Seasonal Allergy Symptoms That May Need Medical Attention, Warns Pulmonologist

Seasonal allergy symptoms such as sneezing, a runny nose, an irritated throat and a persistent cough often become more common as winter approaches. While these symptoms may result from seasonal allergies, they can also indicate exposure to Air Pollution or an underlying respiratory infection. According to pulmonologist Dr Amit Kumar Mandal, mistaking pollution-related respiratory problems for ordinary allergies can delay an important medical diagnosis.

Air quality deteriorates across many parts of North India between October and February. During this period, rising pollution levels can aggravate existing respiratory conditions and cause symptoms that closely resemble allergic reactions. Understanding the difference between seasonal allergies, pollution-related irritation and respiratory infections is important for recognising when medical attention may be necessary.

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

Pollution may also increase the sensitivity of the respiratory system to pollen and dust, making otherwise mild seasonal symptoms more persistent.

The scale of the problem is significant. 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. Nearly nine in ten were associated with non-communicable diseases, including heart disease, lung disease and cancer.

Although not every cough or runny nose signals a serious health problem, certain symptoms should not be dismissed as seasonal allergies.

1. A Persistent Cough That Lasts More Than Two to Three Weeks

A cough is a common complaint during seasonal changes, but its duration and accompanying symptoms can help indicate whether further evaluation is necessary.

Allergy-related symptoms may improve when exposure to the triggering substance decreases. However, a cough that continues for more than two to three weeks deserves medical assessment, particularly if it disrupts sleep or becomes progressively worse.

Dr Mandal highlighted several warning signs that should prompt a consultation:

• A cough that persists beyond two to three weeks.

• A cough that regularly interrupts sleep.

• Coughing up mucus or blood.

• An unexplained loss of weight alongside a persistent cough.

These symptoms can occur in conditions other than seasonal allergies, including asthma, chronic bronchitis, lung infections and tuberculosis.

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

People should avoid relying on cough suppressants or allergy medication for prolonged periods without seeking medical advice when symptoms continue.

2. Wheezing, Breathlessness and Chest Tightness

Sneezing, itching and watery eyes are commonly associated with allergic reactions. Wheezing, breathlessness and chest tightness, however, may indicate a problem involving the airways or lungs.

According to Dr Mandal, difficulty breathing during routine activities, such as climbing a flight of stairs, should not automatically be attributed to seasonal allergies.

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

Symptoms that warrant medical attention include:

• Wheezing or a whistling sound while breathing.

• Shortness of breath during everyday activities.

• A persistent feeling of tightness in the chest.

• Breathing difficulties that are new, worsening or interfering with normal activities.

These symptoms may have several causes, so a medical examination is necessary to establish the diagnosis.

When Is Breathlessness an Emergency?

Certain symptoms require immediate medical attention rather than routine allergy treatment.

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 an increased risk of cardiovascular events, including heart attacks and strokes. People experiencing sudden chest pain, severe breathlessness or other alarming symptoms should seek emergency care without delay.

It is particularly important not to assume that new or severe breathing problems are simply the result of cold weather or seasonal allergies.

3. Fever, Facial Pain and Persistent Nasal Congestion

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

Dr Mandal explained that fever is not a typical symptom 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 evaluation is advisable when nasal congestion lasts longer than ten days without improvement or becomes worse after initially getting better. Facial pain or pressure, particularly when accompanied by fever, can provide additional reasons to seek medical advice.

Although many respiratory infections improve without specific treatment, others may require further investigation or appropriate medication. A clinician can assess the symptoms and determine the next steps.

Eye Symptoms That Should Not Be Ignored

Watery or itchy eyes can occur during periods of high pollution and are also common with allergies. However, not every eye complaint should be treated 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 requires a different treatment approach. People should not assume that eye discomfort is harmless simply because it occurs alongside sneezing or nasal congestion.

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

Why Air Pollution Can Feel 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 measuring 2.5 micrometres or less in diameter. Because these particles are extremely small, they can penetrate deep into the respiratory system.

Exposure can irritate and inflame the airways, producing symptoms such as sneezing, throat irritation and watery eyes. Pollutants can also increase airway sensitivity to other environmental triggers, including pollen and dust.

This means a person may experience overlapping effects from allergies and pollution rather than having only one cause for their symptoms.

The seasonal timing can make the distinction difficult. When respiratory complaints become widespread during winter, people may assume that their symptoms are routine. However, persistent coughing, breathing difficulties, fever or unusual eye symptoms require closer attention.

The most reliable way to distinguish between an allergy, pollution-related irritation and an infection is to consider the full pattern of symptoms and obtain a medical evaluation when necessary.

Who Is Most Vulnerable to Pollution-Related Respiratory Problems?

Some groups may be more vulnerable to the effects of air pollution and respiratory infections. Dr Mandal identified the following people as needing particular caution:

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 when symptoms continue, worsen or interfere with a child’s normal activities.

Older Adults

Older adults may be more susceptible to respiratory complications, particularly if they already have lung or heart conditions. New or worsening 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 advise on appropriate treatment and ways to reduce exposure to pollution.

People With Existing Health Conditions

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

For these individuals, worsening cough, breathlessness or other persistent symptoms should prompt medical advice rather than prolonged self-treatment.

Although these groups may need extra caution, anyone can develop a respiratory problem that requires professional assessment.

Why Self-Medicating With Allergy Tablets May Not Help

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 understanding the cause of persistent symptoms can delay an accurate diagnosis.

For example, a person experiencing a prolonged cough may assume that an allergy tablet is sufficient, even when the symptoms require an assessment for asthma, an infection or another respiratory condition.

Medication should therefore be chosen according to the underlying cause, symptoms and individual health circumstances.

People should consult a healthcare professional if symptoms persist despite treatment, return repeatedly or become more severe. They should also seek advice before starting medication if they have existing medical conditions, are pregnant or are unsure whether a product is appropriate for them.

Practical Ways to Reduce Exposure to Air Pollution

While medical evaluation is important when warning signs appear, reducing exposure to polluted air may also help protect Respiratory Health.

Dr Mandal recommended several practical precautions.

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, travel and other activities.

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

Wear a Well-Fitted N95 Mask When Necessary

When exposure to polluted air cannot be avoided, a properly fitted N95 respirator can help reduce inhalation of fine particles. Its effectiveness depends on fit and consistent use.

A mask should not be considered a substitute for reducing exposure whenever possible or following medical advice for respiratory symptoms.

Pay Attention to Persistent Symptoms

Monitor how long symptoms last, whether they are improving 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 prevent inappropriate self-treatment.

Follow Your Doctor’s Advice

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

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

When Should You Consult a Doctor?

A runny nose, sneezing or mild throat irritation may improve as exposure to allergens or irritants decreases. However, medical attention is advisable if symptoms persist, worsen or are accompanied by other concerning signs.

Arrange 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, difficulty speaking in complete sentences or sudden neurological symptoms such as weakness or trouble speaking.

These warning signs do not establish a diagnosis on their own. A healthcare professional can determine whether symptoms 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, exposure to PM2.5 can cause respiratory irritation, worsen 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, using a well-fitted N95 mask when necessary and seeking timely medical advice can help people respond more 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.