Do Seasonal Allergies Cause Rash? What Patients Need to Know

December 16, 2024

Seasonal allergies, also known as hay fever or seasonal allergic rhinitis, are most commonly triggered by plant pollen, grass, mold, and ragweed.¹ The abundance of these triggers varies throughout allergy season, which occurs in both the spring and fall. Allergic reactions to plant and grass pollen are common during the spring and peak during the evening, whereas allergic reactions to mold and ragweed are common during the fall and peak in the morning.¹

How does the body respond to seasonal allergies? When pollen comes in contact with the body, the immune system reacts by releasing histamine; this leads to physical symptoms such as sneezing, coughing, runny nose, breathing problems, and itching.² Skin rashes are less common but are another possible reaction that may come with seasonal allergies.² Rashes commonly occur when histamines are released into the skin.

Rashes Resulting From Seasonal Allergies

There are 2 types of skin irritation and inflammation — also known as dermatitis — that people may experience as a result of seasonal allergies:³

Eczema, also known as atopic dermatitis, will look like dry, red patches of skin. These patches are itchy and may crack or ooze.
Hives, also known as urticaria, will look like raised, red, bumps that turn white when pressed in the center; these are also itchy. Hives are self-limiting and are treated by avoiding allergens, if possible.

Frequently Asked Patient Questions

How do I prevent my rash from worsening?

Avoid scratching the rash because it can create more irritation and lead to infection. Washing the area with cool water and applying moisturizer can help alleviate discomfort.³ When possible, avoid exposure to the sun and ultraviolet (UV) rays, as they can worsen the condition.⁴

Are these rashes contagious?

Neither hives nor eczema are contagious when they are the result of seasonal allergies. Notably, such rashes can also have other causes (eg, an infection) which may be contagious, although this is not a factor with seasonal allergies. There is no danger that hives or rashes caused by seasonal allergies can spread from one person to another.

What over-the-counter medications can I use to treat my rash?

Medications such as oral antihistamines and topical corticosteroids can help relieve the itchiness and redness of allergic dermatitis.^3,5

For patients with hives, second generation oral antihistamines such as loratadine (Claritin^®), desloratadine (Clarinex^®), fexofenadine (Allegra^®), cetirizine (Zyrtec^®), and levocetirizine (Xyzal^®) are recommended treatments. These are generally non-sedating. First generation oral antihistamines such as diphenhydramine (Benadryl^®) can also be used, but are not recommended due to side effects such as sedation, confusion, dizziness, and impaired concentration. First generation antihistamines should be used with caution in older patients.⁶

For patients with eczema, creams, and lotions approved by the National Eczema Foundation are recommended to provide relief to dry skin.⁷ Hydrocortisone can provide temporary relief from itching and comes in cream, gel, ointment, and lotion formulations. Acetaminophen or ibuprofen can be helpful in alleviating symptoms such as burning, pain, and inflammation.⁸ Do not take more than 3000 mg of acetaminophen daily or more than 3200 mg of ibuprofen daily.

If over-the-counter options are not improving my rash, what other options are available?

If the rash does not improve after a few weeks of trying over-the-counter options, reach out to your healthcare provider. For acute hives that don’t improve with loratadine (Claritin^®), desloratadine (Clarinex^®), fexofenadine (Allegra^®), cetirizine (Zyrtec^®), and levocetirizine (Xyzal^®), your doctor may prescribe different antihistamines, such as cimetidine (Tagamet^®), or famotidine (Pepcid^®). Corticosteroids such as prednisone or prednisolone may be added for 3 to 10 days to control symptoms.⁶

For eczema, your doctor may prescribe topical steroids for localized areas; if a large area of skin is involved, the doctor may prescribe oral steroids for 5 to 7 days.⁸

How do I prevent future rashes?

An allergy test such as a skin prick test, patch test, or provocation test can be performed by your primary care physician to identify possible allergies. The best prevention is avoiding allergens, although this often is impossible.³ To prevent most symptoms of seasonal allergies without persistent drowsiness, oral antihistamines can be taken 2 to 4 weeks before allergy season.⁹

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