Allergies vs. Common Cold: Know the Difference for Best Treatment

When you start sneezing and feeling congested, it’s easy to wonder if you have seasonal allergies or the common cold? While they both share symptoms, they have different causes and require different treatments. Understanding the difference can help you choose the right over the counter (OTC) medication to help you feel better faster.

While the common cold is caused by a virus, seasonal allergies are your body’s reaction to allergens like pollen, pet dander, or mold. You may experience similar symptoms, such as a runny nose, congestion, and sneezing, with both. However, there is one key difference in symptoms - itchiness. If your eyes, nose, or throat feel itchy, allergies are more likely the cause. Colds, on the other hand, often come with body aches, fatigue, and possibly a low-grade fever, which allergies do not cause. Colds typically last 7 to 10 days, while allergies can persist for weeks or even months if you’re exposed to allergens. If your symptoms follow a predictable pattern, like flaring up every spring or fall, you’re likely dealing with allergies rather than a cold.

Treating seasonal allergies

If allergies are to blame, OTC medications may help manage your symptoms.

• Antihistamines are commonly used to relieve sneezing, runny nose, itchy eyes, and congestion. Non-drowsy options like cetirizine, loratadine, and fexofenadine work well for daytime use. Diphenhydramine is another antihistamine but can cause significant drowsiness, making it better suited for nighttime relief.
• Nasal corticosteroids like fluticasone, triamcinolone, or mometasone can reduce inflammation in the nasal passages, relieving congestion and sinus pressure.
• Decongestants such as oxymetazoline nasal spray can provide quick relief but should not be used for more than three days. Oral decongestants like phenylephrine are also available but may not be as effective as prescription options.

Treating a cold

Since colds are viral, they can’t be treated with antibiotics, but OTC medications can help ease symptoms while your body fights off the infection.

• Cough suppressants like dextromethorphan can help reduce coughing, while expectorants like guaifenesin help loosen mucus.
• Pain relievers such as acetaminophen or ibuprofen can help with headaches, body aches, and sore throat discomfort.
• Combination products often contain multiple medications in one, so be sure to read labels carefully to avoid doubling up on ingredients. In general, single ingredient products are recommended over combination products due to lower risk of side effects and drug interactions.

What is pseudoephedrine?

Pseudoephedrine is a type of nasal decongestant used for both colds and allergies. It is sold behind-the-counter without a prescription, and depending on the state you live, you may be able to purchase it in limited quantities singularly or in combination products. Your local pharmacist, doctor, or advanced practice provider* (APP) may not recommend it for you due to the side effects. Please speak to your healthcare professional before taking this medication to treat your symptoms.

When to talk to a healthcare professional

While OTC medications can help with short-term relief, talk to your doctor, APP or pharmacist if:

• You need to take allergy medication daily for an extended period.
• You have a medical conditions like high blood pressure, diabetes or kidney disease that could be affected by certain medications.
• Your symptoms last longer than 10 days (for a cold) or significantly impact your daily life (for allergies).

Knowing whether your symptoms are from seasonal allergies or a cold will help you to choose the right treatment to feel better faster. If you have any questions or are unsure what medicine may be right for you, talk with your doctor, APP or pharmacist as they are great resources for guidance on medication safety and effectiveness.

*An advanced practice provider includes a nurse practitioner or physician assistant.