A man about to sneeze

What exactly is making you sneeze and sniffle this time of year? It’s not always easy to say. Colds and seasonal allergies share a lot of uncomfortable symptoms.

Both commonly occur during spring and fall (although colds also show up in the dead of winter). And both can involve a stuffy nose, an itchy throat, and watery eyes.

But there are a few key differences between the two conditions. Here, a bit of insight into how health professionals make the right diagnosis—and what you need to know to treat each effectively.  

Check Your Symptoms

One way to distinguish between a cold and allergies is to look at all the symptoms and evaluate the presence and severity of each, says Marvin M. Lipman, M.D., Consumer Reports’ chief medical adviser. That can help you (and your healthcare provider) get a feel for which condition is at the root of the problem. 

  1. Fever. Seasonal allergies won’t present with a low-grade fever, but a bad cold often will, Lipman says. (The fever associated with a flu, meanwhile, tends to be higher—often above 100° F.)
  2. Aches and pains. Tender muscles and body aches point to colds (along with some other viral infections), not seasonal allergies. “Aches and pains with a [low-grade] fever are usually symptoms of a cold,” says Jay Portnoy, M.D., a professor of pediatrics in the division of allergy, asthma, and immunology at Children’s Mercy Kansas City in Missouri.
  3. Sneezing. You’ll need to keep tissues on hand for both a cold and seasonal allergies—just keep an eye on how long the sneezing persists. Sneezing is usually apparent at the outset of a cold but disappears after one to two days, according to Lipman. On the other hand, sneezing brought on by seasonal allergies lasts much longer, from weeks to months.
  4. Watery eyes. Teary, itchy eyes are typically brought on by an allergy, says Portnoy.
  5. Runny nose. A nose that practically feels like a faucet is common for both conditions. Just pay attention to the color of the mucus to determine the cause. “For allergies mucus is usually clear,” Lipman says. “A viral infection or cold has mucus that is either greenish or yellowish, or some sort of color.”
  6. Sore throat. Allergies can cause a mildly scratchy throat. But an intensely itchy, painful, and sore throat usually points to a cold, or another viral or bacterial infection, says Portnoy.
  7. Timing. Colds happen in episodes. After about a week or two, a cold and all its symptoms disappear. But the symptoms of seasonal allergies can stick around for weeks and even months, according to Portnoy.  

How to Treat Seasonal Allergies

If your seasonal allergies are mild, an over-the-counter oral antihistamine such as cetirizine (Zyrtec Allergy and generic), fexofenadine (Allegra Allergy and generic) or loratadine (Claritin and generic), should do the trick.

more on colds and allergies

But for moderate to severe allergic rhinitis, or allergies that worsen as the pollen count climbs, consider using nasal steroids, says Portnoy. Several, such as budesonide (Rhinocort Allergy), fluticasone (Flonase Allergy Relief), and triamcinolone (Nasacort Allergy 24 HR) are now available over-the-counter.

“Oftentimes patients get worse not because the antihistamine stopped working, but because the allergy overwhelmed it,” Portnoy says. “[Nasal sprays] are stronger than oral antihistamines because you’re getting the effect right in the nose where the problem is.” And nasal steroids are safe for long-term use, he says, unlike nasal decongestants, such as Afrin.

Intranasal steroids may also provide better relief than oral antihistamines for teary eyes, according to a report published in The Journal of Family Practice.

Make sure to spray them safely, pointing the tip up and slightly outward, tilted toward the ear, suggests Mark Dykewicz, M.D., the Raymond and Alberta Slavin Endowed Professor in Allergy & Immunology at the Saint Louis University School of Medicine.

To keep the medication from either dripping down the back of the throat or dripping from the nostrils, Dykewicz tells patients “to go nose to toes” for 20 to 30 seconds immediately after spritzing. Either bend over while standing or seated on the edge of a chair to let the spray settle in.

How to Treat a Cold

All of our experts suggest a decongestant to help cope with a cold. Evidence shows that phenylephrine (Sudafed PE and generic) is less effective than pseudoephedrine (Sudafed and generic); to get the stronger stuff, which is stored behind the pharmacy counter, you’ll need to ask for it—and show I.D. (No prescription is required, though.)

A nasal decongestant such as oxymetazoline (Afrin and generic) can also do a good job of clearing a stuffy nose, Lipman says. (Just be sure you don’t use it for more than three days, since longer use can cause rebound congestion.)

Finally, be sure to rest. “Drink plenty of fluids including good old chicken soup. Avoid vigorous exercise and take it easy,” Lipman says. “Just give in to the cold for a few days.”