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AAFA Names 100 Most Challenging Cities to Live in for Fall Allergies

When you think of fall, what comes to mind? Changing leaves, cooler weather and pumpkin spice lattes? Or sniffling, sneezing, allergy medicines and the dreaded ragweed? If it’s the latter, you are not alone. About 10 to 20 percent of Americans are allergic to ragweed, fall’s biggest allergy offender.

Ragweed and other fall allergens are found throughout the U.S., but some areas feel the effects more than others. The Asthma and Allergy Foundation of America (AAFA) has released the 2018 Fall Allergy Capitals™ reportDownload PDF. We ranked the top 100 cities in the nation for fall allergies. AAFA calculates the rankings based on:

  • Pollen counts
  • Use of allergy medicines
  • Availability of board-certified allergists

McAllen, Texas, is the #1 fall allergy capital for 2018. It was also at the top of our list of Spring Allergy Capitals™. McAllen is at the top for its high pollen, high allergy medicine use and low number of allergy specialists.

The 10 most challenging places to live with fall allergies in 2018 are:

  1. McAllen, Texas
  2. Louisville, Kentucky
  3. Jackson, Mississippi
  4. San Antonio, Texas
  5. Dayton, Ohio
  6. Providence, Rhode Island
  7. Memphis, Tennessee
  8. Syracuse, New York
  9. Oklahoma City, Oklahoma
  10. Toledo, Ohio

“AAFA’s annual Fall Allergy Capitals™ report provides important insights into cities where people are most affected by seasonal symptoms from environmental factors like pollen, use allergy medication frequently and don't have ready access to board-certified clinicians,” says Kenneth Mendez, President and CEO of AAFA. “Whether you live in an allergy capital or not, it’s important to work with your health care provider to recognize the elements that trigger your allergies and determine the best treatment to enjoy your life unrestricted by seasonal allergies.”

Symptoms of a nasal allergy can include sneezing, congestion, itchy eyes and a runny nose. This is often called “hay fever” or allergic rhinitis. A pollen allergy can also cause allergic asthma to flare.

Ragweed isn’t the only allergen to cause symptoms in the fall. Other fall plants, mostly weeds, that cause problems include:

  • Pigweed
  • Burning bush
  • Cocklebur
  • Sagebrush
  • Mugwort
  • Lamb’s-quarters
  • Tumbleweed
  • Russian thistle

Mold can be an issue year-round but counts tend to go up in the fall. Damp, fallen leaves create a perfect environment for mold growth. Many areas of the U.S. are also still warm, rainy and humid in the early fall – another factor that encourages mold.

In this year's report, we added information on Alaska and Hawaii – two states that were not included in past reports. Alaska is seeing the effects of climate change faster than the rest of the U.S. This is causing dramatic increases in pollen allergies.

Hawaiians, on the other hand, deal with volcanic smog (“vog”), along with allergens and irritants. Vog can make preexisting respiratory conditions, such as allergies or allergic asthma, worse.

If I Live in a Top Allergy Capital, Can I Still Get Relief?

Yes! There are options for allergy treatment everywhere. See a board-certified allergist to be tested and discuss treatment options.

“Too often, people with seasonal allergies suffer silently while their symptoms worsen year after year,” states Neeta Ogden, M.D. and medical spokesperson for AAFA. “Allergy sufferers need to learn more about triggers and visit a specialist for a proper diagnosis and treatment. Often more can be done to relieve allergy symptoms that interfere with daily life.”

Ways to get allergy relief:

  • Limit your exposure to pollen.
  • Use CERTIFIED asthma & allergy friendly® products to help reduce your exposure to allergens.
  • Ask your doctor about long-term allergy treatments.
  • Plan for fall allergy season before it starts, especially if you live in one of the top cities.

Learn more about how your city ranks at

How Can I Learn More About the Report?

The Fall Allergy Capitals™ ranking is an annual research and educational project of AAFA. It is designed to help patients recognize, prevent and safely treat allergy symptoms. Through this ranking, AAFA raises awareness about the impact of seasonal allergies. It provides helpful information that can improve the quality of life for people living with seasonal allergies. The ranking is based on local pollen levels, use of allergy medicine and the number of board-certified allergists in each metro area. Visit to see the full list, study methodology and to learn more about allergy diagnosis, prevention and treatment.

Are you dealing with fall allergy symptoms? Join our community to chat with others who manage pollen allergies. And follow our blog for more news and tips on taming your nasal allergy symptoms.


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