A stuffy nose and itchy, watery eyes are spring-allergy cornerstones—but they’re not the only symptoms that herald a pollen influx for some people. You might not immediately suspect a pulsing headache is due to allergies, but experts say it’s a common occurrence.
In fact, the same immune response that fills your nose with snot or leaves you sneezing up a storm can make your head throb. That’s especially true “if you have multiple seasonal allergies, for instance to grass and tree pollen; live near farms; or spend a lot of time outside during allergy season, being bombarded by pollen,” Beth Oller, MD, a family medicine physician in Stockton, Kansas, tells SELF. Keep reading to learn why allergies can spark headaches, plus how to tell if your head pain is allergy-related and find relief.
If you have spring allergies and breathe in pollen, “your immune system perceives it as a foreign invader,” Dr. Oller says, and releases a bunch of inflammatory chemicals like histamine. The resulting inflammation triggers swelling in your nasal cavities, which are connected to your sinuses, Rekha Raveendran, MD, allergist and immunologist at The Ohio State University Wexner Medical Center, tells SELF. The sinuses extend behind the cheekbones, eyes, and bridge of the nose, and up into the forehead—so when they get puffy, you can wind up with a sensation of facial pressure and also headache, she explains.
At the same time, experiencing the effects of spring allergies may spark migraine attacks in those with migraine. The surge of inflammation and congestion can irritate a nearby nerve that plays a role in migraine, and allergy-driven fatigue and insomnia can be migraine triggers in and of themselves. Research suggests that among people with migraine, those who also have allergies tend to have worse, more frequent attacks than those who don’t.
How can you tell if it’s an allergy headache or another type?
An allergy headache typically feels like a dull throbbing in your temples, cheeks, or forehead, and makes your face feel heavy. It comes along with congestion, Dr. Oller says, and lying down or tilting your head can increase the pressure. (FYI: This is the same kind of pain as you’d get with a sinus headache, which is caused by a viral or bacterial infection in your sinuses—both lead to mucus buildup and swelling within the sinuses.)
By contrast, migraine attacks (whether or not they’re precipitated by allergies) trigger intense pain on one side of the head. They often come along with nausea, and sensitivity to light and sound, which you would not typically find with allergy headaches, Dr. Raveendran says. Meanwhile, tension headaches tend to feel more like a band squeezing around the head, and cluster headaches spark a surge of pain in or around one eye.
What to do if spring allergies leave you with constant headaches
Take allergy medications early and often.
If you get walloped with allergy headaches each year, Dr. Oller suggests starting on an oral antihistamine medication right about now. Pollen counts are rising, and antihistamines take a week or two of daily use to kick in, she explains. The non-drowsy options work best for daytime—think: cetirizine (Zyrtec), levocetirizine (Xyzal), loratadine (Claritin), or fexofenadine (Allegra). You can use the sleepiness-inducing diphenhydramine (Benadryl) at night, but just know that you shouldn’t make a habit of relying on it as a sleep aid.
Both doctors suggest pairing oral allergy meds with a nasal corticosteroid spray like fluticasone (Flonase) or triamcinolone (Nasocort). “They hit those mucus membranes and help decrease inflammation in that region,” Dr. Oller says. It’s best to take both drugs daily throughout allergy season, she adds, not just when you think you need them. (If your headaches are barely alleviated, or the pollen counts in your area are sky-high, you may also be able to safely increase your dose of these allergy meds to boost their efficacy.)
Minimize your exposure to allergens.
The less pollen that enters your airspace, the fewer symptoms you’ll experience. But you don’t have to stay cooped up to cut your exposure. Keeping your windows closed, using a high-efficiency particulate air (HEPA) filter in your HVAC system (or a portable air purifier that has one), and vacuuming often can make a difference, according to Dr. Oller.
Whenever you do spend ample time outside, Dr. Oller says to rinse off once you get home. This way, you’re not inhaling pollen any longer than you have to. While you’re at it, “shower your sinuses too,” Dr. Oller adds, with a nasal saline spray or Neti Pot. This helps clear some mucus to release pressure and offer temporary relief, Dr. Raveendran says.
Use decongestants sparingly.
If the congestion is making it feel like your face is chock-full of mucus, you might be tempted to reach for an OTC oral decongestant. But take note: While pseudoephedrine (Sudafed) can be helpful, it’s not recommended to use it more than a few days in a row, and isn’t a good choice if you have high blood pressure, Dr. Raveendran says. It’s a stimulant that can make some people feel jittery, or cause a fast heart rate or insomnia.
Nasal decongestants, which include phenylephrine- or oxymetazoline-based sprays (like Afrin and Vicks Sinex), can open up your nose fast but should only be used for three days at a time max, Dr. Raveendran adds. “There’s a risk of rebound congestion that leads to overall worsening of symptoms and addiction to the nasal decongestants,” she says.
Tap OTC pain relievers when needed.
Sometimes you just need in-the-moment relief for the head pain. In that case, you can pop an OTC pain reliever like ibuprofen (Advil), naproxen (Aleve), or acetaminophen (Tylenol), Dr. Oller says. The former two may be better at resolving allergy headaches because they combat inflammation. But it’s not advised to take these non-steroidal anti-inflammatory drugs for more than 10 days straight (unless your doctor tells you otherwise) because of potential effects on your stomach and kidneys. Tylenol, by contrast, is generally safer to take long-term, though shouldn’t be combined with alcohol due to the risk for liver damage.
If you find that your allergy headaches have you reaching for pain relievers more than a few days in a row, check in with your primary care doctor or allergist. They may recommend a more intensive treatment, like prescription steroids, or suggest seeing an ear, nose, and throat doctor or neurologist, in case something else might be behind your head pain.
Related:
- Allergies vs. Cold Symptoms: How to Determine What’s Making You Miserable
- Here’s Why You Might Feel a Headache Behind Your Eyes
- ‘The Warmer Months Fuel My Migraines—Here’s How I Cope’
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