Seasonal Allergy Symptoms That May Need Medical Attention, Warns Pulmonologist

seasonal allergy symptoms such as a runny nose, sneezing, throat irritation and a lingering cough often become more common as winter approaches. While these complaints may be caused by allergies, they can also signal exposure to Air Pollution or an underlying respiratory infection. According to pulmonologist Dr Amit Kumar Mandal, assuming that every winter-related respiratory symptom is an allergy can delay the identification of a more serious health problem.

Across many parts of North India, air quality deteriorates between October and February. During this period, polluted air can irritate the respiratory system, worsen existing lung conditions and produce symptoms that resemble allergic reactions.

Dr Mandal, senior director of pulmonology at Paras Health, Panchkula, explained to HT Lifestyle that fine particulate matter, particularly PM2.5, can travel deep into the lungs and enter the bloodstream. Exposure can inflame the airways, causing sneezing, watery eyes and throat irritation.

Pollutants can also make the airways more sensitive to pollen and dust, potentially turning mild seasonal complaints into persistent symptoms.

Citing the State of Global Air 2025 report, Dr Mandal noted that an estimated two million air-pollution-related deaths occurred in India in 2023, with nearly nine in ten linked to non-communicable conditions such as heart disease, lung disease and cancer.

Although a runny nose or occasional cough may not indicate a serious condition, certain symptoms deserve medical attention. Recognising these warning signs can help people avoid inappropriate self-medication and seek timely care.

1. A Cough That Lasts Beyond Two to Three Weeks

A cough is common during seasonal changes, but its duration and accompanying symptoms can provide important clues about its possible cause.

Allergy-related symptoms may improve when exposure to the triggering substance decreases. However, Dr Mandal advised that a cough continuing beyond two to three weeks should be medically evaluated, particularly when it disrupts sleep or occurs alongside other concerning symptoms.

Warning signs include:

• A persistent cough that lasts longer than two to three weeks.

• Coughing that repeatedly interrupts sleep.

• Bringing up mucus or blood.

• Unexplained weight loss alongside a lingering cough.

These symptoms may be associated with conditions such as asthma, chronic bronchitis, a lung infection or tuberculosis rather than a seasonal allergy.

A persistent cough does not automatically mean that someone has one of these illnesses. However, identifying the underlying cause is important because different conditions require different treatments.

People should not rely on cough medicines or allergy tablets indefinitely when symptoms continue. A medical professional can assess the cough, consider other symptoms and determine whether further testing or treatment is necessary.

2. Wheezing, Breathlessness and Chest Tightness

Sneezing, itching and watery eyes are commonly associated with allergies. Wheezing, breathlessness and chest tightness, however, can indicate that the respiratory system is being affected more significantly.

Dr Mandal highlighted breathlessness during ordinary activities, such as climbing a flight of stairs, as a symptom that should not automatically be dismissed as a seasonal complaint.

Air pollution can irritate the airways and trigger or aggravate respiratory conditions. People with asthma and other chronic lung diseases may be particularly vulnerable to these effects.

Symptoms that warrant medical assessment include:

• Wheezing or a whistling sound while breathing.

• Shortness of breath during routine activities.

• Persistent tightness or discomfort in the chest.

• Breathing difficulties that are new, worsening or interfering with daily life.

These symptoms can have several causes, so a proper medical assessment is important.

When Do Breathing Problems Become an Emergency?

Certain symptoms require immediate medical attention rather than routine treatment for allergies.

Dr Mandal warned that chest pain, palpitations, bluish lips and difficulty speaking in complete sentences should be treated as emergency warning signs. Severe breathing difficulty may indicate a serious respiratory or cardiovascular problem.

Air pollution is also associated with cardiovascular risks, including heart attacks and strokes. People experiencing severe breathlessness, sudden chest pain or other alarming symptoms should seek emergency care without delay.

It is particularly important not to assume that sudden or severe breathing problems are simply caused by cold weather, dust or Seasonal Allergies.

