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Tree Pollen Allergy

If you sniffle and sneeze every spring (or as early as late winter in some states), it could be due to a tree pollen allergy. Tree pollen is the first pollen to appear each year in the United States.

Pollen Seasons in the U.S.

February – May: Trees (some start as early as January)

April – June: Grasses

August − November: Weeds

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What Is a Tree Pollen Allergy?
Tree pollen is the cause of most spring pollen allergy symptoms. Tree pollen allergy causes seasonal allergic rhinitis. (Some people call this “hay fever.”) Pollen from weeds and grasses also trigger allergic rhinitis.

Tree pollen season also often overlaps with grass pollen in the late spring and summer. Throughout the U.S., trees produce the most pollen from March through May. But in some regions, such as the South, trees may produce pollen as early as January and peak at multiple times during the year.1

Some trees produce pollen you can see (such as pine trees that release a fine, yellow dust that covers outdoor surfaces). Some trees produce pollen that is very small and can’t be seen.

Tree pollen tends to be light and carried by the wind. Because of this, it can easily find its way into your eyes, nose, and lungs. When that happens, tree pollen triggers the symptoms of allergic rhinitis.

How Do You Know If You Have Tree Pollen Allergy?
Allergic rhinitis is very common. Up to 30% of the people in the U.S. have allergic rhinitis. Talk with your health care provider about your symptoms. If they suspect allergic rhinitis, they will likely recommend allergy therapies. If your symptoms do not improve, seek a referral to a board-certified allergist.

A board-certified allergist can diagnose a tree pollen allergy. They will ask about your personal and medical history, do a physical exam, and run tests to find out types of trees you are allergic to. Board-certified allergists know how to interpret the test results to give you an accurate diagnosis.

What Are the Symptoms of a Tree Pollen Allergy (Seasonal Allergic Rhinitis)?
If you have a tree pollen allergy, you will only have symptoms when the pollen that you are allergic to is in the air. Symptoms of allergic rhinitis include:

  • Runny nose (also known as rhinorrhea – this is typically a clear, thin nasal discharge)
  • Stuffy nose (due to blockage or nasal congestion – one of the most common and troublesome symptoms)
  • Postnasal drip (mucus runs from the back of your nose down your throat)
  • Sneezing (can be repetitive and severe in some cases)
  • Itchy nose, eyes, ears, and mouth
  • Red and watery eyes
  • Swelling around the eyes
  • Moody and irritable
  • Tired
  • Disturbed sleep

If you have asthma and are allergic to tree pollen, you may have allergic asthma. This means tree pollen triggers your asthma symptoms:

  • Cough
  • Wheeze
  • Shortness of breath
  • Chest tightness or pain

A tree pollen allergy can also cause you to have itching or swelling in or around your mouth when you eat certain foods. This is called oral allergy syndrome (OAS) or pollen food allergy syndrome (PFAS). (It can happen to people allergic to some grasses or weeds as well.)

What Is Oral Allergy Syndrome or Pollen Food Allergy Syndrome?
If you are allergic to certain trees, such as birch or alder tree pollen, you may react to certain foods.

OAS/PFAS happens because some tree pollen is similar to the protein in some fruits, vegetables, and nuts.2 Your immune system gets confused and can’t tell the difference between the two. Eating these foods may cause your mouth, lips, tongue, and throat to itch or swell.

Birch tree pollen can cross-react with:

  • Almond
  • Anise or aniseed
  • Apple
  • Apricot
  • Caraway
  • Carrot
  • Celery
  • Cherry
  • Coriander
  • Fennel
  • Hazelnut
  • Kiwi
  • Parsley
  • Peach
  • Peanut
  • Pear
  • Plum
  • Soybean

Alder tree pollen can cross-react with:

  • Almond
  • Apple
  • Celery
  • Cherry
  • Hazelnut
  • Peach
  • Pear
  • Parsley

Talk with an allergist if you think you have OAS/PFAS. Ask them:

  • If you need allergy testing or any other tests to help diagnose it
  • If you should avoid eating foods that cause symptoms
  • To give you a written treatment plan and to guide you on what medicines to use
  • When to follow up
What Types of Trees Cause the Most Allergy Symptoms?

