Cedar Fever

What is cedar fever?

Cedar fever is an allergic reaction to pollen from mountain cedar (also known as juniper) trees. Even though it’s called cedar “fever,” most people don’t have a fever. You may experience allergy symptoms like stuffy nose, cough or sneezing when you breathe in the pollen from this species of tree. This happens because your body mistakenly believes pollen from the cedar tree is an invader. It releases chemicals to fight off this invader. This triggers an allergic response, which gives you symptoms.

What is a mountain cedar tree?

Mountain cedar trees are part of the juniper genus of trees. But most people refer to juniper trees as mountain cedars. Cedar trees are in states like Arkansas, Arizona, New Mexico, Texas, Oklahoma and Missouri. You can also find them in parts of Mexico and Japan. Only male cedars produce pollen. The pollen comes from a small, orange-brown cone. Female juniper trees have a blueberry-like cone.

How common is cedar fever?

Cedar fever is most common in the winter months from about December to February. But people can experience symptoms of cedar fever starting in November and have symptoms through March. It’s worse where there are higher concentrations of Ashe juniper trees like in central Texas. In fact, sometimes there’s so much pollen circulating that juniper trees can look like they’re smoking. Most people think of allergy season as happening in spring, but cedar fever is an exception to this because junipers pollinate in the winter.

What are the symptoms of cedar fever?

Cedar fever causes allergy symptoms, like:

• Stuffy nose.
• Itchy and watery eyes.
• Coughing or sore throat.
• Runny nose.
• Sneezing.
• Low/mild fever.
• Partial loss of smell or taste.
• Fatigue.

It’s common for people to dismiss cedar fever symptoms as the common cold or flu. That’s because cedar fever happens during cold and flu season, and they all share similar symptoms.

People with asthma or other respiratory conditions may have worse symptoms, including shortness of breath, wheezing and chest tightness.

What causes cedar fever?

An allergic reaction to cedar trees happens when your body believes pollen from the trees is dangerous. It reacts by producing chemicals in your body to fight it off. These chemicals trigger an allergic reaction, and you begin showing symptoms. Experts aren’t exactly sure why some people get allergies and others don’t, but genetics and your environment play a role.

You’re more likely to have cedar fever when there’s a high amount of cedar pollen in the air. Juniper trees pollinate in colder weather, usually right after a cold front. The weather conditions are dry and the air pressure is shifting. This makes it an ideal environment for a juniper tree to pollinate. The pollen gets picked up by gusts of wind, creating somewhat of a pollen dust storm. Cedar fever peaks in mid-January.

Certain parts of the United States have high concentrations of juniper trees. For example, central Texas is known for having very high cedar pollen levels.

Is cedar fever the same as hay fever?

Hay fever, or allergic rhinitis, is an allergic reaction that causes sneezing, congestion, itchy nose and sore throat. Pollen, pet dander and mold can lead to hay fever symptoms. Cedar fever isn’t the same as hay fever, but cedar fever can lead to symptoms of hay fever.

How is cedar fever diagnosed?

Your healthcare provider can diagnose a pollen allergy using allergy tests. A skin scratch/prick test is the most common way to diagnose allergies. It involves your provider scratching an allergen into your skin and watching how your skin reacts to that allergen. A blood test is another common way to diagnose allergies.

Your provider can also make a diagnosis based on when your symptoms start and how long they last. If it lines up with cedar pollen season and you don’t have the flu or an infection, they may assume seasonal allergies are to blame.

How is cedar fever treated?

You can treat cedar fever using either over-the-counter (OTC) allergy medications or prescription medications like allergy shots. There are also lifestyle changes you can make to avoid cedar pollen.