3. Fever, Facial Pain and Persistent Nasal Congestion

A blocked or runny nose can occur with allergies and respiratory infections. However, certain accompanying symptoms may suggest that an infection or another condition requires medical evaluation.

According to Dr Mandal, fever is not a typical feature of an uncomplicated allergic reaction. A raised temperature accompanied by nasal congestion, facial pain or pressure may point towards a sinus or respiratory infection.

The duration and progression of symptoms also matter.

Medical assessment is advisable when nasal congestion persists for more than ten days without improvement or worsens after initially getting better. Facial pain or pressure, particularly when accompanied by fever, can provide additional reasons to consult a healthcare professional.

Not every sinus or respiratory infection requires the same treatment. A doctor can evaluate the symptoms and determine whether further investigation or medication is needed.

Eye Symptoms That Should Not Be Ignored

Itchy or watery eyes can occur during periods of high pollution and are also common with allergies. However, not every eye complaint should be managed with over-the-counter allergy drops.

Dr Mandal advised seeking medical attention for eye pain, blurred vision or persistent redness that does not settle.

These symptoms may indicate an eye condition that needs a different approach to treatment. People should not assume that eye discomfort is harmless simply because it occurs alongside sneezing or nasal congestion.

Sudden vision changes or severe eye pain warrant urgent medical assessment.

Why Air Pollution Can Look Like a Seasonal Allergy

One reason pollution-related symptoms are overlooked is that they can closely resemble allergic rhinitis, a condition in which exposure to allergens triggers inflammation in the nose.

PM2.5 refers to fine particulate matter with a diameter of 2.5 micrometres or less. Because these particles are extremely small, they can penetrate deep into the respiratory system.

Exposure to fine particulate matter can irritate the airways and contribute to symptoms such as sneezing, throat irritation and watery eyes. Pollutants can also increase airway sensitivity to environmental triggers, including pollen and dust.

This means that symptoms may result from overlapping causes rather than a single allergy.

For example, someone who is sensitive to pollen may experience worsening symptoms when exposed to polluted air. Another person may develop respiratory irritation primarily because of pollution exposure.

The seasonal timing can make the distinction difficult. When coughs and runny noses become common during winter, people may assume that the symptoms are routine. However, persistent coughing, breathing difficulties, fever or unusual eye symptoms require closer attention.

The pattern of symptoms, their duration and the person’s medical history can help a healthcare professional determine the likely cause.

Which Groups Are More Vulnerable to Air Pollution?

Certain groups may be more susceptible to the effects of air pollution and respiratory infections. Dr Mandal identified children, older adults, pregnant women and people with existing health conditions as groups that should be especially cautious.

Children

Children may be vulnerable to polluted air because their respiratory systems are still developing. Persistent coughing, wheezing or breathing difficulties should not automatically be dismissed as seasonal complaints.

Parents and caregivers should seek medical advice if symptoms continue, worsen or interfere with a child’s normal activities.

Older Adults

Older adults may face a greater risk of complications, particularly if they already have heart or lung conditions. New or worsening respiratory symptoms warrant timely medical assessment.

Pregnant Women

Pregnant women should take persistent respiratory symptoms seriously and consult a healthcare professional when concerns arise. A clinician can recommend appropriate treatment and practical measures to reduce exposure to polluted air.

People With Asthma, COPD, Diabetes or Heart Disease

People living with asthma, chronic obstructive pulmonary disease (COPD), diabetes or heart disease may face additional risks from pollution exposure or respiratory infections.

For people with chronic lung conditions, polluted air may worsen existing symptoms. Those with heart disease may also need to take particular care when air quality deteriorates.

Anyone in these groups who develops persistent coughing, increasing breathlessness or other concerning symptoms should seek medical advice rather than relying on repeated self-treatment.

Why Self-Medicating With Allergy Tablets May Not Work

Antihistamines are commonly used to manage symptoms caused by allergic reactions. However, they may not adequately address airway inflammation caused by pollution or treat an underlying infection.

