Treatment Options

Overview of Treatment Options

Seasonal allergies are also known as pollen allergies because people are mostly affected by them. If you react to pollen, you may experience the symptoms attached to hay fever. When these are hard to manage, a doctor may advise treatment. Whether the doctor advises a certain type of treatment or not depends largely on the severity of symptoms and your health. While there are many over the counter treatments around, you should always talk to your doctor before you buy any. They will be able to warn you of any side effects and answer any questions you may have.

Most seasonal allergies are treated in similar ways because the symptoms are similar: sneezing, a runny or stuffy nose, and itchy, watery eyes. Allergies don’t cause fever (ACAAI). Many of the same medicines also help indoor allergies to dust or pets. Food allergies are different and are managed mainly by avoidance and emergency epinephrine.

The most common treatment options are:

Corticosteroid Nasal Sprays

Corticosteroid nasal sprays are among the most effective treatments for allergic rhinitis (hay fever). They help with congestion, sneezing, itching and runny nose (MedlinePlus).

Several corticosteroid nasal sprays are available without a prescription, including:

These are:

• Budesonide (Rhinocort Allergy)
• Fluticasone (Flonase) 
• Triamcinolone (Nasacort Allergy 24HR)

Starting a nasal steroid before pollen season can help minimize symptoms; once started, it may take days to a couple of weeks for the full effect (ACAAI). Oral steroids are sometimes prescribed for a short time for severe symptoms but aren’t used long-term because of side effects.

Antihistamines

When the body reacts to an allergen, it releases histamine and other chemicals that cause symptoms. Antihistamines block histamine’s effects, relieving sneezing, itching and runny nose, though they help less with congestion (ACAAI).

Antihistamines come as pills, capsules, liquids, nasal sprays and eye drops. Some require a prescription, but many are sold over the counter. Older antihistamines such as diphenhydramine and chlorpheniramine are more likely to cause drowsiness.

Prescribed meds:

• Azelastine – Eyedrops (Optivar)
• Azelastine nasal spray (Astelin; Astepro is now also sold over the counter)
• Carbinoxamine (Palgic)
• Cyproheptadine
• Desloratadine (Clarinex)
• Emedastine – Eyedrops (Emadine)
• Hydroxyzine (Atarax, Vistaril)
• Levocabastine – Eyedrops (Livostin)
• Levocetirizine (Xyzal; also sold over the counter)

Non-prescription meds:

• Brompheniramine (Dimetane)
• Cetirizine (Zyrtec)
• Chlorpheniramine (Chlor-Trimeton)
• Clemastine (Tavist)
• Diphenhydramine (Benadryl)
• Fexofenadine (Allegra)
• Loratadine (Alavert, Claritin)

Antihistamine eye drops are good for itchy, watery eyes. Some combination products pair an antihistamine with a decongestant to help with congestion.

Decongestants

Decongestants relieve a stuffy nose by shrinking swollen tissues and blood vessels in the nose. They don’t help sneezing or itching. They come as pills, liquids and nasal sprays. Don’t use decongestant nasal sprays for more than 3 days, because they can cause rebound congestion (MedlinePlus).

Non-prescribed meds:

• Afrin, Dristan, Vicks, Sinex (oxymetazoline)
• Sudafed PE and others (oral phenylephrine). In 2024 the FDA proposed removing oral phenylephrine as a decongestant because it doesn’t work; as of October 2026 that proposal is not yet final (FDA).
• Sudafed and others (pseudoephedrine), sold without a prescription but kept behind the pharmacy counter

Combination antihistamine-decongestant products (also sold behind the pharmacy counter when they contain pseudoephedrine):

• Allegra-D
• Benadryl Allergy Plus Sinus
• Claritin-D
• Zyrtec-D

Oral decongestants can cause restlessness, trouble sleeping and a faster heartbeat, and can raise blood pressure. Caffeine can add to these effects. Check with your doctor or pharmacist first if you have high blood pressure, heart disease, glaucoma or thyroid problems.

Immunotherapy and Allergy Shots

Allergy shots (immunotherapy) train your immune system to become less sensitive to specific allergens. You get gradually increasing doses, then maintenance doses, usually for 3 to 5 years. You’ll be watched for about 30 minutes after each shot in case of a reaction (Mayo Clinic).

Tablets are also a form of medicine available. The tablets work when they’re placed under the tongue. The kinds made to help with allergies include:

• Grastek
• Oralair
• Ragwitek
• Odactra (dust mites)

Tablets work like shots but are taken at home after the first dose, which is given at the doctor’s office so you can be monitored. Side effects can include itching or swelling in the mouth or throat and stomach upset (Mayo Clinic).

Treatment for Grass and Ragweed Allergies

The only FDA-approved sublingual immunotherapy tablets are for ragweed, northern pasture grasses like timothy, and dust mites. For grass and ragweed, you typically take the tablet before and during the allergy season, and treatment may continue for three years or longer. Allergy drops are not FDA-approved in the U.S. (ACAAI).

Ragweed season usually runs from August into November, peaking in mid-September (ACAAI), so plan ahead with your allergist. Not sure which pollen is the culprit? Our allergy testing guide explains how allergists find out.

Natural Remedies

Some people also try complementary approaches. The evidence is mixed: saline nasal rinses can help, and acupuncture may help some people, but evidence for most others is limited or inconsistent (NCCIH). Examples include:

• Yoga/meditation
• Acupuncture
• Cupping
• Apple cider vinegar
• Essential oils
• Detoxification
• Probiotics
• Herbal teas

Tell your doctor about any complementary approaches you use, and don’t use them in place of proven treatment. Some products, such as the herb butterbur, raise safety concerns (NCCIH). Learn more on our natural remedies page.

Conclusion

Most treatments are safe when used as directed, but some can cause side effects with long-term use. Reducing exposure helps: stay indoors on high-pollen days, keep windows closed and shower after being outdoors. If medicines don’t control your symptoms, ask about immunotherapy.

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Written by: Madiha Ather Hashmi (November 08, 2020)

This article is for general education and is not medical advice. Talk with your doctor or pharmacist about your symptoms and before starting, stopping, or combining any medicine.

Shopping for an air purifier? See our guide to the best air purifiers for allergies, with CADR sizing tips and well-tested HEPA picks.

What actually helps

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HEPA air purifier & filters

A portable HEPA purifier sized to the room can lower airborne particles such as pollen and dust; it only works if you replace filters on schedule. (EPA: Guide to Air Cleaners in the Home)

See the Levoit Core 300 on Amazon

Saline nasal rinse kit

Rinsing with saline can clear pollen from the nose; use distilled, sterile or boiled-then-cooled water, never plain tap water. (FDA: Is rinsing your sinuses with neti pots safe?)

See the NeilMed Sinus Rinse kit on Amazon

Dust-mite pillow & mattress covers

Allergists recommend zippered, allergen-proof encasings for pillows, mattresses and box springs, plus hot-water washing of bedding. (ACAAI: Dust Allergy)

See Hospitology zippered pillow encasements on Amazon

Allergy Treatment FAQs

What is the most effective treatment for hay fever?

Nasal steroid sprays are among the most effective for nasal symptoms (MedlinePlus).

Do antihistamines help a stuffy nose?

Not much. They work best for sneezing, itching and runny nose (ACAAI).

Does phenylephrine work?

The FDA has concluded that oral phenylephrine is not effective as a decongestant (FDA).

Can allergies be cured?

Not usually, but immunotherapy can give lasting relief for some people (Mayo Clinic).

Sources