Do You Have a Cold Or Allergies? Here’s How to Tell, According to Immunologists
By Emily Shiffer | PS by VOXMEDIA
June 24, 2024
If you suddenly come down with cold-like symptoms, it's possible you may have caught a virus. But when allergy season seems to get worse and worse every year, how can you tell if you're dealing with a common cold or seasonal allergies? "Because allergies and colds share similar symptoms, people are often left wondering which offender is the true culprit," says Lakiea Wright, MD, a board-certified internist, allergist, and immunologist at Brigham and Women's Hospital. Knowing what's causing the problem can give you a better idea of how long your symptoms might last, and what you can do to help.
To help you differentiate between a cold and allergies, we asked immunologists to weigh in on a few key differences. Read on to get their advice, and take our quiz at the end to help determine whether you might have a cold or allergies yourself.
Experts Featured in This Article:
Andrea Love, PhD, is an immunologist and microbiologist, as well as an advisory board member for POPSUGAR's Condition Center.
Lakiea Wright, MD, a board-certified internist, allergist, and immunologist at Brigham and Women's Hospital and the medical director at Thermo Fisher Scientific.
Cold Versus Allergies Similarities
Common colds and allergies present with many similar symptoms. According to immunologist and microbiologist Andrea Love, PhD, some of these shared symptoms may include nasal congestion (meaning a runny and/or stuffy nose), sneezing, coughing, a sore throat, and fatigue. "While both have a degree of seasonality - allergies often peaking in spring/fall and cold activity peaking in the winter, you can get a cold or develop allergies any time of the year," she adds.
Cold Versus Allergies Differences
Despite their similarities, there are plenty of ways to tell if you have a cold or allergies. Here's what immunologists had to say about some of the biggest differences:
How to Tell If You Have Allergies
"Seasonal allergies are caused by an inappropriate immune response to allergens," Dr. Love says (think pollen, grass, mold, etc.). This can trigger an allergic reaction, leading to mast cell activation and the release of inflammatory chemicals like histamines. This process typically presents with itching eyes, nose, and throat, which aren't as common with colds. Another thing to consider is the quality of your cough. "Allergies usually create a dry cough," says Dr. Wright. "It's a direct reaction to something you're sensitive to in the airway. Coughs from colds (or the flu) tend to be on the wetter side (caused by mucus your body is trying to move out of your body)."
You may also be able to tell seasonal allergies apart from a cold if you notice your symptoms flaring up after exposure to an allergen. "Depending on the allergen/allergy, there may be seasonality," Dr. Love says. "For example, allergies due to pollen may be more prevalent in the spring or fall." Seasonal allergy symptoms also tend to have a rapid onset, and last for as long as a person is exposed to an allergen.
Itchy Eyes/Nose/Throat
Dry Cough
Flare Ups After Exposure to an Allergen
Rapid Onset
Clear Mucus/Nasal Discharge
How to Tell If You Have a Cold
One of the biggest indicators of a cold, according to Dr. Wright, is the severity of symptoms. After all, a cold happens when your body is fighting off a viral infection. This can lead to fever ("despite the term hay fever, there is no fever associated with allergies," Dr. Wright says), headaches, and muscle aches, all of which are common in colds, but rarely seen with allergies. Dr. Love adds that nasal discharge can also be a big hint, as the mucus caused by a cold is typically green or yellow, while mucus from allergies is typically more clear. Cold symptoms can have a rapid or gradual onset, so if you started feeling sick over time, that's another tell-tale sign you may be dealing with a virus. Symptoms generally last between 7-10 days.
Fever
Headaches
Muscle Aches
Green or Yellow Mucus/Nasal Discharge
Rapid or Gradual Onset
Wet Cough
Treatment for Cold Versus Allergies
While you can't exactly "cure" your cold or allergies, according to Dr. Love, there are some things you can do to help alleviate discomfort and reduce exposure to allergens:
Allergy Treatment
"Generally, seasonal allergies such as allergies to pollen can be managed with over-the-counter antihistamines," Dr. Love says. This helps calm the histamines produced as a result of the IgE-based immune response to an allergen. Antihistamines may include:
loratadine
fexofenadine
cetirizine (which may be combined with a decongestant called pseudoephedrine)
For severe allergies, reducing exposure to the allergen can also be useful. "For example, with severe pollen allergies, limiting outdoor time when pollen count is high, wearing a mask outdoors during those periods, and using HEPA filters in your home may also help," Dr. Love says. "There are prescription medications that are beneficial, which should be used after consultation with a clinical allergist/immunologist. These include nasal corticosteroid sprays and other medications that interfere with the inflammatory response." In these severe instances, allergy immunotherapy may be considered.
Cold Treatment
"With colds caused by respiratory viruses, there are not many treatments that target the virus itself (antivirals), so symptom management is key to allow your immune system to fight off infection," Dr. Love says.
For fever, pain, and body aches, you can use acetaminophen, ibuprofen, or naproxen sodium.
For a stuffy nose, you can use decongestants such as pseudoephedrine.
For cough suppressants, you can use guaifenesin or dextromethorphan.
Of course, if your symptoms persist or become more severe, it's always a good idea to seek professional medical care.
Cold Versus Allergies Quiz
To get a better grasp over your own symptoms, take the quiz below, and see whether you're more likely to have a cold or allergies.
Did your symptoms present suddenly or gradually? A) Suddenly B) Gradually
Is your cough dry or wet? A) Dry B) Wet
What color is your mucus/nasal discharge? A) Clear B) Green/Yellow
Do you have a headache? A) No B) Yes
Do you have a fever? A) No B) Yes
Do you have body aches? A) No B) Yes
Are you experiencing itching eyes/nose/throat? A) Yes B) No
Results
If You Got Mostly A's: You Most Likely Have Allergies
These symptoms are most consistent with allergies, which means there could be a specific allergen triggering your immune system (some common examples include pollen, ragweed, pet dander, and certain kinds of grass). Antihistamines may help alleviate symptoms. If allergies persist or get worse over time, you may want to consult a a clinical allergist or immunologist for prescription medication.
If You Got Mostly B's: You Most Likely Have a Cold
These symptoms are more indicative of a cold. Common colds are caused by viruses, but you can still manage symptoms while your immune system fights against infection. Acetaminophen or ibuprofen may help manage fever and body aches, while decongestants and cough suppressants can help with stuffy noses and coughing. If your cold doesn't improve after 7-10 days, you may want to contact your doctor.
— Additional reporting by Chandler Plante
