Quick answer: seasonal allergies — hay fever, pollen allergies, allergic rhinitis — are managed in the U.S. with two over-the-counter products you can grab without a prescription at CVS, Walgreens, Walmart or the grocery store: a second-generation antihistamine (loratadine/Claritin, cetirizine/Zyrtec or fexofenadine/Allegra) for the itching and sneezing, and a steroid nasal spray (fluticasone/Flonase, triamcinolone/Nasacort or mometasone/Nasonex 24HR), which is the most effective option for a stuffy nose. Follow the directions on the label exactly.
Allergies or a cold? How to tell
The answer usually comes down to three things: the itch, the fever, and how long it lasts.
- It itches. Allergies itch — eyes, nose, roof of the mouth, ears. A cold aches instead.
- Fever. Allergies do not cause a fever. If there is a fever, think infection, not pollen.
- Duration. Colds and flu wrap up in a few days to about two weeks; allergies drag on for weeks or months, as long as the pollen is around.
- Mucus and sneezing. With allergies the drainage stays thin and clear and the sneezes come in runs, often the moment you step outside. With a cold the mucus thickens as the days go by.
If it shows up the same month every year, or every time you mow the lawn, it is seasonal allergies. If body aches and fever are in the mix, read our guide to cold and flu.
What you can buy without a prescription
Everything below is on the allergy aisle of any U.S. pharmacy, no prescription needed. Read the label and follow the directions exactly — the right amount depends on age and weight, so never estimate it yourself.
1. Second-generation antihistamines
These are the foundation: they handle itching, sneezing and runny nose, and rarely make you sleepy.
- Loratadine (Claritin, Alavert) and fexofenadine (Allegra): the least sedating — a good pick if you drive or run machinery.
- Cetirizine (Zyrtec) and levocetirizine (Xyzal): stronger for many people, though a portion of them feel drowsy on it.
Store brands (Equate, CVS Health, Walgreens) hold the exact same active ingredient for a fraction of the price. Compare the Active ingredient line, not the brand on the front.
One note about cetirizine: in 2025 the FDA required a new warning because some people who took cetirizine or levocetirizine daily for months or years developed severe, widespread itching after stopping abruptly. It is rare, but if you have taken either one every day for a long stretch, taper off with guidance instead of quitting cold turkey.
2. Diphenhydramine (Benadryl): handle with care
This is a first-generation antihistamine. It works, but it makes you very drowsy, the grogginess can carry into the next day, and it dulls your driving even after you stop feeling sleepy. It is no longer recommended as a daily treatment for seasonal allergies — the second-generation options do the same job without knocking you out. In older adults it can cause confusion and falls. Never use it to make a child sleep.
3. Steroid nasal sprays: the most effective for congestion
Sold without a prescription: fluticasone (Flonase), triamcinolone (Nasacort Allergy 24HR) and mometasone (Nasonex 24HR Allergy). Three things that change the result:
- It is not a rescue spray. Full effect builds over several days of steady use, so it works best taken every day of your season rather than only on bad days.
- Aim outward, toward the ear on the same side, away from the septum in the middle. That is how you avoid burning and nosebleeds.
- Start early. Starting a week or two before your season beats starting once you are already congested.
4. Eyes, saline and decongestants
- Antihistamine eye drops: ketotifen (Zaditor, Alaway) calms itchy, watery eyes.
- Saline rinse (spray or neti pot): rinses pollen out, with no medicine in it. Use distilled, previously boiled and cooled, or bottled water, never the tap.
- Decongestants: products with pseudoephedrine (Sudafed) are kept behind the pharmacy counter and require an ID. Oral phenylephrine — the ingredient in many products labeled D or PE — was challenged by the FDA because the studies do not show it works when swallowed. Sprays such as oxymetazoline (Afrin) are strictly short-term: more than about three days in a row causes rebound congestion, leaving your nose worse than before.
How to read the Drug Facts label
Every OTC box in the U.S. carries the same black-and-white panel. Check four lines: Active ingredient (what is actually in it), Uses (if your symptom is not listed, it is not your product), Warnings (pregnancy, high blood pressure, prostate problems, glaucoma) and Directions (how much, how often, and the minimum age). If you already take a cold or flu combination product, check whether it contains an antihistamine — doubling up without realizing it is the most common cause of accidental overdose. Full breakdown in our guide to over-the-counter medicines in the U.S.
Pollen depends on where you live
- Trees go first: February through April in the Northeast and Midwest (oak, birch, maple, cedar). Mild Southeastern winters push the start earlier and stretch the season longer.
- Grasses take over in late spring and early summer, roughly May through July.
- Ragweed owns the fall. It releases pollen from August onward and usually peaks in late August and September.
- Mountain cedar in Texas and the Southwest brings the famous cedar fever in the dead of winter, from December and January. In South Florida and California, mild weather stretches the season across most of the year.
Simple habits that genuinely help: keep car and house windows closed on high-pollen days, shower and change clothes when you get home, and dry laundry indoors.
When telehealth is not the answer
- Anaphylaxis: trouble breathing, swelling of the lips, tongue or throat, a hoarse voice, severe dizziness or fainting. That is 911.
- Asthma getting out of control: wheezing, shortness of breath, or a rescue inhaler that stops working.
- Symptoms that do not improve after several weeks of correct OTC treatment, or fever, strong facial pain and thick one-sided drainage.
- Allergy testing, allergy shots (immunotherapy), or any medicine that requires a U.S. prescription: that belongs with an allergist licensed in your state.
Where Doctor Matt fits in
Our doctors are Colombian physicians licensed in Colombia, and they see you by video while you are in the United States. We review your symptoms, help you separate allergies from an infection, and walk you through which over-the-counter products to pick up and how to use them. We see patients with or without insurance, every day from 7:00 a.m. to 9:00 p.m. Colombia time. Visits are conducted in Spanish.
And the limits, stated plainly: we are not licensed in any U.S. state, we do not issue prescriptions valid at U.S. pharmacies, and we have no physical clinic in the United States. We handle minor concerns; emergencies belong to 911. We see children from about age 1 to 2 and up, not newborns. If your case needs a prescription, testing or a hands-on exam, we say so honestly.