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Colds vs. allergies

Written By: Shelley Vanker, UT Physicians | Updated: April 19, 2024
Woman's hands removing a tissue from it's container

Running through boxes of facial tissue? Use this guide to determine your best course of treatment and when to seek medical help.

Congestion, runny nose, and just feeling ick? Symptom relief is often a pharmacy away, but choosing the correct over-the-counter medicine depends on whether you’re fighting a virus like a cold or another culprit like seasonal allergies.

With many shared symptoms, it’s easy to confuse the two.

Elena N. Zamora, MD
Elena N. Zamora, MD, MHA

“For the past few years, because of the pandemic, any sniffle was grounds for a health appointment or staying away from your loved ones,” said Elena N. Zamora, MD, MHA, a family medicine doctor at UT Physicians. “So, I think we still have some of that fear, like is this a virus?”

Zamora, an assistant professor with McGovern Medical School at UTHealth Houston, explains how to discern between allergies and a cold.

Seasonal allergies

A key component to recognizing seasonal allergies is the duration. Zamora says allergies to outdoor pollens can last for the entire blooming season.

“The sun is out, flowers, trees, and bushes are in bloom and people are starting to experience symptoms,” she explained. “This is your body’s immune system responding to some sort of trigger or allergen, and because of that you can have symptoms for months.”

Closely monitoring allergy symptoms is important, she says, because if bad enough they can lead to a sinus infection, middle ear infection, or asthma.

Allergy specific symptoms:

  • Itchy, watery eyes
  • Occurs after outdoor exposure
  • Lasts for several weeks

Allergy treatment:

  • Avoid allergen
  • Oral decongestant medicine
  • Antihistamine medicine
  • Topical nasal steroids


An acute respiratory virus infection, or cold, can often present with a runny nose, congestion, and sneezing. These are shared symptoms with seasonal allergies, but an obvious sign of a viral infection, Zamora says, is a fever.

A cold typically lasts for seven to 10 days and can often include a sore throat in the early stages.

“When we think of a cold, it should run its course,” said Zamora.

Cold specific symptoms:

  • Sore throat
  • Low-grade fever
  • Body aches
  • Fatigue
  • Cough

Cold treatment:

  • Stay hydrated
  • Get plenty of rest
  • Medication as needed for fever
  • Medication as needed for body aches

Treating congestion

A stuffy, runny nose and congestion are common for both allergies and a cold. Treating congestion is important.

“When we are congested, it affects our sleep, and not having adequate sleep makes it difficult to get better,” she said. “Nasal congestion can also trigger a cough and sore throat, so it’s important to address it, whether it’s from a cold or allergy.” 

When to seek help

Martin J. Citardi, MD
Martin J. Citardi, MD

Above all, knowing what you are suffering from is important to finding the correct medication.

“Using the wrong symptom-relieving medication for a cold or allergies can lead to ineffective treatment and potentially worsen symptoms,” said Martin J. Citardi, MD, otorhinolaryngologist with UT Physicians and chair of the Department Otorhinolaryngology – Head and Neck Surgery with McGovern Medical School at UTHealth Houston.

For example, he says, using antihistamines for a cold won’t address an underlying viral infection.

“Incorrect medication use can lead to side effects or interactions with other medications,” Citardi said.

He also recommends tracking specific symptoms and their duration in a symptom diary to help distinguish between a cold and allergies. 

Approximately 1%-5% of acute viral nasal infections lead to acute bacterial sinusitis, which should be treated with antibiotics. This transition happens approximately one week after the start of symptoms. If cold symptoms don’t improve in one week or become worse, the likelihood of an acute bacterial sinus infection is high. For this reason, patients should see a physician for evaluation and treatment when cold symptoms last more than a few days.

If you’re unsure whether it’s a cold or allergies, and there are any doubts about which medicine to take, get a medical evaluation.

Elena N. Zamora, MD, treats patients of all ages at UT Physicians Family Medicine – Texas Medical Center.

Martin J. Citardi, MD, treats patients at UT Physicians Otorhinolaryngology – Texas Medical Center.

As the clinical practice of McGovern Medical School at UTHealth Houston, UT Physicians has locations across the Greater Houston area to serve the community. To schedule an appointment, call 888-4UT-DOCS.