It it a Cold, Sinus Infection, or Allergy?

In Arizona, one of the challenges patients and physicians face during February and March is determining if that runny nose, scratchy throat, and sinus pain is the beginning of the spring allergy season, a late winter cold, or worse.  Here are a few clues to help sort it out.

  1. Allergy itches.  Most seasonal allergy attacks involve itching, either of the eyes, the nose, the throat, or skin.  When an allergic reaction occurs, histamine is released into the tissues causing redness, swelling, and itching.  Histamine is also released during a viral cold (which is why antihistamines are frequently prescribed for a cold) but this is not the primary chemical mediator causing symptoms.  If there is no itching, it probable isn’t allergy.
  2. Colds last about a week. Viral cold symptoms peak around day three, begin to level off by day five, and then begin to resolve.  You may not be well by the seventh day but you should be significantly better compared to how you felt on day three.  A sinus infection is usually a viral cold that becomes complicated by a bacterial infection.  It begins like a cold but rather than getting better by day seven, things are getting worse with increased discharge, pain, and possible fever.  You should see a doctor if cold symptoms persist or worsen beyond the seven day mark.  The allergy timeline is much less predictable with allergy symptoms coming and going throughout the season.
  3. Everyone else is sick.  If everyone in your cubicle, classroom, or home has the same deep cough or sore throat, it is likely a cold.  During a rough allergy season, a lot of people may be sneezing at the same time, but those affected do not cluster in a family, school,  or work-place the way a communicable virus does.
  4. Olive trees in winter.   If you know what you are allergic to (Olive trees, for example) and you know when they pollinate (Olive tree in April), it is unlikely that your February and early March symptoms are caused by allergies (if Olive is the only thing your allergic too).