You made it through the blooming spring and the lush summer. You may have sneezed and rubbed your itchy eyes, but allergies are par for the course during the warm weather months. And now it’s fall—and you’re still sneezing. What gives?

Ragweed, that’s what. Local experts point to ragweed and mold as the two most common fall allergy triggers.

“When adults or children who are allergic are exposed to mold, ragweed or other weeds, they may experience a variety of symptoms,” says Dr. Lisa Suffian, an allergist with Allergy Consultants. “Their symptoms may include nasal itching, eye itching and redness, nasal drainage and congestion, post-nasal drainage into the back of the throat, and sneezing. If the allergic individual also has asthma, exposure to these allergens may cause the person to cough, feel short of breath, experience chest tightness and wheeze.”

As the weather cools, people spend more time indoors, also increasing exposure to indoor allergens such as dust, pet dander, and indoor molds or fungi, notes Dr. Hamsa Subramanian, an allergist on staff at Missouri Baptist Medical Center. “We also see some eczema flareups during the change of seasons. That’s true for spring and fall, also. Then in winter, the air gets drier, and eczema can become worse,” she adds.

Whether the cause is seasonal pollens and molds, or perennial indoor allergens, the same cadre of treatments aims to reduce symptoms. “In allergic rhinitis, once the environmental allergies are identified, then environmental control, in addition to medication therapy, can help alleviate the allergy symptoms,” says Dr. Elyra Figueroa, an allergist with SSM Medical Group Sunset Hills and on staff at SSM St. Mary’s Health Center. “In most patients, these two measures are effective in controlling and treating seasonal symptoms.”

Over-the-counter allergy medications can control runny nose, sneezing and itching, but they are not effective for treating nasal congestion, Figueroa says. She instead recommends a combination of a prescription steroid nasal spray and decongestant to relieve more severe congestion.

“Decongestants, such as Sudafed, Drixoral or Actifed, are available over the counter and they are often combined with an antihistamine, such as in Zyrtec-D, Allegra-D or Claritin-D. Unfortunately, use of pseudoephedrine has been limited due to its side effects of increasing blood pressure, particularly in hypertensive patients,” Figueroa says. This ingredient also is restricted due to its role in the manufacture of illegal drugs. “This seems to be counter-intuitively affecting the patients who are in need instead of hindering those misusing the medication. As a direct result, drug companies have substituted phenylephrine in the decongestant combinations, but it’s not very effective in treating allergies.”

Over-the-counter nasal sprays are only useful for very short-term relief, due to the risk of the medicine itself causing permanent congestion if used for more than three days, but saline nasal washes and neti pots may help clear congestion and bring relief.

Ultimately, though, immunotherapy is the only cure for these types of allergies and may provide a solution for patients who are unable to control their symptoms adequately with medications.

“Immunotherapy is a very natural approach and involves repeated injections of the allergens that an individual is allergic to, as well as sterile water,” Suffian explains. “An allergist can perform skin testing, which is a very non-invasive procedure to determine exactly what allergens the patient is allergic to. Once this is known, immunotherapy is formulated, and the patient begins the course of immunotherapy. Over time, immunotherapy changes the way the patient's immune system responds to the allergens, so they are no longer allergic to them. Immunotherapy is typically 80 percent effective.”

More information and resources about allergy triggers and control are available from the Asthma and Allergy Foundation of America, St. Louis Chapter, at aafastl.org.