Allergy medications

There are several OTC and prescription allergy medications that can improve cedar fever symptoms. These include:

• Antihistamines like cetirizine (Zyrtec®), loratadine (Claritin®) or azelastine (Astelin®). These work by blocking histamine, which is the chemical your body produces in response to an allergen. They come in pill, liquid or nasal spray form.
• Decongestants to help clear your nose by shrinking your nasal passages. Some examples are pseudoephedrine (Sudafed®) or phenylephrine (Sudafed PE®). Decongestants come in pill, liquid or nasal spray form.
• Medications that combine antihistamines and decongestants like loratadine/pseudoephedrine (Claritin-D®) and fexofenadine/pseudoephedrine (Allegra-D®).
• Nasal sprays containing corticosteroids, like fluticasone (Flonase®), work by reducing inflammation in your nasal passages.
• Leukotriene inhibitors like montelukast (Singulair®). Available only with a prescription, these pills block leukotriene, which causes inflammation during an allergic reaction.

Asthma medications

Your provider may prescribe an asthma control medicine and a quick-relief asthma medicine. These can come as separate medicines as a combined medication. Inhalers are devices that deliver medication directly to your lungs. Some people use a different device (called a nebulizer) to treat their asthma.

Allergy shots (immunotherapy)

Allergy shots work by changing your immune system’s response to an allergen over time. This means that your body builds up a tolerance to cedar pollen so it reacts less severely. Your healthcare provider may also recommend a pill you place under your tongue. Keep in mind that it takes time to desensitize yourself, so don’t delay in seeing an allergist if medications aren’t working.

Lifestyle changes

While it may not be possible to avoid going outside, you can change your daily habits to try to minimize how much time you spend outside. For example, avoid being outside when it’s dry and windy because that’s when cedar pollen is worse. Other things you can do include:

• Keep your house and car windows closed to keep pollen out.
• Wash your clothes when you come in from outside to remove the pollen. Dry your clothes in the dryer.
• Pollen can land and stick on your pet’s fur. You may need to bathe them more frequently.
• Clean your home and outdoor surfaces frequently to remove pollen particles.
• Check pollen levels before you go outside. Weather websites and other apps can tell you if the pollen levels are particularly high that day.
• Wear a dust mask, hat and sunglasses when you do go outside to minimize how much pollen gets in your mouth, nose and eyes.
• Change the air conditioning filter in your car and home.

What is the best thing to take for cedar fever?

Treatment for allergies is unique to you. What works for one person may not work for you and vice versa. While many people find relief from medications they can purchase at the grocery store, some people need prescription allergy medication or allergy shots.

When will cedar fever go away?

Cedar fever is seasonal, which means it’ll go away eventually. If you have allergy symptoms in the winter months and don’t have a cold or the flu, it could be cedar fever. Keep in mind that cedar fever only happens in regions with an abundance of juniper trees.

Can this be prevented?

No, you can’t prevent an allergy. You can only manage your symptoms.

How long does cedar fever last?

Cedar fever is seasonal, which means it shouldn’t affect you all year long. In most cases, you’ll experience the most intense symptoms in December to February. But some people have symptoms as early as November and as late as March. It all depends on how your immune system responds to the allergy and what treatments you use to manage it.

How do I take care of myself?

Medications can offer relief for many people with cedar fever. It might take time to find the medication that works best for you. Work with your healthcare provider to find the best treatment based on your symptoms.

While avoiding the outdoors completely for weeks or months can be difficult, taking steps to limit your time outside is often the best way to avoid pollen.

When should I see my healthcare provider?

Contact a healthcare provider if you have symptoms of cedar fever. Many people find relief from over-the-counter allergy medication. But if these don’t work for you, a healthcare provider can recommend more effective treatment. You don’t have to suffer from allergy symptoms — there are treatments that can help you.

A note from Cleveland Clinic

Cedar fever is an allergy to pollen from a mountain cedar tree (juniper tree). Many people find the relief they need from over-the-counter allergy medications. Seek treatment from a healthcare provider if your symptoms disrupt your daily life or don’t improve with medication. You can also avoid the outdoors when cedar pollen is at its worst. Fortunately, cedar fever is seasonal, so your symptoms should improve once spring arrives.