UNC Health Care

Fall Allergies 101: Symptoms, Causes and Treatments

Ah, yes, fall: Colored leaves fall majestically to the ground, the heat has broken, and you just want to spend time outside. There’s no reason to worry about seasonal allergies because they only happen in the spring, right?

What are fall allergy symptoms?

Hint: They’re exactly the same as spring allergy symptoms.


Fall allergies can be just as bad as spring allergies, says Brett Dorfman, MD, an ear, nose and throat specialist (or an otolaryngologist) at REX Ear, Nose and Throat Specialists of Wakefield, in Raleigh.

“Fall allergy season is usually the second most severe allergy season to spring,” Dr. Dorfman says. “And because it lasts until a frost hits, it can be the longest.”

So, if you’re feeling under the weather this fall and aren’t sure why, it could be allergies.


What are fall allergy symptoms?

Hint: They’re exactly the same as spring allergy symptoms.

Fall allergy symptoms include:
  • Nasal congestion
  • Runny nose
  • Postnasal drip
  • Sneezing
  • Itchy nose, throat and ears
  • Itchy, watery eyes
  • Inflamed airways

If you’re experiencing these symptoms, Dr. Dorfman recommends getting them treated before they progress into sinus or ear infections.

What causes allergies in the fall?

In a word: ragweed.

Just like in the spring, the air in the fall is full of pollen. However, while many trees and flowers like to pollinate in the spring, ragweed—the most prevalent cause of fall pollen allergies—and other weeds typically pollinate in the fall.

Fall allergies, due to weed pollen, are the result of a misinterpretation by your body’s immune system. The pollen that enters your body (through breathing) is mistaken for something bad, such as a virus or bacteria. Thus, your body’s immune system launches an attack in the form of sneezing, a runny nose, watery eyes and tightened air passages—all common ways your body attempts to rid you of the allergens.

Why is ragweed the most common cause of fall pollen allergies?

In the spring, the most prevalent cause of pollen allergies is oak pollen. Oak pollen is very small, which allows it to stay airborne longer. Its size also helps it navigate its way into your respiratory system.

Ragweed is the most prevalent cause of fall allergies for the same reason: It’s small. It stays in the air for a longer time, travels farther and more easily navigates its way past your nose hairs and into your respiratory system.

When is fall allergy season?

Fall allergies typically start in the middle of August (or when the nights start to become cooler) and last for about three months (or until the first frost hits). If you suffer from weed pollen allergies, your symptoms—if left untreated—will last throughout this period.

What are the best treatments for fall allergies?

Fall allergy treatments are the same as remedies used to treat springtime allergies.

Try the following to ease symptoms:
  • Antihistamines
  • Steroid nose sprays
  • Eyes drops
  • Eye wash kits
  • Sinus rinses (neti pots)

These treatments are available over the counter. If your symptoms persist while using these medications, see a doctor.

Are fall allergies more prevalent in the Raleigh-Durham area than in other places?

Seasonal allergies are more prevalent in the South, but they’re especially widespread in North Carolina because we have longer spring and fall growing seasons for plants.

Intense heat and intense cold can end growing seasons. Because Raleigh-Durham isn’t close enough to the equator to have long-lasting tropical heat or far enough north to have long-lasting frozen spells, plants tend to pollinate for longer periods.

We also enjoy a high volume of trees and many preserved green spaces in the Raleigh-Durham area. It’s far from a concrete jungle, so we have a lot of pollen for a metropolitan area.

Need a doctor? Find an ear, nose and throat specialist near you.