Dr Mandal cautioned that repeatedly taking allergy medication without identifying the cause of persistent symptoms can delay an accurate diagnosis.

For example, someone with a prolonged cough may assume that an antihistamine is sufficient, even when the symptoms need assessment for asthma, a respiratory infection or another condition.

The appropriate treatment depends on the underlying cause, the symptoms and the individual’s medical history.

People should consult a healthcare professional if symptoms persist despite treatment, return repeatedly or become more severe. Those with existing medical conditions, pregnant women and anyone uncertain about medication safety should seek advice before starting treatment.

Practical Ways to Protect Your Respiratory Health During Winter

Although not all pollution exposure can be avoided, several practical steps may help reduce exposure and support Respiratory Health.

1. Check the Local Air Quality Index

The Air Quality Index (AQI) provides information about local air pollution levels. Checking it before outdoor activities can help people make informed decisions about exercise, commuting and other plans.

When air quality deteriorates, consider limiting strenuous outdoor activity, particularly if you have asthma or another underlying health condition.

2. Wear a Well-Fitted N95 Mask When Necessary

When exposure to polluted air cannot be avoided, a properly fitted N95 respirator can help reduce the inhalation of fine particles.

Its effectiveness depends on an appropriate fit and consistent use. A mask should not replace reducing exposure whenever possible or seeking medical care for persistent symptoms.

3. Monitor Persistent Symptoms

Pay attention to how long symptoms last, whether they improve and whether new warning signs appear.

A cough that continues for weeks, unexplained fever or increasing breathlessness should not be ignored. Seeking medical advice early can help identify the cause and reduce the risk of inappropriate self-medication.

4. Follow Your Doctor’s Advice

People with asthma, COPD or other chronic conditions should follow their prescribed management plans and discuss worsening symptoms with their healthcare professional.

Avoid starting, stopping or repeatedly using medication without appropriate guidance, especially when the cause of symptoms is unclear.

When Should You See a Doctor?

A runny nose, sneezing or mild throat irritation may improve when exposure to allergens or irritants decreases. However, medical attention is advisable if symptoms persist, worsen or appear alongside other warning signs.

Consider arranging a medical evaluation if you experience:

• A cough lasting longer than two to three weeks.

• Coughing up blood or unexplained weight loss.

• Wheezing or breathlessness during everyday activities.

• Fever with facial pain or prolonged nasal congestion.

• Symptoms that worsen after initially improving.

• Eye pain, persistent redness or blurred vision.

Seek emergency care for severe breathing difficulty, chest pain, bluish lips or difficulty speaking in complete sentences. Sudden weakness, trouble speaking or other possible signs of a stroke also require emergency assessment.

These symptoms do not establish a diagnosis on their own. A healthcare professional can determine whether they are related to allergies, pollution exposure, an infection or another medical condition.

The Bottom Line

Seasonal allergies are common as winter approaches, but a runny nose, persistent cough or irritated throat should not always be attributed to changing weather. In polluted regions, PM2.5 can irritate the respiratory system, aggravate existing lung conditions and produce symptoms that resemble allergic reactions.

According to pulmonologist Dr Amit Kumar Mandal, a cough lasting more than two to three weeks, wheezing, breathlessness, fever with facial pain and persistent or painful eye symptoms are among the warning signs that deserve medical attention.

Checking local air quality, reducing exposure to pollution, wearing a well-fitted N95 mask when necessary and seeking timely medical advice can help people respond appropriately to respiratory symptoms.

Rather than relying on allergy medication alone, it is important to identify the cause of persistent or worsening symptoms, especially among children, older adults, pregnant women and people with existing health conditions.

Medical disclaimer: This article is for informational purposes only and is not a substitute for professional medical advice, diagnosis or treatment. Consult a qualified healthcare professional with questions about a medical condition. Dr Amit Kumar Mandal is the senior director of pulmonology at Paras Health, Panchkula, and has more than two decades of clinical experience.