How Should You Prepare Before Allergy Season Starts?
Start intranasal corticosteroid sprays 1-2 weeks before your anticipated symptom onset, begin daily antihistamines, schedule an allergist appointment if symptoms were poorly controlled last year, and prepare your home environment by deep-cleaning, replacing HVAC filters, and ensuring HEPA purifiers are functional.
Pre-seasonal treatment is significantly more effective than reactive treatment. A study in Annals of Allergy, Asthma & Immunology demonstrated that starting intranasal corticosteroids before pollen exposure reduced total nasal symptom scores by 30% compared to starting at symptom onset. The most commonly used nasal sprays — fluticasone propionate (Flonase) and mometasone furoate (Nasonex) — are available over-the-counter and have excellent long-term safety profiles when used as directed.
Knowing your specific allergens through allergy testing helps optimize preparation timing. Tree pollen typically peaks February-May, grass pollen May-July, and ragweed August-November, though exact timing varies by region. Local pollen count forecasts available through weather services and allergy apps help identify when pre-treatment should begin. People with multiple seasonal allergies may benefit from year-round treatment.
Pre-seasonal nasal corticosteroid treatment reduced symptoms by 30% vs reactive treatment
What Treatments Are Most Effective for Seasonal Allergies?
Intranasal corticosteroids are the most effective single treatment. Combining with oral antihistamines and intranasal antihistamines (azelastine) provides additive benefit. For severe cases, allergen immunotherapy modifies the underlying immune response. Leukotriene inhibitors (montelukast) and nasal anticholinergics (ipratropium) are second-line options.
The ARIA (Allergic Rhinitis and its Impact on Asthma) guidelines recommend a stepwise approach: Step 1 — oral antihistamine or intranasal corticosteroid; Step 2 — combination of both; Step 3 — add intranasal antihistamine (azelastine); Step 4 — consider allergen immunotherapy. For eye symptoms, topical antihistamine eye drops (olopatadine/Pataday, ketotifen/Zaditor) provide rapid relief and can be used alongside nasal treatments.
Allergen immunotherapy fundamentally changes the immune response by inducing tolerance. Subcutaneous immunotherapy (SCIT, allergy shots) involves weekly injections during a build-up phase (3-6 months) followed by monthly maintenance for 3-5 years. Sublingual immunotherapy (SLIT) tablets for grass, ragweed, and dust mite allergies offer a home-based alternative. Both provide lasting benefit that persists years after discontinuation — the only allergy treatment with this disease-modifying property.
ARIA guidelines recommend stepwise treatment approach for allergic rhinitis
