is a longer, more intense allergy season that stretches from late winter into late fall.
Inside clinics, patients are arriving with familiar but more severe symptoms.
“A lot of people are really suffering from itchy, watery eyes,” Ray said. “That’s allergic conjunctivitis.”
“They do their best, but it’s been tough trying to get control of different allergic eye symptoms,” Accarino said.
For many, over-the-counter medications that once worked are no longer enough.
“People who used medications as needed are now taking them every day, and even then, they’re struggling,” Ray said.
Some are doubling doses. Others are staying indoors, with windows shut and air conditioning running to filter the air.
The impact goes beyond physical symptoms.
“This is a condition that really affects how people function,” Ray said, talking about the effects on sleep, work, and the ability to be outdoors. “It can be very debilitating.”
Sokol agreed. “Allergies really take the joy out of seasons,” she said. “You wait through a long winter to get outside, and then you can’t enjoy it.”
For those experiencing symptoms, treatment often starts simply. Steroid nasal sprays like Flonase or Nasacort Allergy 24HR, available over the counter, are among the most effective options for congestion. Antihistamines like Zyrtec, Allegra, and Claritin can help control itching and sneezing without causing drowsiness. Eye drops and saline rinses can provide additional relief.
“You really need to use these medications regularly to see a benefit,” Ray said, noting that nasal sprays can take days to reach full effect.
There are also nonmedication strategies. Showering after being outdoors, changing clothes, and keeping windows closed can reduce exposure. Even wiping down pets, who can carry pollen on their fur, can make a difference.
Still, for some patients, these steps aren’t enough. Sokol said that if all of these things fail or if symptoms are affecting quality of life, it is important to visit a doctor.
Allergists can perform skin or blood tests to determine exactly what a person is allergic to. From there, they can tailor treatment plans or consider longer-term solutions, such as allergy shots.
Allergy shots gradually desensitize the immune system to specific allergens. They can be highly effective but require a commitment, such as weekly visits at first, followed by monthly maintenance over several years.
To treat allergic conjunctivitis, Accarino said patients have shown interest in allergy shots.
“People who were on the fence are now saying, ‘I don’t want to go through another season like this,’” said Ray.
Part of the challenge is that not all symptoms are clearly allergies. Irritants like smoke or dust can mimic allergic reactions, and viral infections can also cause congestion and fatigue. Testing helps clarify the difference.
Unfortunately, the season is just beginning.
“Once we get a long stretch of warm days where it’s dry or windy, I think we might see even more symptoms,” Accarino said. “There are still ways to go.”
Aayushi Datta can be reached at aayushi.datta@globe.com.