The leaves are turning, the air is crisp, and for many Mainers, the tissues are coming out. If you sneeze, have a runny or stuffy nose, or get itchy, watery eyes every year from late summer into fall, you may have seasonal allergies (also called hay fever or allergic rhinitis). About 50 million Americans have them, and fall is one of the two peak seasons.

What's in the air this time of year?

• Ragweed. This weed is the biggest fall allergy trigger in the Northeast. It releases pollen from mid-August until the first hard frost. Ragweed pollen travels long distances on the wind, so you don't need to live near a field to feel it.
• Other weeds. Mugwort, pigweed, and lamb's quarters also release pollen in late summer and fall.
• Outdoor mold. Damp fall weather and piles of wet leaves are perfect for mold. Airborne mold spores tend to peak from August through November.
• Indoor allergens. When we close up the house and turn on the heat, we spend more time with dust mites, pet dander, and indoor mold. If your symptoms go on all winter, an indoor trigger may be the cause.

Is it allergies or a cold?

Allergies usually cause itching (eyes, nose, throat), sneezing, and clear drainage. They last for weeks and come back around the same time every year. EVEN IF YOU NEVER HAD ALLERGIES BEFORE, you can develop them at any age. Colds often come with body aches or low fever and get better within 7 to 10 days. Allergies do not cause fever.

Simple ways to limit your exposure

• Shower, wash your hair, and change clothes after spending time outdoors, especially before bed.
• Wear a mask (a simple surgical-type mask is fine for pollen) when raking leaves, mowing, or doing yard work. Sunglasses help protect your eyes.
• Don't dry laundry outside on high-pollen days.
• Indoors: use a HEPA air filter in your bedroom, keep pets out of the bedroom, and keep indoor humidity between 30% and 50% to discourage dust mites and mold.

Treatments that work (many are over the counter)

• Steroid nasal sprays such as fluticasone (Flonase), triamcinolone (Nasacort), budesonide, or mometasone are the most effective single treatment, especially for a stuffy nose. They work best when used every day. Starting a week or two before your usual season begins can help. Aim the spray toward the outside of your nostril (toward your eye), away from the middle of your nose, to lower the chance of nosebleeds.
• Non-drowsy antihistamine pills such as cetirizine (Zyrtec), levocetirizine (Xyzal), loratadine (Claritin), or fexofenadine (Allegra) help with sneezing, itching, and runny nose, and can be taken as needed.
• Antihistamine nasal sprays (azelastine, olopatadine) work quickly. They can be combined with a steroid spray if one medicine isn't enough.
• Saline rinses or sprays can wash pollen out of your nose.
• Use caution with: older sedating antihistamines like diphenhydramine (Benadryl), which can cause drowsiness and affect thinking.

When to reach out to our office

• Your symptoms aren't controlled with over-the-counter treatment, or they affect your sleep, work, or school.
• You have wheezing, chest tightness, or shortness of breath. Allergies can trigger asthma.
• You have facial pain, thick colored drainage, or symptoms lasting longer than 10 days, which could mean a sinus infection.
• You are pregnant, breastfeeding, or choosing medicine for a young child.
• You are interested in allergy testing or allergy shots, which can provide long-term relief for some people.