Ragweed is a flowering plant found across North America and is one of the primary culprits of fall allergy symptoms. In late summer and early fall, nearly 50 million Americans will experience a stuffy nose, sneezing, and itchy eyes all because of ragweed pollen. The symptoms of this seasonal allergy can range from mild to severe and last for weeks.

We put together this guide to help you manage the ragweed pollen season with minimal discomfort. Looking for more information? Schedule an online allergy consult with a licensed health care provider to get relief fast.

Ragweed Overview

Ragweed plants are widespread across North America, predominantly in the Midwest and East. There are over 17 different species of ragweed. While ragweed can grow nearly anywhere, it is often found in grassy areas and open spaces with plenty of sunlight.

A ragweed allergy is a misnomer; the pollen of ragweed flowers causes an allergic reaction. Unfortunately for those managing a ragweed pollen allergy, one ragweed plant can produce up to 1 billion pollen grains. Warm weather, humidity, and breezes all help release ragweed pollen.

The Asthma and Allergy Foundation of America (AAFA) suggests that ragweed pollen can be up to seven times higher in urban areas, where temperatures are over 3 degrees warmer than surrounding rural areas. Counterintuitively, pollen counts are often higher in downtown areas than in parks or less-developed regions.

Ragweed season begins in late July and will continue through mid-September or October as the plant starts to flower. The wind picks up and carries the pollen grains produced during this time hundreds of miles. This is how the plant reproduces and why you have difficulty breathing in the fall.

Allergic Reactions to Ragweed

Allergic reactions happen when your body perceives innocuous substances, such as pet dander or pollen, as potential threats capable of causing illness. The harmless substance causing a reaction is known as an allergen. In response to allergen exposure, your body initiates an immune reaction. Essentially, it panics and releases a chemical known as histamine. Histamines are meant to help fight infection and disease, but they cause an inflammatory response that leads to bothersome symptoms like itchy eyes, a runny or itchy nose, and a scratchy throat.

Seasonal allergies, also called seasonal allergic rhinitis or hay fever, manifest during seasonal transitions when pollen becomes airborne. Various plant species, including ragweed, release pollen to transport genetic material to reproduce the following generation of plants.

Common symptoms of an allergic reaction to ragweed include:

• Itchy, red, irritated, and watery eyes
  
• Sneezing
  
• Runny nose
  
• Nasal congestion (a stuffy nose)
  
• Post-nasal drip
  
• Itchy throat
  
• Chronic cough
  
• Headaches
  
  

These symptoms can vary in severity from person to person. For those with asthma, a ragweed allergy can exacerbate asthma symptoms such as coughing, wheezing, and shortness of breath.

Oral Allergy Syndrome

As if the discomfort of allergy symptoms weren’t enough, people with a ragweed allergy may experience additional symptoms caused by oral allergy syndrome (OAS) or pollen food allergy syndrome (PFAS).

Oral allergy syndrome is a condition in which individuals who are allergic to certain pollens, particularly ragweed pollen, may experience allergic reactions when they consume certain fresh fruits, vegetables, or nuts. Ragweed allergies play a significant role in oral allergy syndrome because the proteins found in ragweed pollen are structurally similar to proteins found in these foods.

When individuals with ragweed allergies eat raw or uncooked fruits, vegetables, or nuts that contain similar proteins, their immune system can mistake them for ragweed pollen and trigger allergic symptoms. Cooking or processing the foods involved often eliminates the allergenic proteins, allowing individuals with oral allergy syndrome to enjoy these foods without adverse reactions.

Ragweed-associated OAS symptoms commonly result from eating foods like:

• Banana
  
• Chamomile
  
• Kiwi
  
• Peach
  
• Peppers
  
• Fennel
  
• Celery
  
• Carrot
  
• Melons (cantaloupe, watermelon, and honeydew)
  
• Cucumber
  
• White potato
  
• Zucchini
  
• Sunflower seeds
  
  

Ragweed Allergy Diagnosis

Diagnosing a ragweed allergy involves a combination of a medical history assessment, physical examination, and specific allergy testing. To begin, a health care provider will discuss the patient's symptoms, including the timing and severity of their allergic reactions, to determine if they align with ragweed pollen exposure. A primary care provider can diagnose a ragweed allergy. However, they may refer you to an allergist for allergy testing.

Allergy testing is a crucial step in confirming a ragweed allergy. Skin prick tests or blood tests (specifically IgE antibody tests) can identify whether the individual's immune system produces antibodies in response to ragweed allergens. In a skin prick test, a tiny amount of ragweed extract is applied to the skin, and if a raised, itchy bump develops, it indicates an allergic reaction.

On the other hand, blood tests measure the presence of specific IgE antibodies against ragweed allergens in the bloodstream.

Once a ragweed allergy is diagnosed, the healthcare provider can work with the patient to develop a tailored management plan, which may include allergen avoidance strategies, medications, and allergy immunotherapy (allergy shots) for long-term symptom control.

Ragweed Allergy Treatment

For most people, easing seasonal allergy symptoms can be achieved through readily available over-the-counter treatments. While allergy medications cannot cure allergies, they serve to assist your body in regulating its immune response, particularly the release of histamines, which ultimately reduces symptoms like sneezing, congestion, and eye irritation.

Allergy relief options come in various formats, with antihistamines being the most prevalent. This category encompasses oral antihistamines, antihistamine nasal sprays, and eye drops. These medications work to moderate your immune system's reaction to allergy triggers. Additionally, for relief from nasal congestion, decongestants can be used to alleviate blockage in your nasal passages.

