April 09, 2026 | Black & Kletz Allergy
When most people think of Springtime allergies, they think of people with nasal congestion, runny noses, post-nasal drip, itchy eyes, watery eyes, redness of the eyes, itchy throat, and sneezing. This description is of someone who has hay fever (i.e., allergic rhinitis). For the most part, this visualization is correct, however, many individuals also have or only have asthma symptoms in the Spring. These unlucky people may experience wheezing, chest tightness, coughing, and/or shortness of breath in the Spring. Some of these individuals only develop asthma symptoms in the Spring, while others have asthma symptoms all year round but have increased symptoms in the Spring.
Why do some people develop asthma symptoms in the Spring? What is it that is causing these flare-ups? In the Washington, DC, Northern Virginia, and Maryland metropolitan area, the trees usually begin to pollinate in late February. They reach a peak in late April and taper off in late May. Grass pollen usually begins to pollinate in May, reaches a peak in June and tapers off in early August. Depending on whether an individual is allergic to trees or grasses will determine when this person experiences asthma symptoms. It should be noted that it is usually the ugly trees and not the pretty flowering trees that cause patients to exhibit allergy or asthma symptoms. The pollens from ugly trees (e.g. birch, maple, oak) are light in weight and thus dispersed by the wind to reproduce. As a result, individuals breathe in the pollen causing a certain percentage to become sensitized to the pollen. When this occurs, the patient may experience hay fever and/or asthma symptoms when they are exposed to these pollens. On the other hand, the pollens of the pretty flowering trees are heavier in weight and thus unable to reproduce by relying on the wind alone. Adaptation in nature created the symbiotic relationship with bees to help these trees reproduce. Bees are attracted to the pretty and scented flowers. They land on the flowers and unknowingly coolect pollen from the flowers which attaches to their abdomens. When they land on another flower, there is an exchange of pollen and as a result, reproduction occurs.
Asthma is a chronic inflammatory disorder affecting the lower respiratory tract. The lower respiratory tract is made up of the muscular tubes that carry air in and out of the lungs as well as the tissues in the lungs where the exchange of gas occurs. The inflammation found in people with asthma is usually linked with inflammation of the upper respiratory tract (e.g., nose, sinuses). As mentioned before, the main symptoms of asthma may include chest tightness, wheezing, coughing, and/or shortness of breath. The frequency of these symptoms differs depending on the seriousness of the asthma. The symptoms can be sporadic or constant. The severity is categorized as either mild, moderate, or severe. Asthma usually begins in childhood, although it can also be diagnosed for the first time in adulthood. The course of asthma is variable. The symptoms can be mild, moderate, severe, frequent, infrequent, intermittent, and/or persistent at various times throughout one’s life. Although the underlying cause for most cases of asthma is genetic, many external factors such as the environment play a crucial role in the severity, frequency, and course of the disease. These external factors typically trigger or cause exacerbations of asthma in most patients.
In the Spring, there are however many other factors that can cause asthma symptoms in sensitive persons. Most of the following factors are ubiquitous and not only present in the Spring, however they still may cause increased asthma symptoms that may be recognized in the Spring. Mold is often the culprit in mold-sensitive individuals. In the Washington, DC metro region, due to its weather and the fact that Washington, DC was built on a swamp, makes this area more humid and thus prone to more mold growth. Combine that with the added rain that the area gets in the Spring and it becomes a lightning rod for mold sufferers. In addition to molds, other environmental allergens (e.g., dust mites, pet dander, cockroach) are still around in the Spring and thus likely to cause asthma symptoms. Excessive humidity, dry air, smoke, cold air, pollution, chemical aerosol sprays, colognes, perfumes, fragrances, and other strong odors may irritate the airways of the lungs and result in the exacerbation of asthma. As these “irritants” cannot be “desensitized” by traditional allergy immunotherapy since they are technically not caused by allergens, avoidance is the key to decreasing the risks of more severe asthma when irritants are the trigger. Occupational asthma can also occur at any time of the year and may affect bakers, farmers, hairstylists, seafood processors, painters, carpenters, pharmaceutical workers, welders, chemical manufacturers, textile workers, food processors, animal handlers, adhesive handlers, and metal workers. Occupational asthma may be caused by the inhalation of harmful fumes, gases, chemicals, plastics, dust, dyes, metals, animal proteins, enzymes, and/or other particulates. Exertion can also play a role, particularly in the Spring. Many asthmatics do worse with exercise and given that there is pollen in the air at this time of the year, the pollen can make it worse. Just as the tree and grass pollen can cause nasal symptoms by direst contact, it can do the same for the mucosal linings of the airways and lungs. Another common trigger for asthma are infections. Upper respiratory tract infections (URIs) and lower respiratory tract infections may be responsible for causing exacerbations of one’s asthma and may occur at any time of the year. A variety of viruses such as rhinoviruses, coronaviruses, adenoviruses, and myxoviruses, are well-known to aggravate asthma.
The diagnosis and treatment of asthma begin with the allergy specialist performing a comprehensive history and physical examination. The diagnosis is further established by doing a pulmonary function test. Occasionally a chest X-ray may be needed to rule out other respiratory conditions. Allergy skin testing or allergy blood testing is often performed since both indoor and outdoor aeroallergens are often a trigger in many asthmatic patients. The treatment of asthma begins with prevention. It is desirable for an asthmatic patient to attempt to evade triggers that are recognized to cause or worsen their asthma symptoms. Medications are used in the treatment of asthma in most asthmatic individuals. Every asthma patient should have a short-acting beta2 agonist rescue medication [e.g., albuterol (ProAir, Proventil, Ventolin), levalbuterol (Xopenex), pirbuterol (Maxair), albuterol/budesonide (AirSupra)] to use if symptoms develop or to use prophylactically before exposure to a known trigger such as pets, exercise, etc. In addition, many patients will need other medications to control their asthma symptoms. Other medications used to manage asthma may include, inhaled corticosteroids, inhaled long-acting beta2 agonists, oral phosphodiesterase inhibitors, oral leukotrienes, oral beta2 agonists, and biologicals [e.g., Xolair (omalizumab), Fasenra (benralizumab), Tezpire (tezepelumab), Nucala (mepolizumab), Dupixent (dupilumab)]. Allergy injections (i.e., allergy immunotherapy, allergy shots, allergy desensitization, allergy hyposensitization) may also be helpful in the treatment of asthma as it helps decrease and prevent allergic triggers such as tree pollens, grass pollens, dust mites, molds, pets, and cockroaches. It is important to note that the treatment of asthma is individualized and differs with each individual depending on the frequency and severity of the patient’s symptoms as well as their allergic profile.
The board certified allergists at Black & Kletz Allergy have 3 locations in the Washington, Northern Virginia, and Maryland metropolitan area. We have offices in Washington, DC, McLean, VA (Tysons Corner, VA), and Manassas, VA. All 3 of our offices have on-site parking and the Washington, DC and McLean, VA offices are Metro accessible. The McLean office has a complementary shuttle that runs between our office and the Spring Hill metro station on the silver line. The allergy specialists of Black & Kletz Allergy diagnose and treat both adult and pediatric and patients. For an appointment, please call our office or alternatively, you can click Request an Appointment and we will respond within 24 hours by the next business day. The allergy doctors at Black & Kletz Allergy have been helping patients with asthma, hay fever, sinus disease, hives, eczema, insect sting allergies, food allergies, medication allergies, and immunological disorders for more than 50 years. If you are bothered by allergies, it is our goal to improve your quality of life by decreasing or preventing your annoying allergy symptoms.
