(NEXSTAR) – With less than a week before the arrival of spring, allergy sufferers are bracing for the season, which will be especially bad in 20 U.S. cities, according to an Asthma and Allergy Foundation of America (AAFA) report released Tuesday.
These “allergy capitals” are located largely in the southern and eastern parts of the country, with Wichita, Kansas, taking the top spot for the third year in a row.
The AAFA’s 2025 Allergy Capitals study ranks the top 100 cities based on pollen scores for trees, grasses and weeds, along with over-the-counter medication usage and the number of local allergy specialists.
Kenneth Mendez, CEO and president of AAFA, told Nexstar that there are likely environmental reasons behind the outsized leaderboard presence of cities located in the southeastern U.S.
“Remember, we’re looking at three things within the pollen counts – that’s trees, weeds and grasses,” Mendez said. “So there’s three different seasons for that, and you find all those types of pollen in that region.”
The cities projected to be the most insufferable when it comes to seasonal allergies in 2025 are:
- Wichita, KS
- New Orleans, LA
- Oklahoma City, OK
- Tulsa, OK
- Memphis, TN
- Little Rock, AR
- Raleigh, NC
- Richmond, VA
- Greenville, SC
- Greensboro, NC
- Virginia Beach, VA
- Augusta, GA
- Dallas, TX
- Baton Rouge, LA
- Winston-Salem, NC
- Chattanooga, TN
- Knoxville, TN
- Charlotte, NC
- Scranton, PA
- Jacksonville, FL
You can see the full list of 100 cities on the Asthma and Allergy Foundation of America website.
What’s different in 2025?
Eight California cities made dramatic jumps up the ranking, thanks to a “grass and weed pollen explosion” the AAFA says was worsened by wet weather in 2024 that fed plant growth.
| Metropolitan Area | 2025 Rank | 2024 Rank | Reason for the Change |
| Sacramento, CA | 23 | 94 | Much higher grass pollen, higher weed pollen |
| Bakersfield, CA | 21 | 91 | Much higher grass pollen, much higher weed |
| Stockton, CA | 24 | 93 | Much higher grass pollen, higher weed pollen |
| San Jose, CA | 41 | 97 | Much higher grass pollen, higher weed pollen |
| Fresno, CA | 28 | 78 | Much higher weed pollen |
| Oxnard, CA | 33 | 75 | Higher grass pollen, much higher weed pollen |
| Los Angeles, CA | 51 | 85 | Higher grass pollen, much higher weed pollen |
| San Francisco, CA | 53 | 81 | Higher weed pollen |
New Orleans also made a dramatic jump from the 34th spot last year to second place in 2025.
According to the 2025 Allergy Capitals report, New Orleans saw a much higher weed pollen season, potentially made worse by additional water from Hurricane Francine, which made landfall on Sept. 11, 2024, as a Category 2 storm.
The timing happened to coincide with the fall weed pollen season, according to the report, which was followed by abnormally warm temperatures that stretched the growing season.
Why the allergy season is growing longer
Pollen, the fine powder produced by plants as part of the reproduction process, is more abundant in warm weather, and experts say the season is only getting longer as our climate warms.
A study cited by the National Institute of Environmental Health Services found that the northern U.S. pollen season lengthened by as much as 13 to 27 days between 1995 and 2009.
“Some parts of the United States now experience pollen (tree, grass or weed) year-round,” according to the AAFA report. “Warmer temperatures also trap heat in urban areas, increasing air pollution and stimulating pollen production.”
While pollen causes a certain level of misery in all allergy sufferers, the season can be dangerous, even potentially life-threatening for some.
“There’s something called allergic asthma, which is asthma that’s triggered by seasonal allergies,” Mendez said. “What a lot of people don’t realize is that 10 people die each day from asthma, so it’s really important to have your allergies under control if you have allergic asthma.”
In 2022, there were 3,602 deaths caused by asthma, according to the Centers for Disease Control and Prevention.
How to relieve allergy symptoms
The first thing to figure out is what specifically you’re allergic to, according to Dr. Nana Mireku, an allergist in the Dallas-Fort Worth area. Many Americans are allergic to several things at once; allergists can run tests for different triggers.
Over-the-counter nasal sprays can help relieve symptoms, but they take a while to kick in, so it’s best to start them in early March, Shah said.
Antihistamines are another option. Shah said she’s seen some patients benefit from switching to a similar brand if one stops working, but said that there isn’t much broader data to back the recommendation.
For young children and people who have to take many different allergy medications, immunotherapies in the form of shots and oral drops can help desensitize the immune system to allergens, treating symptoms at their root.
“We tell people all the time, understand what your triggers are,” Mendez said. “The only way you could understand what your triggers are so you can manage your allergies is to see a specialist.”
The Associated Press contributed to this report.