Some of the trees that cause the most allergy symptoms throughout the United States are:3

  • Alder
    • Found in every state except Nebraska and South Dakota
    • A common cause of OAS
  • Ash
    • Mostly found in Eastern and Southeastern states, but can be found in most states except Alaska and Hawaii
    • Very allergenic
  • Aspen
    • Found in every state except Hawaii
    • Related to cottonwood and poplar
  • Beech
    • Found in the Northeast, Eastern Midwest, and the South
  • Birch
    • Found in every state except Hawaii
    • A common cause of OAS
  • Box elder
    • Found in every state except Alaska and Hawaii
    • A type of maple that is very allergenic
  • Cedar
    • Found in coastal states in both the Eastern and Western United States and Oklahoma
    • Related to juniper
  • Cottonwood
    • Found in every state except Hawaii
    • Related to aspen and poplar
  • Elm
    • Found in every state except Alaska, Colorado, Hawaii, Montana, and Wyoming
  • Hickory
    • Found in the Midwest, Northeast, and Southeast
    • Very allergenic
  • Juniper
    • Found in every state except Alaska and Hawaii
    • Related to cedar
  • Maple
    • Found in every state except Alaska and Hawaii
  • Mulberry
    • Found in every state except Alaska and Nevada
    • Very allergenic
  • Oak
    • Found in every state except Alaska and Hawaii
    • Very allergenic
  • Olive
    • Found in every state except Alaska and Hawaii
  • Pecan
    • Found in the Midwest, Northeast, and Southeast, as well as California and Arizona
    • Very allergenic
  • Poplar
    • Found in every state except Hawaii
    • Related to aspen and cottonwood
  • Walnut
    • Found in every state except Alaska, Arizona, Colorado, Hawaii, Idaho, Washington, Nevada, Oregon, and Utah
    • Very allergenic
  • Willow
    • Found in every state except Alaska and Hawaii
    • Very allergenic
Are Tree Pollen Counts Getting Worse?

Most trees bear “male” and “female” flowers on the same plant. However, there are some “female” trees that produce fruit and seeds, and do not release pollen into the air. These trees rely on insects and small animals to transfer pollen for pollination. There are also “male” trees that do not produce fruit and seeds, but release pollen instead. These trees rely on the wind to carry pollen to other trees for pollination.

Historically, city planners have designed streets and parks to have wind-pollinating (or “male”) trees instead of fruiting (or insect-pollinating) trees. The reason why is the fruiting trees can produce seeds, fruits, or pods that may be a challenge to clean up. The downside of more wind-pollinating plants is increased pollen production. Planting only “male” trees is sometimes referred to as “botanical sexism.” This practice leads to more pollen in American cities.

Experts believe this is part of the reason why pollen counts have been increasing.4

Climate change is leading to longer growing seasons. This is a major source of increased pollen. The trees are releasing pollen for longer periods during the year and the pollen amounts released appear to be higher and stronger. Climate change is also causing increased carbon dioxide gas in the air, which stimulates trees to make more pollen.

What Is the Treatment for Tree Pollen Allergy?

There is no cure for a tree pollen allergy, but you can manage it. There are many allergy treatment options to help you.

It’s helpful to know what types of trees you are allergic to. You can reduce your exposure to the trees you are allergic to by watching pollen reports for your area. You can also learn what time of year tree pollen starts to appear in your area so you can start allergy treatment before it begins for better relief during the season.

  1. Track the pollen count for your area. The news media often reports the count for your area, especially when pollen is high. You also can get your area’s pollen counts from the National Allergy Bureau.
  2. Stay indoors in central air conditioning when the pollen count is high, if possible. Get a CERTIFIED asthma & allergy friendly® air filter for your air conditioner.
  3. Prevent pollen from being tracked into your home. If you spend a lot of time outside during peak pollen time:
  • Take your shoes off outside
  • Don’t wear your “outside” clothes to bed
  • Cover your hair when outside or wash it at night
  • Wipe off pets before they enter your home
  • Showering after coming inside the home after being outdoors for a significant period of time.
  1. Take allergy medicines and start treatment before tree pollen season starts in your area. Find out what time of year tree pollen starts to appear in your area so you can start allergy treatment at least two weeks before pollen season begins. Many over-the-counter medicines work well to control pollen allergy symptoms. They can also help eye, nose, and airway symptoms.

