2 NC cities among worst places for pollen allergies, study says. One’s No. 7
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- New study ranks Raleigh and Winston‑Salem among 20 worst U.S. metros for pollen.
- Report analyzes pollen counts, medication and allergist availability across 100 metros.
- Health officials advise early medication, check pollen counts and reduce outdoor exposure.
If you’ve spent a spring in North Carolina, you know allergy season can be brutal. Now, a new report suggests two cities in the state are among the most tough places in the country for people who suffer from seasonal allergies.
According to the Asthma and Allergy Foundation of America, two of the state’s largest cities, Raleigh and Winston-Salem, rank among the 20 worst places to live in the U.S. for allergy sufferers.
The nonprofit’s 2026 Allergy Capitals report analyzed the 100 most-populated metro areas, using factors such as pollen levels from trees, grasses and weeds, use of over-the-counter allergy medications and the number of board-certified allergists and immunologists.
Here’s what to know about the findings.
Top 20 worst US cities for seasonal allergies
Two North Carolina cities are among the 20 worst in the country for people who have seasonal allergies:
- 1. Boise, Idaho
- 2. San Diego, California
- 3. Tulsa, Oklahoma
- 4. Provo, Utah
- 5. Rochester, New York
- 6. Wichita, Kansas
- 7. Raleigh, North Carolina
- 8. Ogden, Utah
- 9. Spokane, Washington
- 10. Greenville, South Carolina
- 11. San Francisco, California
- 12. Minneapolis, Minnesota
- 13. Salt Lake City, Utah
- 14. Richmond, Virginia
- 15. Colorado Springs, Colorado
- 16. Little Rock, Arkansas
- 17. Toledo, Ohio
- 18. New Orleans, Louisiana
- 19. Winston-Salem, North Carolina
- 20. Lakeland, Florida
Other North Carolina cities on the list of the 100 worst metro areas for allergy sufferers include:
- Greensboro at No. 22
- Durham at No. 48
- Charlotte at No. 55
What kind of pollen is in the air?
The North Carolina Division of Air Quality monitors how much pollen is in the air from late February through mid-November using a pollen sampler in Raleigh. Lab technicians analyze pollen samples and publish a daily report with the number of pollen grains counted.
The most recent report from DAQ shows high tree pollen counts and low weed and grass pollen counts. Juniper, cedar, cypress, pine and maple are the culprits behind the pollen.
When will the pollen start?
The crunchy, greenish-yellow stuff from pine trees tends to be worst in North Carolina in April, The News & Observer previously reported, and it’s thickest early in the morning on warm, dry, breezy days.
Tree pollen is responsible for most spring pollen allergy symptoms, according to the Asthma and Allergy Foundation of America.
What can you do to protect against pollen?
To prepare for spring, Dr. Neeta Ogden, an allergist with the Asthma and Allergy Foundation, recently recommended to the Charlotte Observer to start allergy medications about two weeks before the season begins, which is typically early to mid-March in North Carolina.
She also advised checking pollen counts regularly and working with a health care provider to make a treatment plan.
Common treatments include antihistamines, nasal steroid or antihistamine sprays, saline nasal rinses and allergy eye drops, Ogden said. People with allergic asthma may also need inhalers and should make sure their medications are up to date.
During allergy season, Ogden said it’s important to reduce pollen exposure by:
- Limiting time outdoors on high-pollen days,
- Showering before bed and
- Keeping windows closed at home or in the car.
“It’s a lot about reducing exposure and staying on top of your symptoms,” she said.
Portions of this story were previously published in The News & Observer.
