Most people have heard of hay fever and hives. And who doesn’t cough? So let’s start with the medical names for some common symptoms of allergies. It’ll help you decode the information that comes with any allergy medication.

• Allergic rhinitis: A blocked or runny nose, plus sneezing. Seasonal allergic rhinitis, also known as hay fever, is linked to outdoor allergens such as pollen. Perennial allergic rhinitis means symptoms can be year-round. They happen indoors from allergens such as dust mites.

This is one of the signs it might not be a cold or flu. There are others too. Read on to find out why you might get an allergy cough and how to tackle it.

Coughing can be voluntary. You do it consciously to clear your throat. Coughing can also be involuntary. Nerve endings in your nose, mouth or throat detect something foreign or irritating. They send signals to a cough center in your brain. Impulses from this cough center then tell the spinal motor nerves in your diaphragm, abdominal wall and muscles to move. It’s a cough reflex. An allergy cough is like that.

You could have hay fever from tree pollen, grass or weeds. Maybe you react to mold spores.

Animal dander or dust mites may give you perennial allergic rhinitis. A common symptom triggered by all these common allergens is postnasal drip. The trickle of watery mucus drips down the back of your throat and irritates it. Messages race off to the cough center. And you cough.

Allergies can also make you cough when you breathe in these harmless substances. Your immune system thinks the foreign particles are a threat and reacts by causing inflammation in your airways. An allergy cough can be one of the symptoms. Sometimes it’s the only symptom. 

• Often with postnasal drip (also known as upper airway cough syndrome)
• Often worse at night
• Typically lasts longer than three weeks

A tell-tale sign can be if you have other hay fever symptoms at the same time. For instance, a runny nose or maybe a stuffy nose, sneezing, itchy eyes or dark circles under your eyes. You might also get lower respiratory symptoms like shortness of breath, chest tightness and wheezing.

Allergic rhinitis can feel like a cold. They have similar symptoms because colds can cause rhinitis too along with a dry cough. Sometimes it may be difficult to know whether your immune system is fighting off an allergen or a cold virus.

There are differences though. Cold symptoms appear gradually and usually last about one to three weeks. An allergy cough may go on for as long as you’re exposed to your trigger. For instance, a hay fever cough could linger the whole pollen season. You may be glued to the pollen forecast for several weeks.

Allergy symptoms tend to have a pattern. They usually appear soon after exposure to your allergen. For instance, it might be an allergy cough if it happens mostly outdoors or when visiting friends with a pet.

Only your healthcare provider will be able to say for certain if you have a hay fever cough or an allergy cough triggered by dust mites, pet dander or mold. Try to remember when and where it first developed. You may find it useful to keep an allergy diary. Jot down if it’s worse at a certain time of the year (seasonal allergies), inside or outdoors.

Your healthcare provider will look at your medical history. They may give you a physical exam and listen to your chest. Whistling sounds when you breathe out is one of the tell-tale signs of lower respiratory symptoms. A skin prick or blood test may help make the diagnosis. If it is allergy, your healthcare provider will discuss ways to avoid your trigger and your treatment options.

Water with honey and lemon can be soothing. Or take a spoonful of honey (not for children under one); studies suggest it may be as effective at stopping a cough as most over-the-counter medications.

Make sure you stay hydrated. And try sleeping propped up on pillows. The first thins mucus. The second stops it from collecting at the back of your throat and making you cough. Coughing interrupts sleep. That can make you tired, affecting concentration and performance at school or work.

If drug-free remedies don’t seem to be working, then medication is the next option. Your allergy cough relief options may include:

• Antihistamines: Tablets containing loratadine, fexofenadine or cetirizine can help with allergic postnasal drip. Nasal antihistamine sprays containing azelastine can also reduce postnasal drip.
• Decongestants: Can reduce postnasal drip by drying out your airways. Nasal sprays and drops should only be used for short periods or they may make your symptoms worse.
• Corticosteroids: Steroid nasal sprays can help reduce postnasal drip. Some are available over-the-counter, while others need a prescription. Steroid inhalers containing fluticasone, beclomethasone or budesonide can treat lower respiratory symptoms. They are for calming the inflammation of the airways causing an allergy cough.
• Bronchodilators: Sprays containing albuterol (also known as salbutamol) may open the airways. They’re short-acting so may be used in combination with steroid inhalers.

Treatments such as these may provide short-term relief for your allergy cough symptoms. Some are available with a prescription, others over-the-counter. You may also have seen expectorants at the pharmacy. The most common ingredient in these cough remedies is guaifenesin. Expectorants are meant to thin mucus making it easier to clear. Studies into their effectiveness have had mixed results. You may find one that works for you. Ask your pharmacist for advice.

• cough for more than a few weeks
• have a severe cough or it gets worse quickly
• get chest pain
• lose weight and don’t know why
• have swollen glands in your neck
• have difficulty breathing
• see blood in your mucus

Allergy immunotherapy means either regular injections (allergy shots) at the doctor's office or taking tablets under your tongue – first at the doctor's office and then at home. Treatment takes three to five years. You’ll need to complete the full course even if your allergy cough disappears sooner. Your healthcare provider can tell you if it might be right for you.

Occasionally a cough can be a sign of something more serious. Seek medical attention if you:

• cough for more than a few weeks
• have a severe cough or it gets worse quickly
• get chest pain
• lose weight and don’t know why
• have swollen glands in your neck
• have difficulty breathing
• see blood in your mucus

Allergies and this troublesome viral infection have confusingly similar symptoms. For instance, a dry cough. But COVID-19 can also cause fever, chills and body aches which you don’t usually get alongside an allergy cough. Feeling tired and weak is less common with allergies, as is losing your sense of taste and smell. You can check the up-to-date health information about COVID-19 here. If in any doubt, get yourself tested.