Is it a cold or allergies? How to tell the symptoms apart

When flowers are in bloom and cold viruses are circulating in the spring, it can be hard to tell if symptoms like sneezing, coughing, and runny nose are the result of a cold, allergies, or both. .

In the United States, approximately a quarter of adults treat seasonal allergies, according to the Centers for Disease Control and Prevention. And each adult receives on average two to three colds per year, usually in winter and spring.

Understanding what’s causing your symptoms is crucial for effective treatment, experts say. The good news is that there are simple ways to tell colds from allergies.

Signs you have a cold (or other viral illness)

Many viral infections like the common cold cause slightly different symptoms than those caused by seasonal allergies, said Dr. Joyce Yu, a pediatric allergist immunologist at Columbia University Irving Medical Center.

Fever. While most adults and older children don’t have a fever (or a low fever) when they have a cold, fever is a “sure red flag” that you have some kind of viral infection, a said Dr. Yu. It could be a cold or another illness, like the flu or Covid-19.

But, Dr. Yu said, a “fever never occurs with allergies,” so you can always rule it out.

Aches. If your muscles are sore, sore, achy, or tired, that discomfort is likely caused by a cold (or other viral illness) rather than allergies, Dr. Yu said.

It’s more than just a feeling of fatigue, she added. “If you feel like a truck has run you over, maybe it’s more because you’re sick” of an infection, she said.

Sore throat. Allergies can cause postnasal drip throat irritation, said Dr. Jyothi Tirumalasetty, an assistant clinical professor of medicine at Stanford University who specializes in allergies and immunology. But a sore throat is more typical of a cold, especially if it’s more painful.

If your tonsils are also red or swollen, that’s another sign you have a cold (or another viral infection), she said.

Severe cough. A cough can come from a cold or from allergies, Dr. Tirumalasetty said, but when it’s caused by a cold, it’s usually more serious. If a coughing fit is so bad that it wakes you up in the middle of the night, for example, that’s a sign of a cold, she says.

With a cold, it’s possible to have a wet, oily cough or a dry cough, but with allergies, it’s usually dry.

An exception to the severity rule, however, is if you have asthma in addition to your allergies, Dr. Tirumalasetty said. In this case, your allergies could be triggering asthma symptoms, which can include a lot of coughing and wheezing.

Signs you have seasonal allergies

Clear mucus. A runny nose with a clear snot may suggest you have allergies rather than a cold.

When you have a cold, Dr. Yu said, the mucus in your nose tends to be thicker and more yellow or green. The thickness can also make you feel congested.

With allergies, the mucus in your nose is more likely to be thinner and runnier, making it clearer.

But these are just generalizations, Dr Yu said.

Itching. If you feel like scratching your skin, especially around your eyes, nose and ears, that’s a sign you have allergy symptoms rather than a cold, Dr. Yu said.

Red or watery eyes and swollen eyelids are also more typical of allergies than colds, Dr. Tirumalasetty said.

Sneeze. Sneezing is a tricky symptom, Dr. Yu said, because it’s common with both allergies and the common cold. But, unlike allergies, sneezing is not the predominant feature of a cold. So if you sneeze a lot but don’t feel sick with a sore throat, body aches, fatigue or other cold symptoms, it could be a sign of allergies.

Chronology of symptoms

With spring seasonal allergies, which are primarily caused by tree pollen, you’ll likely experience a slow and steady progression of your symptoms over a few weeks as the trees release more pollen, Dr. Tirumalasetty said.

But with a viral infection like a cold, Dr. Yu said, your first symptoms usually develop within just a few days.

And in most cases, all of your cold symptoms will go away within weeks, Dr. Tirumalasetty said, whereas seasonal allergy symptoms can last an entire season.

If you notice that you experience allergy symptoms around the same time each spring, you can assume that your current symptoms are at least partly due to allergies, said Dr. Shradha Agarwal, immunologist allergist at the Icahn School. of Medicine of Mount Sinai. in New York – unless your current symptoms are very different from your usual symptoms.

If you think you have a cold and aren’t feeling better after a week or two, Dr. Tirumalasetty said, see a doctor or allergist to assess whether you have allergies or another condition like a sinus infection.

What to do

Some over-the-counter treatments can relieve cold and allergy symptoms. Oral antihistamines like Claritin, Zyrtec and Allegra, for example, can manage symptoms like a runny or stuffy nose and sneezing, Dr. Yu said.

Saline rinses can also help unclog your sinuses, says Dr. Agarwal, whether you have a cold or allergies.

And if you think what you have is indeed a cold, Dr. Yu recommended taking the day off or staying home to avoid making others sick as well.