Allergy seasons are getting longer and worse, and many people report symptoms that start earlier and last longer. Noah Greenspan, PT, DPT, a board-certified clinical specialist in cardiovascular and pulmonary physical therapy and founder of Pulmonary Wellness Complex PT, says increased heat, humidity, and greater prevalence of allergens are driving more exposure and poorer air quality, with impacts that vary by location.
The Asthma and Allergy Foundation of America (AAFA) ranked the top 100 “allergy capitals” in the contiguous U.S. for 2026. Rankings are based on pollen scores for tree, grass, and weed pollen, over-the-counter allergy medication use, and the number of allergy specialists. Compared with past years, more Western cities appear among the worst.
Top 20 worst U.S. cities for spring allergies (AAFA, 2026)
1. Boise, ID
2. San Diego, CA
3. Tulsa, OK
4. Provo, UT
5. Rochester, NY
6. Wichita, KS
7. Raleigh, NC
8. Ogden, UT
9. Spokane, WA
10. Greenville, SC
11. San Francisco, CA
12. Minneapolis, MN
13. Salt Lake City, UT
14. Richmond, VA
15. Colorado Springs, CO
16. Little Rock, AR
17. Toledo, OH
18. New Orleans, LA
19. Winston-Salem, NC
20. Lakeland, FL
You can find the full AAFA 2026 report for the complete list and methodology.
How to reduce exposure and manage symptoms
– Monitor local pollen counts and avoid outdoor activities when counts are high.
– Keep windows closed in your home and car; rely on your HVAC with clean filters to filter airborne allergens.
– Change HVAC filters regularly, especially during peak months.
– Remove shoes at the door, change clothes after being outside, and shower before bed to keep pollen out of living spaces.
– Wear sunglasses outdoors to shield your eyes from pollen.
Medication and medical care
Over-the-counter antihistamines, nasal sprays, and eye drops can help. Nicolle Overstreet, DO, a family physician, advises starting treatment promptly and suggests people begin meds about two weeks before symptoms typically begin each year to get a head start. If over-the-counter options aren’t effective, consult a healthcare professional about prescription treatments or allergy testing. Regular testing can help identify triggers and guide targeted management.
If you have chronic allergy-related inflammation, track symptoms to notice patterns and flare-ups so you can adjust prevention and treatment strategies accordingly.
