Iowa Specialty Hospital

Sneezing: Is It Allergies Or Something Else?

September 18, 2023

You’re sniffling, sneezing, and you feel crummy.  Allergies may be your first thought, especially if you have a history with them.  As seasons shift, however, it can become harder to distinguish between the symptoms of seasonal allergies and those of the common cold, the flu, and COVID-19, since they can all have similar symptoms.  This can lead to confusion as to when you should seek medical care. 

Seasonal Allergies

Allergies occur when your immune system reacts to a foreign substance, such as pollen, bee venom, pet dander, or a food that doesn’t cause a reaction in most people.  Your body’s immune system produces substances known as antibodies that identify a particular allergen as harmful, even though it isn’t.  This reaction can cause you to experience symptoms such as sneezing, a runny nose, watery eyes, itchy skin, or a scratchy nose or eyes. The severity of allergies varies from person to person and can range from a minor irritation to anaphylaxis – a potentially life-threatening emergency.  While most allergies can’t be cured, treatments can help relieve your allergy symptoms.

The Common Cold

Respiratory allergies and colds can look and feel a lot alike.  They both cause similar symptoms, such as sneezing and a runny or stuffy nose.  However, unlike allergies, colds are caused by a virus, so you can spread them to other people.  A cold probably won’t give you itchy eyes, but you may have aches, pains, or a fever – all of which don’t happen with allergies.  Colds can last from 3-10 days, whereas allergies can last an entire season or longer.

The Flu

As with a cold, the flu is caused by a virus – a strain of the influenza virus. The symptoms are also similar – a runny or stuffy nose, a sore throat, and coughing.  In general, however, you feel worse with the flu than when you have a cold.  The flu comes on quickly, accompanied by chills, muscle aches, and tiredness.  It can also cause a high fever that may last for a few days or longer.  You’ll rarely have these more serious symptoms with a cold, and never with allergies.


COVID-19 is caused by the SARS-CoV-2 virus. As with the common cold and the flu, this virus is spread by tiny particles that originate from the lips and nose when a person sneezes, coughs, sings, or touches a surface, such as a phone or computer keyboard, and is then transmitted into the mouth, nose, or eyes.  The most common symptoms of COVID-19 are fever, cough, and tiredness.  However, there are many other possible signs and symptoms which may include a sore throat, runny or stuffy nose, diarrhea, nausea, or vomiting.  Most colds do not include diarrhea, nausea, or vomiting, and a fever is rare with the common cold.

Sinus Infection

One difference between allergies and a sinus infection is itchy eyes.  A sinus infection rarely causes irritated, water eyes.  Another symptom to watch for is thick mucus that is either yellow or green – that’s more likely a sign of a sinus infection. Fever, tooth pain, and bad breath are also sometimes symptoms of a sinus infection; you won’t have these with allergies.

Timing and Duration of Symptoms

The timing of your symptoms and their duration can help you determine what is ailing you.  While COVD-19 symptoms generally appear two to 14 days after exposure, the symptoms of a common cold usually appear one to three days after exposure.  As far as duration, a cold or virus will typically run over 10 days to two weeks.  With COVID-19, many people have reported experiencing symptoms that have lasted several weeks and even months.

What You Can Do

If you are known to have allergies, the best way to prevent issues is to avoid your known triggers.  For example, if you’re allergic to pollen, you can stay inside as much as possible with windows and doors closed when there is a lot of pollen in the air.  If you’ve been outside, take a cool shower and change your clothes. Avoiding your known triggers is the best way to prevent issues. Stay on top of allergy medications as well.  Allergies usually subside when you avoid your triggers and take allergy medication, such as antihistamines or nasal sprays.

If allergies are causing your symptoms, you may also benefit from visiting with an allergist to see if additional medical therapy is available for you.

If you’re experiencing certain symptoms, however, such as a cough that lingers or congestion and sinus pain, it is worthwhile to connect with your provider to rule out whether you may have another condition, such as bronchitis. 

Colds are the main cause of acute sinusitis, and most episodes resolve in about a week to 10 days.  Multiple treatment options are available, including over-the-counter medications, nasal sprays, steroids, and antibiotics. 

Getting vaccinated against the flu and COVID-19 are also good ways to reduce the severity of your symptoms during future illnesses.

As always, seek immediate medical attention if you are coughing up blood, experiencing pain, or have shortness of breath.


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