Top 20 Worst U.S. Cities for Spring Allergies in 2026

• The Asthma and Allergy Foundation of America (AAFA) has ranked the top 20 worst cities for pollen allergies in 2026.
• Allergy seasons are lasting longer and are more intense due to climate change, which can worsen allergy symptoms.
• Experts offer tips for coping with seasonal allergies this spring and beyond.

You may feel like your spring allergies are worsening, beginning earlier, or lasting longer. You’re not alone in feeling this way.

“Allergy seasons are getting longer and worse all the time, and I think we can expect an increase in allergy-driven symptoms this spring and every spring going forward,” said Noah Greenspan, PT, DPT, board certified clinical specialist in cardiovascular and pulmonary physical therapy, a leading expert in cardiopulmonary rehabilitation, and the founder of Pulmonary Wellness Complex PT.

“People naturally spend more time outdoors, in nature, and other areas where increased heat and humidity, greater prevalence of allergens, and therefore exposure to triggers, and compromised air quality are more common. In addition, we can expect that the impact of various environmental triggers will vary by geographic location and the characteristics of the exposures,” Greenspan told Healthline.

Indeed, some areas of the United States experience year-round pollen from trees, weeds, and grasses.

The AAFA has ranked the top “allergy capitals” in the contiguous (lower 48) states by how difficult it is to live there with pollen allergies. Here’s what you need to know to cope.

The AAFA has ranked the top 100 allergy capitals in the United States for 2026.

The following are the top 20 out of 100 based on pollen scores for tree, grass, and weed pollen, over-the-counter allergy medication use, and the number of allergy specialists.

The AAFA notes that, compared with previous years, more cities in the West are among the top 20 allergy capitals.

1. Boise, ID
2. San Diego, CA
3. Tulsa, OK
4. Provo, UT
5. Rochester, NY
6. Wichita, KS
7. Raleigh, NC
8. Ogden, UT
9. Spokane, WA
10. Greenville, SC
11. San Francisco, CA
12. Minneapolis, MN
13. Salt Lake City, UT
14. Richmond, VA
15. Colorado Springs, CO
16. Little Rock, AR
17. Toledo, OH
18. New Orleans, LA
19. Winston-Salem, NC
20. Lakeland, FL

You can find the full list of the top 100 allergy capitals in the AAFA 2026 report.

If you know allergens, like pollen, may trigger symptoms, you may want to reduce your exposure. Here are a few ways to do just that:

• Monitor the pollen count in your area so you can avoid going outside during high pollen times.
• Keep the windows in your house and car closed, and let your HVAC system filter out allergens.
• Remember to change your HVAC filters regularly, especially during your worst allergy months.
• Try to keep pollen outside as much as possible by removing your shoes by the door when you enter your house, changing your clothes after being outside, and showering before bed.
• Wear sunglasses when outside to help protect your eyes from pollen.

You can also use over-the-counter allergy medications to help reduce your symptoms. If these don’t seem to work, you can consult with a healthcare professional about alternative treatment options.

“Start taking antihistamines, nasal sprays, and eye drops as soon as possible,” said Nicolle Overstreet, DO, family physician with Medical Offices of Manhattan. “If you’re feeling symptoms, start treating [them]. I advise patients to start 2 weeks before their symptoms started last year, to get a head start,” she told Healthline.

Overstreet recommended frequent allergy testing, when possible, to effectively reduce and manage symptoms.

If you’re prone to allergies and inflammation, you should monitor your symptoms regularly to track trends and flare-ups, Greenspan said.