New ranking names this NC city one of the worst for allergy sufferers. Here’s why

Juli Leonard /

What our itchy eyes and noses have long suspected is finally confirmed: the Triangle — specifically Raleigh — is one of the worst places in the U.S. for seasonal allergies.

In a report released Thursday, the Asthma and Allergy Foundation of America (AAFA) named Raleigh as one of this year’s “Allergy Capitals,” meaning it’s among the most challenging cities in the country for those with seasonal pollen allergies.

The full report ranks the 100 most-populated U.S. metropolitan areas, but Raleigh and another North Carolina city, Greensboro, ranked in the top 20. Other North Carolina cities, including Charlotte, Winston-Salem and Durham, appear on the list, but with average or better-than-average ratings for seasonal allergies in those locales.

The report calculates and assigns rankings to the cities based on total pollen scores for tree, grass, and weed pollen, over-the-counter medication use and the number of allergy specialists in each city. The report and rankings are based on data from the previous year.


Wondering where, exactly, Raleigh falls in the top 20 rankings? And what does it mean for Raleigh to be an Allergy Capital?

Here are key takeaways from AAFA’s 2023 Allergy Capitals report.

Raleigh is one of the worst places in U.S. for seasonal allergies

Raleigh ranks 16th in the list of most challenging places in the United States to live with seasonal pollen allergies, according to AAFA’s report.

That ranking also places Raleigh as the most challenging place in North Carolina to live with season allergies, with the city ranking higher than the other North Carolina cities included in the report.

Overall, according to the report, Raleigh has a worse-than-average overall ranking for seasonal allergies. The overall ranking is based on these five data points:

Tree pollen: Raleigh ranked 39th for tree pollen, based on the daily pollen count in the city for this type of pollen.

Grass pollen: Raleigh ranked 16th for grass pollen, based on the daily pollen count in the city for this type of pollen.

Weed pollen: Raleigh ranked 11th for for weed pollen, based on the daily pollen count in the city for this type of pollen.

Sale and use of over-the-counter allergy medicine: Raleigh received a worse-than-average ranking in this category.

Number of allergists and immunologists: Raleigh received a worse-than-average ranking in this category.

Raleigh’s No. 16 ranking this year is a big jump from last year, when the City of Oaks was ranked 81st in the Allergy Capitals report and was assigned a better-than-average overall ranking for seasonal allergies.

How do other NC cities rank for seasonal allergies?

While Raleigh’s ranking makes it the worst place in North Carolina for seasonal allergies, other North Carolina cities are also included in the report. Here’s how they ranked:

Greensboro ranked 19th overall, placing it in the top 20 with Raleigh. Greensboro received an average ratings for pollen counts and worse-than-average ratings for allergy medicine use and allergy specialists.

Winston-Salem ranked 29th overall. Like Raleigh and Greensboro, Winston-Salem received a worse-than-average overall rating for seasonal allergies.

Charlotte ranked 32nd, earning an average overall rating for seasonal allergies.

Durham ranked 79th, with AAFA deeming the Bull City’s overall seasonal allergy rating as better-than-average.

How to cope with seasonal allergies

In addition to issuing the Allergy Capital rankings, AAFA also provides advice for how to cope with and manage seasonal allergies — something those of us in No. 16 Raleigh could surely use.

AAFA recommends:

Managing your contact with pollen. Limiting your exposure to pollen can reduce the symptoms and impacts you get from it. AAFA recommends, among other suggestions, limiting your outdoor activities to days with low pollen counts, keeping your windows closed during peak-pollen times and removing your shoes before you enter your home to avoid tracking pollen inside.

Taking allergy medicine. Taking over-the-counter or prescription allergy medicine can prevent and treat allergy symptoms. You might try nasal corticosteroid sprays to reduce inflammation in your nose, antihistamines to relieve sneezing and itching, decongestants or other options.

Rinsing out your nose. “A nasal rinse can help clear your sinuses and nose,” AAFA says. A recipe and instructions for a saline sinus rinse are available from the American Academy of Allergy, Asthma & Immunology at

Asking your doctor about immunotherapy. “If you do not get complete relief from medicines that treat allergy symptoms, talk with your allergy doctor about immunotherapy,” AAFA says. “Immunotherapy is a long-term treatment that can help prevent allergic reactions or make them less severe. It can change the body’s immune response to allergens.”

More information

Looking for more information about this year’s Allergy Capitals, or want to see the full report and rankings? Visit the AAFA’s website at

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