As everyone who lives in St. Louis already knows —spring and fall aren’t just beautiful, they’re
brutal for allergies. Every season contributes to airborne particles that trigger allergies. That is
why our region consistently ranks moderate to severe in terms of allergy burden.
For many, symptoms are mild and manageable. For others the symptoms can be significant.
Studies show up to 30% of Americans can suffer from allergies and cost the economy up to $5
billion annually. It is the most common medical reason employees miss work and is the largest
productivity loss to employers. In children it is associated with missed school, irritability,
inattention, and loss of sleep.
The good news is that most seasonal allergies are very treatable with the right approach.
What Are Seasonal Allergies?
Seasonal allergies (also called allergic rhinitis or “hay fever”) are an immune response to
airborne allergens like pollen. When your body encounters these particles, it releases histamine
and other inflammatory chemicals, leading to symptoms including:
- Sneezing
- Runny, Sniffing, or congested nose
- Itchy, watery, or red eyes
- Sinus drainage or postnasal drip
- Fatigue, “brain fog”
Why St. Louis Is a Hotspot
St. Louis sits in a geographic “perfect storm” for allergens—river valleys, dense vegetation, and
variable weather patterns all contribute to high pollen counts. Warm winters and early springs
have also extended allergy seasons in recent years, meaning symptoms often start earlier and
last longer. For many patients, this means what used to be a “few bad weeks” can now feel like
a months-long issue.
First-Line: What You Can Do at Home
Before reaching for medications, small environmental changes can make a meaningful
difference:
- Avoidance of known irritants when possible
- Windows closed during high pollen days
- Changing clothes, showering after known exposures
- Avoid excessive moisture or damp areas in your house
- Unfortunately data does not show that HEPA filters and Dust Mite coverings on pillows or
bed linens are effective.
Over-the-Counter Treatments That Actually Work
For many patients, over-the-counter (OTC) medications are highly effective—especially when
started early and used consistently.
- Antihistamines tablets: This is the classic first step in treating allergies. This includes
medications like cetirizine (Zyrtec), loratadine (Claritin), and fexofenadine (Allegra). This can
help treat symptoms such as sneezing, itching, runny nose, and watery eyes. They are well
tolerated and typically don’t cause drowsiness. - Intranasal steroid sprays: I actually prefer this for most people as an effective single therapy.
This includes fluticasone propionate (Flonase) and triamcinalone acetonide (Nasocort). These
help reduce inflammation to significantly reduce symptoms. However, they are best taking
daily and may take a few days for maximum effect. - Salt water sinus rinses: This is a very simple method to flush out pollen and reduce
inflammation. Examples include Ocean Nasal Spray, Neti Pot, salt water, and many more. - Antihistamine eye drops: This can help with watery and itchy eyes. Pataday or Alloway are
common examples. These medications can lead to immediate symptom relief. However,
these should not be used long term without physician oversight.
When Allergies Are More Than “Just Annoying”
There’s a point where seasonal allergies move beyond inconvenience and start affecting your
health. At this stage, a more tailored approach may include prescription therapies, combination
regimens, or even allergy testing and immunotherapy. Consider seeking medical care if: - Symptoms persist despite consistent OTC treatment
- You have significant sleep disruption or fatigue
- There is associated wheezing, chest tightness, or asthma symptoms
- You’re unsure whether symptoms are allergies vs. infection
Why Personalized Care Matters
One of the most common frustrations I hear from patients is, “I’ve tried everything, and nothing
works.” In reality, most people haven’t tried the right combination of therapies, used them consistently, or discussed their specific triggers and lifestyle. Allergy care is not one-size-fits-all. The correct diagnosis, consideration for additional testing, appropriate timing of treatment, and considering for proper medications (OTC and/or prescription) are essential in allergy care.
That’s where having direct access to your physician—and the time to address these details—
can make a meaningful difference.