WICHITA, Kan. (KSNW) – Pollen, weeds and grass make you miserable? You’ll want to steer clear of a few dozen “allergy capitals,” cities around the country that are especially challenging for allergy sufferers.

The Asthma and Allergy Foundation of America released its 2024 Allergy Capitals report this month detailing the worst major cities in the United States for people living with seasonal allergies. They looked at the 100 largest cities in the contiguous U.S. and evaluated them based on daily pollen counts, over-the-counter allergy medication use, and the availability of allergy specialists.

They found people who live in the South, Southeast and parts of the Midwest tend to have the most issues.

Two Texas cities ended up in the top 15, with Dallas landing at number four and Houston at 14. Both cities reported having higher-than-average tree and grass pollen, while Dallas also had worse-than-average medicine use.

Other Texas cities that made the list included El Paso landing at 22, in part due to low access to allergy specialists. Despite having better-than-average medicine use, San Antonio finished at 24 due to higher-than-average pollen.

Austin ended up in the middle of the pack at 54 due to higher-than-average pollen, but the city fared well with better-than-average medicine use and great access to allergy specialists.

Wichita, Kansas, came in at the top of the list for the second straight year thanks to the city’s higher-than-average tree and grass pollen, worse-than-average medicine use, and low access to allergy specialists. 

Cities in Texas, Virginia, Oklahoma and the Carolinas dominate the list of worst places for allergies. Dr. Nana Mireku, an allergist in the Dallas-Fort Worth area, said “people are pretty miserable right now and allergists are pretty busy.”

The worst allergy cities, according to the Asthma and Allergy Foundation of America, are:

  1. Wichita, Kansas
  2. Virginia Beach, Virginia
  3. Greenville, South Carolina
  4. Dallas, Texas
  5. Oklahoma City, Oklahoma
  6. Tulsa, Oklahoma
  7. Richmond, Virginia
  8. Des Moines, Iowa
  9. Raleigh, North Carolina
  10. Fayetteville, Arkansas
  11. Allentown, Pennsylvania
  12. Baton Rouge, Louisiana
  13. Sarasota, Florida
  14. Houston, Texas
  15. Columbia, South Carolina

If you’re looking for allergy relief, you’ll want to head west or north. California has several cities listed among the best places for allergy sufferers, including San Jose, Sacramento, Stockton, Bakersfield and Los Angeles.

Akron, Ohio; Albuquerque, New Mexico; and Madison, Wisconsin also all scored very favorably for allergies. (See where all 100 large U.S. cities ranked by reading the full report here.)

As the weather warms up, you may be starting to feel more and more allergy symptoms. Tree pollen is usually the first thing to trigger allergies, before grass pollen and weed pollen come later in the spring and into summer. Ragweed pollen typically comes around back-to-school season, according to the Asthma and Allergy Foundation of America.

This year, allergy season started early, experts say. Dr. Rachna Shah usually starts looking at pollen counts in the Chicago area in April. But she peeked at her data in mid-February, and saw tree pollen was already at a “moderate” level.

“This season has been so nuts,” said Shah, an allergist and director of the Loyola Medicine Allergy Count. “Granted, it was a pretty mild winter, but I didn’t expect it to be so early.”

Shah said she believes this season will be longer than other years, assuming the weather remains warm. Experts say climate change has led to longer and more intense allergy seasons.

More than 80 million Americans deal with itchy eyes, runny nose and other symptoms of seasonal allergies, according to the Asthma and Allergy Foundation of America.

Allergies happen when you encounter these things in nature, but your immune system reacts to it and starts making antibodies, the Mayo Clinic explains. That reaction is what makes you feel symptoms, like runny nose or itchy eyes.

The Associated Press contributed to this report.