Happy spring to everyone and everything—except for seemingly brand-new allergies that joined your life, out of absolutely nowhere, even though you’re a fully grown adult who has never had them before. Yep, this can happen. Though surprise adult-onset allergies are inconvenient, uncomfortable, and just…rude, they’re a fact of life for some people, as you’re possibly learning firsthand.
According to the CDC, nearly a third of adults in the United States have an allergy, whether to food or their surroundings, and not all of those allergies show up during childhood. “Allergies can develop at any time due to a combination of genetic, environmental, and immunological factors,” Payal Gupta, MD, a triple-board-certified allergy, asthma, and immunology specialist based in Brooklyn, tells SELF.
That doesn’t mean you should bubble-wrap yourself to protect against contact with potential allergens, even if you’re going through it right now. Solid treatments exist to help ensure that if adult-onset allergies do affect you, you can find ways to deal. Here’s what you should know about this fun new development—and how to effectively handle adult-onset allergies.
Food and environmental allergies are different in a few major ways.
An allergy is your immune system reacting—or rather, overreacting—to something it considers to be a threat. While experts say any kind of allergy can develop at any age, understanding the difference between food and environmental allergies is a huge help when it comes to diagnosing and treating them.
One clear-cut difference between food and environmental allergies is the series of symptoms each present, Corinna Bowser, MD, a board-certified allergist and immunologist at Bryn Mawr Specialists Association in Havertown, Pennsylvania, tells SELF. “An environmental allergy usually presents with sneezing, itchy eyes, itchy nose, nasal congestion, coughing, mucus, or a skin rash,” she says. Examples of environmental allergens include pollen (which is what’s behind seasonal allergies), mold, pets, cockroaches, mice, and dust mites.
Environmental allergies might be a bit trickier to track if they’re seasonal (for instance, if they're triggered by pollen in the spring). “In the first year of getting their symptoms, people might think, ‘Do I have COVID? Do I have the flu? Rhinitis? I don't understand what's going on,’” Timothy Craig, DO, an allergist, clinical researcher, and professor of medicine at Pennsylvania State University, tells SELF. “Usually, through a few seasons, people figure it out.”
If you’re reacting to something in your diet, your symptoms will probably clue you in. According to Dr. Craig, when you experience a food allergy, it often presents differently than an environmental one would. “You might get itching in the mouth, some GI upset, rash and itching, shortness of breath, or feeling that you're going to pass out, a combination of those, and sometimes all of them, unfortunately,” he says.
Food allergies can be deadly if yours sends you into anaphylaxis, which affects an estimated 5% of the population. Anaphylaxis is an allergic reaction that can lead to respiratory collapse if untreated with epinephrine (like an injection with an EpiPen). Other than food, common allergen culprits that can lead to anaphylaxis are insect stings, latex, and medicines, according to the Cleveland Clinic. That’s all to say that it would be incredibly unlikely for an allergy to pollen or dust to send you into anaphylactic shock.
The general consensus is that food allergies are less common than environmental allergies to present for the first time in adulthood. One reason for this is that seasonal allergies are more common than food allergies. An estimated 25.7% of adults have a seasonal allergy, while 6.2% have a food allergy. For kids, those numbers are 18.9% and 5.8% percent, respectively.
Research indicates that shellfish is the most common adult-onset food allergy. “You can be 50 years old and get a shrimp allergy—or any other allergy for that matter as well,” says Dr. Craig.
Other food allergies that might strike in adulthood include sensitivities to peanuts and tree nuts. Sometimes, people become averse to fruit and vegetable pollen, which is associated with oral allergy syndrome (OAS). OAS, or pollen food allergy syndrome (PFAS), is kind of a hybrid of food and seasonal allergies, because it’s triggered by fruits and vegetables that have similar proteins to those found in pollen.
Why do some allergies develop later in life?
In the sense of cold, hard facts, it’s sort of a mystery. “The exact reasons why allergies develop at any given time can vary from person to person and often remain unclear,” says Dr. Gupta. Even so, research supports several contributing causes behind allergies that show up in adulthood.
One way to have a sense of what might be headed your way in the allergy department is to chat with your biological fam about their own allergies, if possible. “People with a family history of allergies are more likely to develop them,” says Dr. Gupta.