Allergy Medicine Guide for Pollen Allergy

Nasal rinse: Using a saline (saltwater) nose rinse can help cut down mucus and rinse pollen out of your nose. Remember to use these as directed.

Nose sprays: Corticosteroid nose sprays are effective and have few side effects. They treat the swelling and inflammation in your nose. (Examples include Nasacort®, FLONASE®, and RHINOCORT®.) Antihistamine nasal sprays such as Astelin and Patanase are also effective options.

Eye drops: Allergy eye drops can be very helpful in managing eye allergy symptoms. They can relieve burning sensation, itchiness, redness, increased tearing, and swelling. Common eye drops include SYSTANE® ZADITOR®, Optivar, and Pataday®. In addition, artificial tears can be helpful.

Antihistamines: Antihistamines come in pill, liquid, or nasal spray form. They can relieve sneezing and itching in the nose and eyes. They also reduce a runny nose and, to a lesser extent, nasal stuffiness. Look for a long-acting, non-drowsy antihistamine. (Examples include ZYRTEC®, Claritin®, Allegra®, CLARINEX®.)

Decongestants: Decongestants are available as pills, liquids, nasal sprays, or drops. They help shrink the lining of the nasal passages and relieve stuffiness. They generally are only used for a short time (usually three days or less – examples include SUDAFED®, Vicks Sinex™, Afrin®). Check with your doctor before using decongestants if you have high blood pressure, glaucoma, thyroid disease, or trouble urinating.

Leukotriene modifiers (such as montelukast): This medicine can help by blocking chemicals your body releases when you have an allergic reaction. (Examples include SINGULAIR®, Zyflo CR®, ACCOLATE®.)

Cromolyn sodium: This is a nasal spray that blocks the release of chemicals that cause allergy symptoms, including histamine and leukotrienes. This medicine has few side effects, but you must take it four times a day. (Examples include NasalCrom®)

  1. Talk with an allergist about immunotherapy. There are two types: allergy shots and sublingual immunotherapy (SLIT). This type of treatment may help give you long-term relief. If you have allergic asthma, your asthma action plan may include some of these allergy treatments to help you keep your asthma under control.
Should I Move to Get Relief From My Tree Pollen Allergy?

Trees that produce allergenic pollen live in every state. If you move, you may get some relief for a short time. But you can develop allergies to the trees in your new location in a few years. Instead, work with an allergist on a solid treatment plan.

Medical Review: June 2022 by John James, MD

References

1. Lo, F., Bitz, C.M., Battisti, D.S. et al. Pollen calendars and maps of allergenic pollen in North America. Aerobiologia 35, 613–633 (2019). https://doi.org/10.1007/s10453-019-09601-2

2. Oral allergy syndrome (OAS) | AAAAI. (n.d.). Retrieved February 12, 2022, from https://www.aaaai.org/tools-for-the-public/conditions-library/allergies/oral-allergy-syndrome-(oas)

3. Tree and Plant Allergy Info for Research – Allergen and Botanic Reference Library. (n.d.). www.pollenlibrary.com. Retrieved April 19, 2022, from https://www.pollenlibrary.com/

4. Ogren, T. L. (2015, April 29). Botanical Sexism Cultivates Home-Grown Allergies. Scientific American Blog Network. https://blogs.scientificamerican.com/guest-blog/botanical-sexism-cultivates-home-grown-allergies/

Allergy Capitals

Your location can have an impact on your seasonal allergies. AAFA’s Allergy Capitals™ report looks at the top 100 most challenging cities in the continental United States to live with seasonal pollen allergies.

Read the Report>