Do you sneeze every spring, break out in hives after dinner, or wake up with a stuffy nose? You’re not alone. 31.7% of adults and 29.5% of children in the United States have been diagnosed with seasonal allergies, food allergies, or eczema. That’s more than 82 million Americans.
We see these patients every day. Learn what triggers your immune system. Explore the most common allergens and the allergy treatment options available to you.
The Most Common Allergy Triggers
1. Pollen Is the Leading Seasonal Trigger
Pollen from trees, grasses, and weeds is the main cause of seasonal allergies. Doctors also call it “hay fever” or “allergic rhinitis.” Different plants release pollen at different times of the year, so allergy symptoms vary seasonally:
- Trees (oak, birch, cedar)—peak in spring, from March to May
- Grasses (Bermuda grass, bluegrass, timothy) – from late spring to summer
- Ragweed and other weeds – from late summer to fall, from August to November
Pollen concentrations peak on warm, dry, windy days and are lowest immediately after rain. Are your symptoms worse outdoors during a certain season? Pollen is a likely cause.
2. Dust Mites Are the #1 Year-Round Indoor Trigger
These microscopic organisms live in bedding, mattresses, pillows, carpets, and upholstered furniture. It’s not the mites themselves that trigger the immune response, but the particles in their waste. Year-round nasal congestion that improves during travel and worsens upon returning home is a characteristic sign of dust mite allergy.
3. Pet Dander
Many people believe that pet dander causes allergies. This is a misconception. In fact, the culprit is a protein found in the animal’s skin flakes, saliva, and urine. Most often, these are cats and dogs, but rabbits, birds, rodents, and even horses can also trigger allergy symptoms. Dander is light and sticks to clothing and furniture, remaining in the house long after the animal has left.
4. Mold Spores
Mold grows wherever there is moisture—in bathrooms, basements, rotting leaves, and in compost heaps. It is abundant and releases microscopic spores that become airborne and are easily inhaled. Indoor mold species, such as Aspergillus and Penicillium, cause symptoms year-round. Outdoor molds, such as Alternaria, become active in late summer and fall.
5. Food Allergens
Food allergies affect nearly 22 million Americans. Most reactions are caused by nine foods: milk, eggs, peanuts, tree nuts, sesame, wheat, soy, fish, and seafood. A person may experience a tingling sensation in the mouth or hives. Some symptoms include severe vomiting, difficulty breathing, and life-threatening anaphylaxis. Food allergies differ from food intolerances (such as lactose intolerance), which do not involve the immune system and are not life-threatening.
6. Insect Stings
Bee, wasp, and hornet stings can cause severe allergic reactions in hypersensitive individuals. For most people, the sting causes localized pain and swelling. However, in people with a venom allergy, the reaction can progress to anaphylaxis within minutes. Insect venom is the leading cause of severe allergic reactions in adults, accounting for 50% of anaphylaxis cases reported.
7. Medications
Penicillin and other antibiotics, as well as over-the-counter NSAIDs such as ibuprofen and aspirin, are considered by experts to be among the most common drug allergens. Always inform your doctor of any previous drug reactions before starting a new medication.
8. Contact Allergens
Latex rubber in gloves, balloons, and some medical devices; poison ivy; and some cosmetic ingredients cause contact dermatitis, a type of skin allergy. Nickel in jewelry and fragrances in personal care products are also very common causes of contact dermatitis. Approximately 20% of the population experiences a skin allergy at least once in their lifetime. Symptoms include redness, itching, blistering, or a rash.
What Are the Root Causes of Allergies?
Why do some people develop allergies and others don’t? Consider the combination of genetic, environmental, and biological factors. Allergies don’t have a single cause; they are the result of multiple factors acting together over time.
Genetics and early childhood exposure are important. People raised in overly sterile environments, with limited early exposure to bacteria, parasites, and various microbes, are more likely to develop allergic diseases. An immune system unprepared for early exposures may overreact to harmless substances later in life. Children raised on farms, who attended daycare early in life, or who had pets as infants have significantly lower rates of allergies and asthma.
Environmental factors exacerbate genetic risk. Air pollution, cigarette smoke, and chemical irritants can increase respiratory sensitivities and prime the immune system for allergic reactions. Climate change is also a growing contributor. Rising temperatures extend pollen seasons, increase pollen concentrations in the air, and promote mold growth, exposing people to higher allergen loads for longer periods each year.
The microbiome—the community of trillions of bacteria living in and on the human body—is emerging as another key factor. Disruptions to the gut flora in infancy, often caused by antibiotic use, cesarean section, or formula feeding, are associated with higher rates of food allergies and eczema. A diverse, balanced microbiome maintains immune tolerance.
Age and hormonal changes can alter immune function in ways that can trigger or resolve allergies. Allergies that manifest in adulthood are more common than many people think. Moving to a new city, getting a new pet, changing jobs, or even pregnancy can reveal a hidden allergic predisposition that was previously unnoticed.
Why Allergy Symptoms Are Getting Worse
Are your allergies worse than they were ten years ago? There’s a scientific explanation. Pollen seasons in North America are starting 20 days earlier, lasting 10 days longer, and containing 21% more pollen than in 1990. Human-induced climate change is cited as the primary cause.
