Symptoms and Treatment of Grass Allergy

Even though grass is everywhere, you can live well with this allergy.

Grass Allergy
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Does breathing in the fresh air of a beautiful spring day trigger itchy eyes and a runny nose? Or do you experience an itchy rash by simply sitting on a grassy hill?

If so, you may be experiencing a grass allergy. This type of allergy is common and can occur from breathing in grass pollen or in some people, direct skin exposure to grass.

Interestingly, grass allergy can also be associated with fruit pollen syndrome, resulting in food allergies to tomatoes, potatoes, and peaches.

What Are the Symptoms of a Grass Allergy?

Grass pollen is most present in the air during the late spring or early summer months, and it's known to cause a variety of different allergic symptoms like:

  • Allergic rhinitis (sneezing, runny and stuffy nose, nasal congestion)
  • Allergic conjunctivitis (itchy, watery and/or red eyes)
  • Asthma (a cough, wheezing, chest tightness, trouble breathing)

One reason why grass allergy is so common is that the pollen is scattered by the wind and not carried around by insects, so there are simply more opportunities for exposure.

Less commonly, direct contact with grass may result in allergic reactions such as itching, urticaria (also called hives), and eczema (also called atopic dermatitis). 

How Is Grass Allergy Diagnosed?

There are two major classes of grass: northern and southern grasses. Northern grasses are common in colder climates and include timothy, rye, orchard, sweet vernal, red top, and blue grasses.

Southern grasses are present in warmer climates; Bermuda grass is the major grass in this category. 

If you have a grass allergy, you are more likely to be allergic to most types of grasses, if not all grasses, as grass pollens have very similar proteins that cause allergies. Still, to be certain, an allergy test can determine which strains you are allergic to.

An allergy test may consist of a blood test or an allergy skin prick test. In the skin prick test, a liquid drop of grass extracts (the allergen) is pricked onto the skin surface of the back or forearm. If a red, raised area develops within 15 minutes or so, then the test is positive, indicating you have a grass allergy.

How Are Food Allergies Related to Grass?

Allergies to grass can predispose a person to oral allergy syndrome (OAS) caused by cross-reactivity between proteins in fresh fruits and vegetables and grass pollen.

Grass pollen allergy is associated with OAS to tomatoes, potatoes, melons, oranges, and peaches. The proteins in the fruits and vegetables that cause OAS can be easily broken down by cooking or processing the offending foods. That's why symptoms don’t usually occur with cooked or processed foods like tomato sauce.

If you eat a fresh tomato, however, you may experience itching, burning, or stinging in your mouth, throat, and tongue. The symptoms generally last only a few seconds or minutes, as the proteins that cause the symptoms are broken down quickly by saliva. Anaphylaxis from OAS is rare but can occur.

How Is a Grass Allergy Treated?

If you think you might have a grass allergy, speak to your physician and get tested.

If you have a confirmed grass allergy, there are ways to decrease your exposure and lessen your symptoms.

Reduce exposure: For one, you can try to reduce your grass exposure by staying inside and closing your windows during days of high grass pollen count. It's also wise to shower after being outside to remove any residual pollen on your skin. 

OTC solutions: There are also over-the-counter remedies that may ease your symptoms like nasal saline sprays or rinses. These sprays can hydrate the inside of your nose, reducing congestion. The nasal steroid spray Flonase (fluticasone propionate) is also over-the-counter and can reduce inflammation in your nose—you should talk with your doctor before trying it, though, as it may cause some side effects.

If you are exposed to grass and have an allergic reaction, you can take over-the-counter antihistamines to relieve your symptoms. Oral antihistamines can treat itching and hives caused by direct grass exposure. They are especially effective when combined with bathing or changing clothes after significant grass exposure, such as after a soccer game.

Prescription medication: Severe allergies may require prescription medication. You can also try immunotherapy—the introduction of small amounts of an allergen into your system—which, in time, may lessen your reaction to grass.

Immunotherapy: Immunotherapy can be administered as allergy shots (called subcutaneous immunotherapy) or sublingually, in which a tablet containing grass pollen underneath the tongue. Subcutaneous immunotherapy may be more effective, but sublingual immunotherapy is probably more convenient and comfortable. In addition, whole-body or systemic reactions to the dissolvable tablets occur more rarely with the tablets compared to the shots. 

There are currently two FDA-approved sublingual (under the tongue) tablets for treating allergic rhinitis (with or without allergic conjunctivitis) in children and adults from a grass pollen allergy:

  • Oralair (a 5-grass pollen extract sublingual tablet)
  • Grastek (a Timothy grass pollen sublingual tablet)

A Word From Verywell 

A grass allergy is common, and the good news is that you can live well with it by making small behavioral modifications and using over-the-counter or prescription medications as needed. If these no not work, don't worry as immunotherapy is a sensible option.

Be sure to see an allergist so you can devise a treatment plan that works best for you.  

Sources:

American Academy of Allergy Asthma & Immunology. Mowing Down Your Grass Allergies.

Di Bona D, Plaia A, Leto-Barone MS, La Piana S, Di Lorenzo G. Efficacy of grass pollen allergen sublingual immunotherapy tablets for seasonal allergic rhinoconjunctivitis: A systematic review and meta-analysis. JAMA Intern Med. 2015 Aug;175(8):1301-9.

Sussman G, Sussman A, Sussman D. Oral allergy syndrome. CMAJ. 2010 Aug 10;182(11):1210-11.

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