A 2020 analysis of 117,130 people supports that idea—particularly with regard to asthma, hay fever (which is what’s behind seasonal allergies), and eczema. “So far, genetic studies of allergic disease have investigated the presence of the disease rather than the age at which the first allergic symptoms develop,” the study authors wrote. “Our results support the notion that early and late onset allergic disease have partly distinct genetic architectures.” So if you’re suddenly sneezing around your dog, you might be able to blame your mom.
Sometimes, a change in location means a change in environment, which can provide a fun new set of potential irritants to bother your immune system. The first time you experience “exposure to allergens [like] pollution may influence the development of allergies,” says Dr. Gupta. This might mean that you’re having symptoms of an allergy you’ve always had, but never knew about because you were never significantly exposed to the allergen before.
If you’ve made a move lately, or are even spending a lot of time in a new place, it might explain whatever reaction you’re noticing. For instance: “If you have, say, a teacher who never had any allergies and now teaches in a public school system in a big city where there's mice and cockroaches…it wouldn't surprise me if they develop new allergies,” says Dr. Bowser. While the teacher in this scenario might have always been allergic to mice and cockroaches, they may have never encountered them to a degree that put their immune system on high alert and caused symptoms, so the allergy is presenting as new in adulthood.
The immune system is complex and always changing, which can influence the way we react to allergens. And, yep, that extends to adult-onset allergies. “The immune system can be influenced by many factors—by what you ate in your childhood, your gut’s bacteria composition, or how often you use antibiotics,” says Dr. Bowser. All of these things, she says, can prompt potential allergic reactions, because allergies are, as a reminder, an immunological response—if your immune system changes, so can the way it reacts to outside substances.
How to treat and manage adult-onset allergies
After realizing that you’re probably dealing with a new allergy, it’s time to do something about it. The good news is that in many cases, with the help of medical treatment and lifestyle shifts based on a plan created with a doctor, you can go about your life way more comfortably.
Your first order of business is to see a primary care physician. From there, they might refer you to an allergist for further testing to help narrow down what, exactly, is irritating you. They might conduct allergy tests and prescribe medications, allergy shots, or other therapies to help ease your symptoms.
If you suspect you have environmental allergies—where your symptoms may be persistent and annoying, but not life-threatening—Dr. Gupta says to keep a log you can then share with your medical provider. “Keep track of when and where you experience these symptoms, and consult with an allergist or health care provider for proper testing and treatment,” she says. This data can help providers land on a diagnosis and care plan for you.
Some treatment options include medications like antihistamines and nasal steroid sprays. “Histamine is the chemical that causes allergies in our body, so medications that block this chemical are very important. Antihistamines can come in the form of pills, nasal sprays and eye drops,” says Dr. Gupta. “Allergies cause inflammation, so anti-inflammatory medications like steroids can also help.” Your doctor might also suggest you try allergy shots or sublingual immunotherapy, which is an allergy shot alternative in the form of an oral tablet.
For food allergies, talk with your doctor about an epinephrine injector prescription.
Once you’ve identified your allergy and sought the care of a medical professional to help you build a personalized treatment plan, it’s time to make sure you have the supplies you need on hand, including up-to-date prescriptions in your medicine cabinet. For relief from environmental allergies, Dr. Craig suggests using oral antihistamines or nasal steroids. For food allergies, the American College of Allergy, Asthma & Immunology (ACAAI) recommends using an epinephrine injector as needed for emergency intervention to treat anaphylaxis and seeking immediate medical care. Make sure to keep your injector with you—like in your purse or pocket—at all times.
After you’ve identified an allergy, the most effective treatment for both food and environmental allergies is making as little contact as possible with whatever it is that’s bothering you.
But…you’ve got a life to live, and in the case of environmental allergies, completely avoiding the people, places, and things that are part of it might not be realistic. Instead, certain lifestyle tweaks won’t fundamentally change your way of living, but will help cut down on your allergy symptoms, like not running outside on days with high pollen counts (which you can check on websites like Pollen.com), or having your dog sleep in the other room, rather than in your bed.
Armed with knowledge about your symptoms and a plan to address them, Dr. Craig says you can likely avoid making any sweeping changes to your life: “Before you give up on dating somebody because of the cat or the dog, go for allergy shots.” And, if you’re not a pet person, the same goes for outdoor runs in the spring, or whatever it is that makes you so happy you could cry—happy tears, not watery-eyed allergy tears, that is.
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