Is Your City a Top Allergy Capital?

If you’re already starting to sneeze, cough, and itch more than usual, you may want to think about where you live. The Asthma and Allergy Foundation of America’s 2025 rankings found that certain cities are particularly brutal for people who are allergic to pollen.

According to the report, climate change is causing pollen season to start earlier and last longer. As a result, the burden of environmental allergies is growing across the United States, William Anderson, MD, the clinical medical director of the Allergy and Immunology Clinic at the University of Colorado Anschutz Medical Campus, told Health.

Still, some urban areas are more challenging than others for people with pollen allergies. Read on to learn if you live in a top “allergy capital”—and what you can do about pollen allergies regardless of where you live.

Pollen is airborne particles dispersed from flowers, plants, trees, grass, and weeds. It can travel hundreds of miles and is all around us. We’re continuously exposed to pollen, Anderson said.

People with a pollen allergy have antibodies in their bloodstream that identify and attack the pollen when exposed to it, Ahmed Soliman, MD, the director of the Temple Head & Neck Institute and an otolaryngologist at Temple University Hospital, told Health.

This reaction triggers their mast cells, a specialized cell in the bloodstream, to release a chemical called histamine, which causes allergic symptoms like sneezing, runny nose, nasal congestion, and red, watery eyes.

There are three main types of pollen: weed pollen, tree pollen, and grass pollen. Tree pollen tends to erupt in the spring, grass pollen explodes in the summer, and ragweed spikes in the fall.

According to Anderson, allergies vary from person to person, depending on how their body’s immune system responds to various types of pollen. “One person may be allergic to grass pollen while the other may be allergic to tree pollen,” he said.

The route of exposure plays a role, too. “If someone inhales pollen through their nose, they may have more nasal symptoms, while if pollen gets on their skin, they can have rashes or hives,” Anderson said. And the more pollen exposure a person has, the greater their reaction will be.

The researchers examined pollen scores, over-the-counter medication use, and access to allergen specialists to understand how pollen allergens affected U.S. cities in 2024.

For a third year in a row, Wichita, Kansas, ranked number one. In second place was New Orleans, followed by Oklahoma City, Oklahoma; Tulsa, Oklahoma; and Memphis. You can find the full list on the AAFA’s website. 

The type of pollen also varied in severity, depending on location and time of year. In Austin and Las Vegas, tree pollen was more of a problem in March and April, whereas grass pollen was a bigger threat in Richmond, Virginia, and Rochester, New York, in May and June. Weed pollen, on the other hand, afflicted Bakersfield, California, and Boston the worst—typically in September and October.

In general, the cities in the southern and eastern parts of the country had the most significant pollen problems. According to Anderson, southern regions typically see warmer, wetter climates, which is ideal for plant growth.

Notably, California experienced major jumps in both grass and weed pollen counts. For example, Sacramento shot up from 94th place in 2024 to 23rd this year, thanks to a spike in grass and weed pollen. Bakersfield, Stockton, San Jose, Fresno, Oxnard, Los Angeles, and San Francisco saw similar patterns.

One thing that’s increasingly clear: Climate change is worsening allergies in pretty much every area. As the temperature gets warmer, the first and last frost dates fluctuate, which means plants release pollen longer in the fall and earlier in the spring, Anderson explained. 

“Ultimately, this will cause individuals to be more likely to develop allergies, and their existing allergies may get worse,” Anderson said.

According to the report, past research found that pollen seasons begin roughly 20 days earlier and last 10 days longer compared to 30 years ago. And that trend isn’t expected to slow down anytime soon. Some estimates suspect that by the end of the century, spring pollen season will start up to 40 days earlier, and summer and fall pollen seasons will end up to 15 days later. 

Warming temperatures increase not only the length of the pollen season but also its intensity. Plants grow better in warmer weather for a longer period of time, which means they release more pollen. Past research also shows that higher levels of carbon dioxide gas in the environment are associated with more pollen. 

It’s best to hold off, the researchers say. Even if you live in a city that’s low on the list, your area likely still has pollen. And if you move away, there’s a risk that you could develop allergies to the pollen in your new town, the report states.

The report ranked cities based on pollen scores, medication usage, and the number of allergists nearby. So, while your location may have a more moderate pollen count, medication usage may be sky-high.

And, as the report revealed, several cities lack board-certified allergists, meaning people may be suffering but not getting the allergy care they need, according to Anderson. “This shows the need to train more allergists and recruit them to these more affected cities,” he said. 

Before you dream up a move, Anderson recommends undergoing allergy testing to see if pollen is the source of your symptoms. “An allergist can use this information to provide guidance on which seasons you need to be most vigilant to treat your allergies,” he said.

Multiple treatments can help those who struggle with seasonal allergies. Corticosteroid nasal steroids can alleviate symptoms, as can oral and topical antihistamines, like loratadine, cetirizine, and leukotriene inhibitors. 

Some people may benefit from immunotherapy, either as an injection or sublingually, to regulate their body’s immune response to allergens. 

Over-the-counter solutions, such as nasal rinses, are available to clear the sinuses. Eye drops can reduce burning, itchiness, and swelling, and decongestants, like Sudafed oral pills and Afrin nasal spray, can provide short-term relief.

Lifestyle changes can also make a difference. Stay indoors when pollen counts are high, and plan outdoor activities when counts are low. Run the air conditioning, use air cleaners with HEPA filters, and regularly wash your bedding, floors, rugs, and furniture. On those high-pollen days, it can help to wear a hat or mask to limit how much pollen you inhale. You can track local pollen activity in your local weather report or the Pollen Wise app. 

Pollen is here to stay, but there’s a lot you can do—even if you live in Wichita, Kansas—to manage your symptoms and protect your quality of life.