Spring pollen washed away months ago, but that doesn't mean everyone's out of the woods when it comes to seasonal allergies.
Fall marks the beginning of cold and flu season, but it's also a time when many people experience allergy symptoms.
In the Southeast, fall allergies can flare up in August and usually fizzle out by mid-November.
Spring allergies are more notorious than fall allergies, because the tree species that pollinate in the spring produce more pollen than fall weeds.
But ragweed, the primary pollen source, or allergen, that grows in the fall can produce up to 1 billion pollen grains, which are lightweight and may travel hundreds of miles in the wind, according to the American Academy of Allergy, Asthma and Immunology's website.
"We have a high amount of pollen, because our weather is fairly mild, our winters aren't that terribly cold, and ragweed will last until the first frost," said Dr. Mark Cromie, an allergist and president of the Chattanooga Allergy Clinic. "Allergies can be anywhere but the Southeast is more of a pollen belt because of our climate."
Symptoms of seasonal allergies, often called hay fever or allergic rhinitis, include runny nose, sneezing, nasal congestion and itching around the face.
Some people can alleviate symptoms using an over-the-counter antihistamine, nose spray and sinus rinses, but others with more severe symptoms may benefit from medical care under a board-certified allergist who can administer allergy tests and treatment.
Allergic reactions occur when the body's defense, or immune system, overreacts by attacking a normally harmless substance, like pollen, dust, mold, some foods and medications.
"Food allergies are more rare, but are potentially much more dangerous - pollen is not going to cause a life-or-death situation, but a peanut allergy could," Cromie said.
The worst outcomes of seasonal allergies are chronic sinus disease, chronic ear infections and exacerbations of underlying asthma, which can cause asthma attacks and hospitalizations.
Dr. Susan Raschal, an allergist at Covenant Allergy and Asthma Care, said about 30 percent of the population is genetically predisposed to allergies, but patients often struggle to distinguish between allergies and other sinus conditions.
"People frequently think they have allergies, and it's not, and then other people think that it's a sinus infection when it's not," she said, adding that the best indication of allergies, or allergic rhinitis, is a nasal symptom combined with itching of the eyes, nose, throat, mouth or ears.
"If they have colored discharge, then immediately they say infection, and for them what that means is an antibiotic," Raschal said. "But the truth is that the majority of people have viral infections, and viruses do not respond to antibiotics."
Tiffany Potter, nurse practitioner at CHI Memorial Convenient Care in Cleveland, Tenn., said the protocol is to limit antibiotic use in patients with symptoms lasting less than a week.
"Nasal drainage can be a rainbow of colors but not necessarily be a bacterial sinus infection requiring antibiotics," Potter said.
She said sometimes color indicates strong immunity and that cells are responding to infection.
As research grows, practitioners are more aware of the dangers of antibiotic misuse.
"Bacteria are very smart, and they will become resistant to the antibiotics that we already have," Potter said. "We want people to feel better - we just don't want to overuse antibiotics in the wrong way."
Contact staff writer Elizabeth Fite at efite@timesfreepress.com or 423-757-6673.