Dreading another cedar season? Many of our friends and family would grumble, “Yes.” And for some of us, that includes our friend in the mirror.

What we call “mountain cedar” is technically known as “ashe juniper,” but by any name, the effects are just as unfortunate. Heavy golden pollen lines the countryside, lifts into the air, and wreaks havoc on our heads. Here, cedar allergy is so prolific and painful that we’ve coined the term “cedar fever.”

“If you put a dot on Fredericksburg, Texas, and draw a 70-mile radius circle around it, that’s two thirds of the world’s cedar crop,” says family physician Dr. Jay Gruhlkey. Between weather patterns and geography, all that pollen “sits on I-35,” he says. Cedar concentrations in the air are considered “high” above 500 cubic parts per million. “Some days in Central Texas, we’ve recorded 35,000 to 40,000 cubic parts per million,” he says.

Cedar allergies are just part of living in the Hill Country, we may think. But that need not be the case. We can take control of cedar allergies and improve our winter health—maybe for good. The key, doctors suggest, is starting early.

Allergic reactions are our bodies crying wolf. We have smart immune systems that catch dangerous invaders like viruses and bacteria and fight accordingly. But for some of us, our bodies get confused, and when they see something like cedar, they overreact to our own sniffly dismay.

“Allergies are a bit like a knee injury,” says ear, nose, and throat physician Dr. Charles Lano Jr. An injured joint will swell up, red, puffy and sore, a day after the injury. That’s the body’s inflammatory response: It’s shipping in more cells and materials to repair the hurt tissue. The swelling, in part, is because your knee becomes crowded.

This crowding is also present with allergies. When an allergic person breathes in pollen and it coats the sensitive linings of the nose, throat, or eyes, those areas become irritated—“Injured!” the body declares—and the body recruits more cells for repair. Stuffiness ensues.

The most common symptoms of cedar allergies are nasal, Lano says, with sneezing, congestion, and runny noses. Then come itchy eyes (“Cedar has a way of making those eyes really itchy and drippy,” Lano says.), scratchy throats, and even patchy rashes on the skin. In extremely allergic patients or on extremely high-pollen days, pollen can cause dangerous contractions of bronchial tubes, leading to asthma flare-ups and serious breathing problems.

These symptoms may sound similar to those of colds or longstanding sinus infections. Remember, Lano says, that colds will usually run their course in under two weeks, unlike season-long allergies, and colds and sinus infections rarely come with watery eyes.

If you suspect you have cedar allergies, mark your calendar on days when you have these symptoms. Then compare the timing of your allergy symptoms with local pollen counts. If your symptomatic days match days with high cedar pollen counts, you’ve probably found your culprit.

Seasonal allergies are difficult for our bodies to handle. A common misconception is that we can get over allergies, or build up our bodies to resist them. But Gruhlkey explains, “Seasonal variation is hard to build resistance against.” Each new cedar season, our bodies must start from scratch on a pollen-fighting plan.

Our bodies aren’t likely to conquer cedar allergies alone, but a number of medical and lifestyle steps can boost us to overcome allergies. The best time begin those steps is before cedar blooms.
“With pollen allergies, prevention is the key,” says local allergist Dr. Priyanka Gupta. “We know cedar comes every year in December, January, February, so I always tell my patients to start thinking about cedar before it hits.”

Early to mid-November is a reasonable time to start taking medications like antihistamines and corticosteroid nasal sprays. These drugs build up in your body, strengthening their effects the longer you take them. So begin taking these medications before you encounter cedar pollen, and continue through the end of cedar pollen season, usually around February or March.

During the season, a natural and safe way to fight allergies is with saline rinses or nebulizers, Gupta says, to wash mucus from the nose and sinuses daily. Remember to use filtered or distilled water, not water straight from the tap.

On days with high cedar pollen, lifestyle changes can also help limit exposure. “If you are outside when pollen counts are high, wear a mask, glasses, or gloves,” Gupta says. “Then come back in and shower,” she recommends, to rinse off any pollen remaining on your skin.

Also, brush or bathe pets before bringing them indoors to keep them from tracking pollen into the carpet, couch, and bed.

Before going outside, be sure to check daily pollen counts. On some days, it may be best to do outside work or exercise in the mornings or late afternoons, when cedar blossoms are closed and the air is still. Pollen levels vary quite a bit, Gupta says, based on weather and other factors, so stay informed and flexible to avoid pollen as much as possible.

If you’ve tried allergy medications and lifestyle changes with limited success, you can also ask your doctor about allergy drops and shots, treatments called immunotherapy.

Immunotherapy conditions your body to relax around allergens like cedar pollen. If you expose yourself to small amounts of the allergen year-round—through a weekly injection in your arm or a daily drop of serum under your tongue—your body learns to live with cedar pollen and becomes more tolerant to high-pollen days. Both allergy drops and shots have been shown effective and safe for use with proper supervision.

Cedar is a part of life in the Hill Country—but that doesn’t mean cedar allergies must be. They can take an annual toll on our quality of life, but there is an upside of these nasty allergies: “They’re something we can manage,” says Gruhlkey, whether by taking allergy shots or drops, controlling your environment, managing medications, or combining these strategies. “You don’t have to suffer.”

If it’s time to take back your winter health and overcome cedar allergies, talk to your doctor this fall about what cedar-beating steps would be best for your lifestyle and medical history. And remember, an ounce of prevention can be worth a pound of cure—and avoid the pounding headache.