Rising temperatures are causing plants to bloom earlier and for longer periods. Increased CO₂ concentrations in the atmosphere force plants to invest more energy in pollen production. For allergy sufferers across the US, this directly translates into longer seasons and more days with severe symptoms. Now more than ever, it’s important to get tested as soon as possible.
How to Recognize Allergy Symptoms
Allergy symptoms vary depending on the trigger and the route of exposure. The most common presentations:
- Nasal and sinus symptoms include sneezing, runny nose, congestion, and postnasal drip
- Eye symptoms include itchy, red, watery eyes (allergic conjunctivitis).
- Skin symptoms include hives, eczema flare-ups, and contact dermatitis
- Respiratory symptoms include coughing, wheezing, and shortness of breath
- GI symptoms (food allergy) include nausea, vomiting, and stomach cramps
| EMERGENCY — Signs of Anaphylaxis Throat or tongue swelling • Difficulty breathing • Sudden drop in blood pressure • Rapid heartbeat • Loss of consciousness. If these occur, call 911 immediately and use an epinephrine auto-injector if available. |
Allergy Treatment Options
Effective allergy treatment starts with accurate diagnosis. Our team uses comprehensive allergy testing to identify your specific triggers before recommending a personalized treatment plan. Options include short-term symptom control and disease-modifying therapies that address the root cause.
Avoidance and Environmental Control
How can you reduce exposure to known allergens? Use HEPA air filters, dust mite mattress covers, monitor pollen levels daily before going outside; maintain indoor humidity below 50%; and bathe pets regularly.
Medications
To relieve mild to moderate allergy symptoms, use over-the-counter antihistamines and nasal corticosteroid sprays. For more persistent cases, prescription medications are available. These include stronger nasal steroids, leukotriene modifiers, and eye drops. In 2024, the FDA approved epinephrine nasal spray (Neffi) as a new emergency treatment for anaphylaxis.
Allergen Immunotherapy
Only immunotherapy can change your immune system’s response to an allergen. It truly modifies the course of the disease. Three administration methods are available:
- Subcutaneous immunotherapy involves regular injections over 3-5 years. They gradually desensitize the immune system to specific allergens.
- Sublingual immunotherapy involves daily drops placed under the tongue. No clinic visit is required after the solution is prepared. It is popular in Europe and is increasingly used in the United States.
- Intralymphatic immunotherapy is a more modern approach. It involves just three injections directly into the lymph node over two months. This reduces the traditional 3-5-year course to just a few weeks. Available in some specialized centers from 2024.
Biologics
For patients with severe or food-related allergies, the biologic drug omalizumab (Xolair), approved by the FDA in February 2024 for the treatment of food allergies, is highly relevant. They target specific inflammatory processes rather than suppressing the immune response as a whole. Doctors typically prescribe them for complex or treatment-resistant cases.
Allergy Treatment Comparison
Table 2: Side-by-side comparison of common allergy treatment options to help you discuss choices with your provider.
| Treatment | Best For | Duration | Rx Needed? | Disease-Modifying? |
| Antihistamines (OTC) | Mild seasonal symptoms | Daily / as needed | No | No |
| Nasal Corticosteroids | Nasal congestion | Daily | Some | No |
| SLIT (Sublingual drops) | Pollens, dust mites | 3–5 years | Yes | Yes |
| SCIT (Allergy shots) | Multiple allergens | 3–5 years | Yes | Yes |
| ILIT (Intralymphatic shots) | Pollens | 2 months / 3 doses | Yes | Yes |
| Biologics (e.g., Xolair) | Severe/food allergy | Ongoing | Yes | Partial |
Frequently Asked Questions
Can allergies develop in adulthood even if you didn’t have any as a child?
Yes. Allergies that develop in adulthood are more common than many people think. Exposure to new environmental conditions, pets, or foods, combined with changes in the immune system over time, can trigger allergic sensitization at any age.
What is the difference between seasonal and year-round allergies?
Seasonal allergies are caused by external allergens. Allergen concentrations peak at certain times of the year, with pollen being the primary allergy sufferer. Year-round allergies are caused by year-round exposure to indoor dust mites, animal dander, mold, and cockroach allergens. Many patients experience both.
How does allergy treatment by an ENT doctor differ from treatment by a general practitioner?
ENT doctors specialize in the ears, nose, and throat. Inhalant allergies most directly affect these organs. At Brookhaven ENT, you can undergo an allergy evaluation in the doctor’s office, diagnose structural factors such as a deviated septum or nasal polyps, and receive a full range of immunotherapy options, including sublingual and subcutaneous immunotherapy.
Are allergies hereditary?
There is a strong genetic predisposition. If one parent has an allergy, the child has a 30-50% chance of developing one. If both parents have allergies, this risk increases by 60–80%. However, genes alone do not determine outcome; environmental exposure also plays a significant role.
Ready to Identify Your Allergy Triggers?
Allergy & Facial Surgery team provides comprehensive allergy testing and personalized treatment plans to help you return to the life you enjoy.
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