Your Headache Could Be Seasonal Allergies

It can feel like you’ve won the lottery when you skate through allergy season without the constant stuffiness and itchy eyes that everyone else seems to struggle with. But allergists say it’s possible to deal with the consequences of seasonal allergies without even realizing it. Some people with seasonal allergies only have one vague symptom — a headache.

Those headaches that keep flaring up during the spring could actually be due to allergies, even if you have no other symptoms. “It’s more common than people think,” said Dr. Alan D. Workman, a sinus surgeon at Massachusetts Eye and Ear and assistant professor of rhinology and skull base surgery at Harvard Medical School. “Many patients with ‘sinus headaches’ don’t have active sinus infections but rather allergy-related inflammation.”

While treating these allergy headaches with the usual remedies may give you some relief, allergists say it’s not the best solution for your head pain. Here’s how to tell if your headaches are actually due to seasonal allergies, plus what to do next.

Classic seasonal allergy symptoms include a runny nose, sneezing, watery eyes, a stuffy nose, headaches, fatigue and coughing, according to the National Library of Medicine. But it’s also possible to just have a headache. Allergens like pollen, mold and pet dander can cause your immune system to react with a sinus headache, even if you have no other allergy symptoms, according to the American College of Allergy, Asthma, & Immunology.

“Allergies cause sinus and nasal inflammation, which can cause headaches if severe,” said Dr. Purvi Parikh, an allergist with Allergy & Asthma Network in New York.

That inflammation can lead to a range of issues, including a thickening of the mucous membrane lining the sinuses, nerve irritation or pressure changes in the sinus cavities, especially in the forehead and cheeks, Workman said. That can lead to a headache.

The best way to tell seasonal allergy headaches from other headaches is to look for a pattern, said Dr. Catherine Monteleone, an allergist-immunologist at Rutgers Robert Wood Johnson Medical School. If you experience headaches in the spring and fall — times when most people have seasonal allergies — but not during other times of year, she said, allergies could be to blame.

The location of your headaches matters, too, Workman said. Allergy headaches are usually felt in your face, around your cheeks, eyes or forehead, he explained. “They are typically more of a pressure sensation than frank pain,” he said. But migraine or tension headaches usually come with other symptoms, like nausea, light sensitivity or more general pain, Workman said.

One more thing to keep in mind, per Workman: Allergy headaches may come on or get worse when you’re exposed to allergens such as pollen, mold or dust.

Treating these headaches with the usual over-the-counter medication can help you to feel better in the moment, Monteleone said. “Nonsteroidal anti-inflammatory drugs like ibuprofen can be helpful,” she said. “It usually takes the inflammation and pain down.”

But the problem with this approach is it doesn’t target the cause of your headaches, and the pain may flare up again once the medication wears off. That’s why Workman suggests using oral antihistamines like cetirizine (Zyrtec) or diphenhydramine (Benadryl). Nasal steroid sprays can also be helpful, he said.

“For some, a daily nasal spray during peak seasons can make a big difference,” Workman said. Allergen immunotherapy, which is usually given in the form of allergy shots, may also help lower the risk of symptoms long-term, he said.

Monteleone also suggests using warm compresses on your face, drinking plenty of fluids and using a nasal rinse like a neti pot to clear out your sinuses. “If you can, don’t go out on high-pollen days,” she said.

The cause of any kind of headaches can be tricky to pin down, given how many different things can trigger head pain. That’s why Workman recommends tracking when your headaches happen and if they follow any pattern.

If you suspect that allergies are behind your headaches, he suggests trying over-the-counter antihistamines or a nasal steroid spray to see if you get any relief. If that doesn’t help or you feel like it’s not helping enough, Monteleone said, it’s time to see a doctor.

“It’s worth seeing an ear, nose and throat physician or allergist who can help determine whether allergies, sinus issues or another type of headache is the main driver, and get you on the right treatment plan,” Workman said. If allergies are behind your headaches, Monteleone recommends focusing on lifestyle remedies, like keeping your windows shut and doing regular nasal irrigation. “All of that is useful,” she said. “It’s not just about taking medicine.”