The millions of people who suffer from seasonal allergies each year are too familiar with symptoms like sneezing, wheezing, and sniffling. But many donât realize there are lots of other, more unusual ways allergies can show up. âPeople have a preconceived notion of what allergies are, but thereâs so much outside just itchy eyes or sneezing,â says Dr. Purvi Parikh, an allergist and immunologist at NYU Langone Health. âIt can mimic a lot of infectionsâpeople think theyâre getting sick with something, but itâs actually allergies.â
We asked allergists to share some of the lesser-known symptoms they see in their offices, from black eyes to nasal creases.
A sore throat
Perhaps you suspect youâre coming down with strep throat. It could actually be seasonal allergies. Blame it on post-nasal drip, that lovely sensation of mucus sliding down the back of your throat. âWhen your nose is all blocked up or inflamed, inflammation has nowhere to go, so it starts draining down your throat,â Parikh explains. âThatâs what causes the sore throat, or having to clear your throat often.â
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There are a few ways to zero in on the likely culprit: If you have severe throat pain that begins suddenly and is paired with a fever and swollen tonsils, strep throat is certainly a contender. But if your symptoms are more gradual, and youâve also noticed hoarseness or a chronic cough, consider making an appointment with an allergist.
Clogged ears
If you suddenly feel like your ears are pluggedâand youâre not, for example, on an airplaneâyou could be dealing with allergies. âYour ear, nose, and throat are all connected by the same tube, so if your nose is congested, it can affect your ears and your throat,â Parikh says. Once you start treating your allergies, whether thatâs with over-the-counter medication or allergy shots, your ears should return to normal, she adds.
Nose bleeds
Kids are famous for clawing at their stuffy nosesâand sometimes, that leads to an alarmingly bloody mess. âTheyâre snorting up the snot, and theyâre blowing really hard,â says Dr. Cindy Salm Bauer, division chief and medical director of allergy and immunology at Phoenix Childrenâs. âThatâs irritating and harmful, and of course the nose is going to get upset and bleed.â
The solution: using nose spray. Most people, however, donât do so correctly. Instead of squirting the spray straight backâwhich can exacerbate nose bleedsâspray it toward the ear, or laterally on each side. âItâs weird to squirt toward the ear, because youâre like, âReally, the side of my nose?ââ Bauer says. But thatâs exactly where it needs to go to be able to do its job.
Snorting, grunting, and other strange noses
The parents of Bauerâs patients often demonstrate the weird noises their kids makeâall in the name of helping their embarrassed children. âTheyâre like, âAlright, Iâve waited for this appointment. If youâre not gonna do it, Iâm gonna do it,ââ she says. âThen they attempt to make the noise that the child makes.â
Typically, those sounds occur because of postnasal drip, which can lead to animal-like snorting, grunting, and throat clearing. âIt can almost mimic a tic,â Bauer says. âThatâs tough for some families, when the kids are constantly making this noise or habitual grunt.â Once they start allergy treatment, however, parents typically report a significant improvement.
Exhaustion
People who are suffering from seasonal allergies often experience fatigueâbut donât realize why theyâre so tired. Itâs the âNo. 1 most common quality-of-life issueâ that Dr. Karen Kaufman, who runs an allergy, asthma, and immunology practice in Vienna, Va., hears about from patients. âTheyâre choking on mucus all night long, theyâre breathing through their mouth, and theyâre not having restful sleep,â she says. âIt leads to tremendous amounts of fatigue.â
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Poor sleep can trigger trouble focusing at work or school, as well as behavioral issues among kids. Bauer describes âahaâ visits with families who discover their kids have allergies and soon see dramatic improvements in well-being. They return to her office and say: âWho would have thought that identifying and treating allergens would help my child literally behave better and be happier?â
Undereye circles
Dark circles under your eyes can happen as a result of allergic rhinitis, or hay fever. When you experience nasal congestion, and your nose becomes inflamed and swollen, âit causes some of the blood thatâs draining under your eyes to pool a little bit,â says Dr. Jeffrey Chambliss, who specializes in allergy and immunology at UT Southwestern Medical Center. âWeâre seeing darker pigmentation of the skin thatâs really more blood flow-related and not necessarily stemming from a problem in your eyeâmore from inflammation in your nose.â
For a lot of patients, these dark circles, which resemble a black eye, get better in tandem with allergy symptoms. Sometimes it takes longer to improve than, say, itching or sneezing, but over time, the blue or purple color typically fades, he says.
A nasal crease
In addition to dark circles, some people with seasonal allergies develop a horizontal line on the bottom third of their nose thatâs darker or lighter than their skin tone. Itâs known as an allergic salute or a nasal crease, and itâs caused by rubbing your nose over and over again, Chambliss says. While a horizontal line is most common, âSome patients who really rub their nose vigorously can get other shapes,â he adds. âI had a patient who almost had an X across the end of their nose because they would rub more in a circular motion, rather than just up and down.â
Itching, tingling, or mild swelling in your mouth
Oral allergy syndromeâsometimes called pollen-food allergy syndromeâhappens when your body mistakes fruits or vegetables for a pollen that youâre allergic to, Chambliss says. If youâre allergic to birch tree pollen, for example, and opt for a healthy snack like an apple, peach, cucumber, or bell pepper, you could get an itchy, tingling, or burning sensation in your mouth, lips, tongue, and throat. âItâs rare that you get life-threatening symptoms, so sometimes patients donât immediately connect it to being possibly driven by an allergy,â he says. âThey just say, âWell, I avoid it because it makes my mouth feel funny.ââ
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Heating up the fruit or veggie in question typically improves or alleviates symptoms. âIf you eat apple pie or banana bread, you donât get those symptoms because itâs been heated to change the shape of the protein,â Chambliss says.
Bad breath
The daily appointments that stand out the most in Bauerâs mind often have to do with badâmake that âhorribleââbreath. And her patients arenât skimping on dental hygiene. âIt makes sense if you have mucus in your nose dripping down the back of your throat,â which can be a breeding ground for bacteria, she says. âIt can be really malodorous.â Plus, allergies often lead to mouth breathing, which can dry out the mouth, exacerbating the scent wafting out. Fortunately, with proper treatment, Bauer says, halitosis often becomes much less offensive.
Rashes
Parikh sees lots of patients with rashes at this time of year, and many donât realize a pollen allergy could be the culprit. The two most common types are hivesâraised welts that are itchy, red, and uncomfortableâand eczema, which is characterized by dry, itchy, and inflamed skin. If you canât stop scratching, try taking an over-the-counter antihistamine or applying hydrocortisone cream, she advises. âIf the rash isnât improving, definitely go and see an allergist or dermatologist to get further treatment,â Parikh says, âand to make sure itâs not something else.â