By Shea Wright 

Springtime is known for ushering in warmer weather, blooming flowers, and fresh cut lawns. But for many, the season also brings a surge in respiratory ailments that can leave many wondering: Do I have a common cold or seasonal allergies? 

According to the Centers for Disease Control and Prevention (CDC), approximately 26% of adults and 19% of children in the United States experience seasonal allergies. These statistics highlight the widespread nature of seasonal allergies, underscoring the importance of understanding their symptoms and management. 

VCU Health News spoke with ear, nose, and throat (ENT) specialist P. Todd Nichols, M.D., at VCU Health Community Memorial Hospital about the differences between allergies and colds, and when it’s time to see a medical professional. 

Dr. Nichols, you’re an ENT specialist. What is an ENT and what medical conditions do they treat? 

Otolaryngologists, or “ENT’s,” treat medical and surgical problems of the ears, nose and sinuses, mouth, throat, and neck. This includes hearing, balance, swallowing, salivary glands, voice, thyroid surgery, head and neck cancer, and obviously sinus and allergy problems. 

What are the most common ear, nose, and throat issues you treat in patients during allergy season? 

Allergies are not limited to the nose. Patients often report associated ear infections, hearing loss, sore throat, swollen glands, cough, wheezing, shortness of breath, rashes and even dizziness. It is really a disease that affects the whole body. 

Cold and flu season is still going strong in Virginia. What are some of the differences between seasonal allergies and flu symptoms? 

Colds and allergies can feel very similar. Congestion, sneezing, sore throat, sinus pressure, and headache can be seen with both. Itching symptoms of the eyes, nose or throat suggest allergy. Fever and body aches suggest a person may have a cold or virus.

Allergies begin shortly following exposure to pollen. Cold symptoms are usually more gradual in onset. The length of symptoms can also be helpful in telling the difference. Viral symptoms usually last 1-2 weeks, while allergies can last much longer. If nasal drainage becomes colored and lasts for more than 3-5 days, a sinus infection may have developed, and is usually accompanied by fever, sinus pressure, headache and dental pain.   

Aside from medication, what lifestyle changes or treatments can help people better manage their seasonal allergies? 

Spring allergy season is tough, especially in Virginia. All the trees, grasses, and flowers are blooming, so everyone wants to be outside. But staying indoors where there is air conditioning can help minimize symptom severity. Showering when returning inside can also be helpful. Saline sinus rinses help to remove pollen from the nasal passages. The use of an air filter indoors is also an effective adjunct for patients with severe symptoms. 

At what point should I see an ENT specialist rather than manage my allergies with over-the-counter medications? 

Choosing over the counter medications can be challenging. In general, oral antihistamines are best for itching, runny nose, and sneezing. Nasal steroid and antihistamine sprays work better for congestion and sinus pressure. Decongestants can be helpful but should be used with caution if there is a history of hypertension or prostate trouble.  

Seeing a medical professional should be considered if over-the-counter medications are not working or if you begin to experience shortness of breath or mouth or throat swelling. An ear, nose, and throat evaluation can help to identify structural nasal or sinus abnormalities and check for nasal polyps. We can also do allergy testing to determine your exact sensitivities. 

When should I consider surgery or advanced treatments for chronic sinus issues?  

When it comes to persistent allergy symptoms, sinus issues, or concerns about chronic congestion, an ENT specialist can provide expert care and tailored treatment options. Surgery is considered for symptoms lasting more than three months despite medical treatment.  

A physical exam and sinus scans are necessary to determine the extent of disease and the exact surgical plan. Oftentimes, patients still need to manage symptoms with medication after surgery and to prevent recurrence. This can include allergy immunotherapy as well as prescription “biologic” immune modifying medications. 

If you're struggling with symptoms that won't go away, scheduling a consultation with an ENT could be the key to breathing easier this spring. 

Meet our team of ear, throat, and nose specialists at VCU Health Community Memorial Hospital 

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