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Cold and Allergy Symptoms: What's the Difference?


Should you chalk up those sniffles to cold and flu season? Not so fast! "Many women write off the symptoms of allergies, asthma, or a sinus infection," says Beth Corn, M.D., an assistant professor at Mount Sinai School of Medicine in New York City. And that can keep relief further away. Here's how to know whether what you're suffering are cold symptoms or allergy symptoms—and get the right treatment. Here's your symptom decoder:

1. You've gone through a box of tissues in three days!
"If things start to dry up after three or four days, chances are you have a cold," says James L. Sublett, M.D., chief of pediatric allergy at the University of Louisville School of Medicine. "With rest and plenty of fluids, you'll feel better on your own after about a week." Seasonal allergies, on the other hand, usually get progressively worse and can last for months.

Take action: Try an antihistamine, such as loratadine (Claritin), for allergy symptoms. This remedy prevents the action of histamine—a chemical your body releases in response to pollen, dust, and other allergens—and keeps allergy symptoms like sneezing and congestion under control. "Skip the over-the-counter decongestant sprays," says Corn. "They provide instant relief, but if used for more than a few days in a row, they can irritate your nasal tissue and make congestion worse." If symptoms of allergies persist beyond two weeks, schedule an appointment with your physician, who may prescribe a stronger once-a-day antihistamine, such as fexofenadine (Allegra), or a nasal steroid spray to lessen inflammation and mucus production. "Also pay attention to any recent changes you've made to your routine," says Corn, "such as that new perfume you spritzed on this morning or the different cleaning spray you just used." To breathe easier, flush excess mucus using a neti pot or nasal saline spray (during flare-ups or daily for up to three weeks), and consider investing in a HEPA air filter to remove those indoor pollutants.

HOME REMEDIES: 5 Easy Ways to Nix Symptoms of Allergies

2. You wheeze while exercising
If the problem starts a few minutes into your workout and goes away when you stop, it's most likely a symptom of exercise-induced asthma—a condition that causes your airways to constrict during strenuous activity. But when that shortness of breath lingers throughout the day, seasonal allergies are probably to blame.

Take action: Ask your doctor for a simple lung function test (covered by most insurance plans), or take an online screening quiz from the American College of Allergy, Asthma & Immunology. If you do have the condition, you may need to use a prescription inhaler when symptoms arise or take a daily steroid pill. If allergies are the culprit, rethink your fitness routine. "During exercise, you breathe deeply and inhale more allergens," says Sublett. "Consider scheduling outdoor workouts in the late afternoon or evening, when pollen counts are lowest. On days pollen and mold spore counts are high (check levels here), pop an antihistamine and keep your sweat session inside.

3. Your nose is runny, and your face is tender
You may have a sinus infection, especially if you have brown or discolored mucus in addition to a headache and pressure in the eyes, nose, or cheeks. Other symptoms: a persistent cough, fever, and unexplained bad breath.

Take action: See a physician as soon as possible; she'll probably prescribe an antibiotic. "Left untreated, chronic cases may lead to tissue damage that requires sinus surgery," says Sublett. In the meantime, take acetaminophen for the fever, and use a neti pot to clear away mucus buildup in the sinuses and relieve the congestion.

4. You're nodding off during the day but not at night
Allergies may be the problem. More than 40 percent of sufferers toss and turn at night, found a study published in the Archives of Internal Medicine. According to researchers, congestion coupled with stimulating medications, like certain decongestants, can make it hard to fall asleep. "Because your immune system is working overtime, you may also feel exhausted," says Sublett.

Take action: First, check to make sure that the antihistamine you're taking is non-sedating (read labels and look for a brand with the active ingredient loratadine). In the evening, skip decongestants with pseudoephedrine or phenylephrine, which can keep you awake. Then, for a better night's rest, ban allergens from your bedroom by closing your windows and running the air conditioner on the "recycle" setting. "That cleans the air, trapping any stray particles," says Sublett. (Be sure to change the filter every three months.) Also, shower before bed rather than in the a.m. so you can rinse off pollen that may have accumulated on your hair and skin.

5. You can't stop clearing your throat
That postnasal drip could signal a cold (especially if you have a low-grade fever), allergies, or even a sinus infection.

Take action: Start with a neti pot and add an antihistamine. Then, if symptoms of allergies continue, consult a physician. "You may need a prescription nasal steroid spray to relieve the inflammation that leads to excess mucus," says Corn. If you still have allergy symptoms after three weeks, see an allergist for skin or blood testing to determine what you're allergic to. She may recommend allergy shots and refer you to an ear, nose, and throat specialist to check for a deviated septum or polyps—non-cancerous growths in your sinus cavity or nasal passages.

6. Your eyes and skin are itching like crazy
Blame allergies again. "That flood of histamine causes tiny blood vessels in your eyes and skin to dilate and leak, which can lead to itching and redness," says Sublett.

Take action: Try a targeted approach. "Use preservative-free artificial tears, like those from Clear Eyes and Visine, first," says Corn. "If you don't feel better, see an allergist for prescription antihistamine eyedrops." For your skin, pick up an over-the-counter oral antihistamine and a cortisone cream, like Cortizone-10 ($9; If the itching doesn't go away after a few days, see an allergist, who can prescribe a topical steroid cream. While you wait for your appointment, take warm showers instead of hot ones, which can dehydrate skin and make you itchier. Use mild soap and fragrance-free lotions, like those by Cetaphil, and skip the mascara and eyeliner, which can cause even more irritation.


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