Cedar fever vs. seasonal allergies: What’s the difference?

Mountain cedar, also called Ashe juniper, is one of the biggest allergy triggers during fall and winter. It can affect both adults and children, making this season especially challenging for those with allergies.

Mountain cedar occupies around 8.6 million acres in Texas, predominantly in the Texas Hill Country. One tree can release billions of pollen, and winds from the west, south and southwest then spread the pollen to other parts of the state.

Unlike most trees pollinating in the spring, mountain cedar blooms in isolation in the winter months, from mid-late December to February.

The good news? Relief is out there. Let’s take a closer look at what cedar fever is and how you can feel better each day.

What is cedar fever?

Allergies to cedar pollen are so significant that they've been dubbed “cedar fever,” although the "fever" is due to inflammation causing a slight increase in body temperature. The cedar allergy season typically lasts from December to February, peaking in mid-January.

Up to 20% of Texans experience cedar pollen allergies, which is why Central Texas, specifically Dallas, consistently ranks high on the national “Allergy Capital” list by the Asthma and Allergy Foundation of America (AAFA). The mountain cedar trees produce enormous amounts of pollen, which can cause people who are allergic to experience much discomfort. During peak season, pollen counts can reach extreme levels, triggering symptoms in even those who don't typically struggle with allergies.

Why do some people get cedar fever while others don’t?

As for why some people experience cedar fever more than others, it's mostly related to genetics. You may be genetically prone to getting allergies, but you also need to be living in a high-allergy environment to develop a problem. This explains why some people who move to Texas from other states suddenly develop cedar fever symptoms, even if they never had allergies before. 

Understanding cedar fever symptoms

Cedar fever symptoms can range from mild to severe and often mimic those of a common cold or flu. The most common cedar fever symptoms include:

• Sneezing and a runny or stuffy nose
• Itchy, watery or red eyes
• Nasal congestion and sinus pressure
• Scratchy or sore throat
• Fatigue and feeling run-down
• Headaches or facial pain
• Post-nasal drip and coughing
• Mild increase in body temperature due to inflammation
• Asthma exacerbation

Many people mistake cedar fever symptoms for a cold or sinus infection, but there are key differences. Cedar fever symptoms typically don't include body aches or a genuine fever above 100°F. If you notice your symptoms worsen on windy days or improve when you're indoors, cedar pollen is likely the culprit.

How is a cedar allergy different from other seasonal allergies?

Many common seasonal allergens like ragweed, grass pollen and birch or oak tree pollens are found across much of the country; however, mountain cedar allergies are more regionally specific. Here are some other primary differences: 

Timing: Winter vs. spring or summer

Cedar fever occurs during the winter months (December-February), while most people associate allergy season with spring. Unlike most other trees which pollinate in spring, juniper trees pollinate in the winter.

Pollen seasons in the US:

• February to April: Most trees, except mountain cedar
• April to early June: Grasses
• August to the first strong frost: Weeds

Severity of cedar fever symptoms

Mountain cedar allergy is known for triggering more intense reactions that are often mistaken for a cold or the flu. The intensity of symptoms distinguishes it from other seasonal allergies.

Cedar fever can affect nonallergy sufferers

Juniper pollen is unique in that it can cause allergic reactions in those with no other environmental allergy or sensitivity.

Remedies and care for cedar fever

If you're symptomatic to the point it is affecting your quality of life, relief is out there. There are some treatments your physician may be able to recommend—but you must start early.

Environmental control: In addition to medical treatments, there are several steps you can take to minimize your exposure to cedar pollen and reduce cedar fever symptoms:

• Check daily pollen counts and limit outdoor activities when counts are high
• Keep windows closed during peak cedar season
• Use air purifiers with HEPA filters in your home
• Shower and change clothes after spending time outdoors
• Wash bedding regularly in hot water
• Avoid hanging laundry outside to dry during cedar season

Over-the-counter medications: If you're experiencing cedar fever symptoms like sneezing, a runny nose, itchy or watery eyes and congestion, your primary care doctor can typically suggest over-the-counter remedies, including nasal steroids, allergy eye drops, antihistamines and saline nasal rinses. These can provide significant relief when used consistently throughout cedar season.

Prescriptions: If that doesn't help, your doctor may recommend a prescription antihistamine nose spray for symptom relief. Allergy management is usually taken in two steps—medication and immunotherapy (allergy shots or drops).

Virtual care: We know that physically getting to the doctor when you feel sick with allergies isn't always easy and sometimes, all you need is a quick consult. If you're experiencing cedar fever, virtual care makes it easy to get the same expert support you receive in-person at a doctor's office—right from the comfort of your home.

Seeing an allergist: If all these other remedies don’t help, your doctor may recommend a referral to the allergy immunology clinic for further allergy testing and allergy immunotherapy (allergy shots), which can be effective in 70-80% of people. For cedar allergy, this involves getting regular injections of cedar pollen proteins that increase over time to help desensitize your body to its effects.

But don't delay seeing an allergist immunologist. If you go to an allergist in January, at the peak of cedar fever season, then allergy immunotherapy may not be able to do as much for you. Your immune system needs six to 12 months of allergy shots to build immunity to specific triggers like cedar. This means starting your treatment plan in late spring or early summer is ideal for maximum protection during the next cedar season.

Are allergies affecting your quality of life? Find allergy relief through our Allergy Care program.