Antihistamines are medications that help with allergy symptoms. They work by stopping the release of histamines in your body.

The antihistamines used to treat allergies are called H-1 blockers. These drugs focus on histamine receptors to prevent allergy symptoms.

You can find many of these drugs without a prescription at most pharmacies. They come in various forms, like pills, capsules, chewable tablets, liquids, nasal sprays, or eye drops. If your symptoms are severe, your healthcare provider can prescribe stronger antihistamines.

OTC Antihistamines include:

• Cetirizine (generic for Zyrtec)
  
• Loratadine (generic for Alavert and Claritin)
  
• Diphenhydramine (generic for Benadryl)
  
• Fexofenadine (generic for Allegra)
  
• Brompheniramine (generic for Dimetane)
  
• Chlorpheniramine (generic for Chlor-Trimeton)
  
• Clemastine (generic for Dayhist)
  
• Doxylamine (generic for Vicks NyQuil)
  
• Azelastine
  
  

Decongestants are fast-acting aids for a stuffy and runny nose. These drugs are meant for short-term use only. They reduce swelling in your nose so that you can breathe more easily.

You can get decongestants as an oral pill or a nasal spray. You'll find them in both over-the-counter and prescription forms. Some medicines have antihistamines and decongestants to quickly relieve your symptoms and minimize the allergic reaction. Those with underlying heart disease or hypertension should use caution with decongestants or avoid them completely.

Oral medications containing a decongestant and antihistamine include:

• Desloratadine and pseudoephedrine (Clarinex-D)
  
• Loratadine and pseudoephedrine (Claritin-D)
  
• Cetirizine and pseudoephedrine (Zyrtec-D)
  
• Fexofenadine and pseudoephedrine (Allegra-D)
  
  

Decongestant nasal sprays include:

• Oxymetazoline (Afrin)
  
• Tetrahydrozoline (Tyzine)--also available as eye drops
  
  

Nasal sprays containing corticosteroids are excellent treatment options for people with chronic allergy issues. They might not work right away—it can take a few weeks—but they're the best choice for long-term symptom management. These drugs are thought to help stop histamines from causing allergies before they even start.

OTC steroid nasal sprays include:

• Mometasone (Nasonex)
  
• Budesonide (Rhinocort)
  
• Triamcinolone (Nasacort)
  
• Fluticasone (Flovent)
  
  

For those managing severe symptoms or chronic allergies, immunotherapy can provide long-term immunity against allergens.

Sublingual immunotherapy (SLIT) for allergies is a treatment method that helps individuals reduce reactivity tobuild immunity against specific allergens, such as pollen or dust mites. Unlike traditional allergy shots, SLIT involves placing a small amount of allergen extract under the tongue, where it is absorbed into the bloodstream.

Over time, regular exposure to these small doses helps the body become less sensitive to the allergens, reducing allergic reactions and symptoms like sneezing, itching, and congestion. It's a convenient and non-invasive approach that can be administered at home under medical supervision, making it a popular choice for managing allergies in a safe and effective manner.

Sesame now offers video allergy testing and referral services to determine what allergies are causing your symptoms and whether or not an In-Person Allergy Treatment appointment is right for you. If appropriate, you will be given an initial dose of sublingual immunotherapy with observation from a licensed health care provider.

Note that all treatments and prescriptions are at the discretion of your health care provider.

Prevention

In addition to medicated treatment plans, you can use simple at-home strategies to minimize your exposure to pollen.

Preventative methods include:

• Keep windows and doors closed during peak ragweed season (usually late summer to early fall) to minimize pollen entering your home.
  
• Use high-efficiency particulate air (HEPA) filters to trap pollen and other allergens in your home's HVAC system.
  
• Regularly clean and vacuum your home using a vacuum cleaner equipped with a HEPA filter to remove pollen and dust.
  
• Regularly wash your bedding, curtains, and pillowcases in hot water to reduce allergen buildup.
  
• Consider using allergen-proof covers on pillows and mattresses to prevent dust mites and pollen from accumulating.
  
• Shower and change your clothes after spending time outdoors to remove pollen from your body and clothing.
  
• Dry your laundry in a dryer rather than hanging it outside to prevent pollen from sticking to your clothes.
  
• Monitor local pollen forecasts and try to stay indoors on high pollen count days, especially during peak ragweed season.
  
• Use a saline nasal rinse to flush out allergens from your nasal passages.
  
  

While there is no cure for a ragweed allergy, these preventive and medicated relief options can help ease your symptoms. If you want more information or want to discuss possible treatment options, book a visit with a licensed health care provider today.

Sources:

• Asthma and Allergy Foundation of America (n.d.). Ragweed Pollen Allergy. AAFA.org. www.aafa.org/
  
• American College of Allergy, Asthma & Immunology (n.d.). Ragweed Allergy. ACAAI.org. www.acaai.org/
  
• Chen, K. W., Marusciac, L., Tamas, P. T., Valenta, R., & Panaitescu, C. (2018). Ragweed Pollen Allergy: Burden, Characteristics, and Management of an Imported Allergen Source in Europe. International archives of allergy and immunology, 176(3-4), 163–180. https://doi.org/10.1159/000487997
• National Institute of Environmental Health Sciences (n.d.). Pollen. NIEHS. www.niehs.nih.gov
  

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