Seasonal Allergies, Sinus Headaches and Migraine

March 23, 2022

For many of us, the arrival of spring is a welcome sign of warmer weather on the horizon, but this time of year can also be difficult for those who suffer from seasonal allergies.

According to Barbara Nye, M.D., a headache specialist with Atrium Health Wake Forest Baptist, seasonal allergies can trigger a sinus headache or migraine. Migraine can also cause watery eyes, head fullness and can be a disabling disease that affects 39 million people in the U.S., according to the American Migraine Foundation.

“It is important to take the time to listen to patients,” said Nye, who is also an associate professor of neurology at Wake Forest School of Medicine. “The overwhelming majority of headache diagnoses come from listening to and speaking with patients, rather than from physical exams or imaging.”

Nye said there is a very high rate of self-misdiagnosis – people often think they have a sinus headache when they are actually suffering from migraine.

“There is a lack of awareness among the general population when it comes to migraine,” she said. “Unfortunately, migraine carries a stigma, and there are many people who simply suffer with the pain and debilitating effects.

“It’s easy to run down to the drugstore and pick up medication for a sinus headache, so many people believe it is more treatable than migraine.”

So how can someone know if they’re suffering from migraine or a sinus headache?

Nye said there are three questions to ask:

  • Have you had functional impairment due to headaches in the past three months?
  • Have you been nauseated or felt sick to your stomach?
  • Do you have light sensitivity?

If the answer to all three is ‘yes,’ there is a about a 95% probability that someone is experiencing migraine, according to Nye, citing an ID Migraine validation screener.

Nye said it is important for patients to pay attention to the location of their pain. A sinus headache causes pressure that remains in the sinus cavities while migraine causes a throbbing pain that wanders. 

Known migraine triggers include:

  • Aged cheeses
  • Alcohol, especially red wine
  • Chocolate
  • Changes in barometric pressure
  • Withdrawal from caffeine

Allergy medication may help improve migraine symptoms, if the migraine trigger is seasonal allergies. However, Nye said there is a possibility that overusing medications can increase the likelihood of developing headaches.

If there is a clear relationship between someone’s headache and seasonal allergies, an allergy specialist can help identify the specific allergy trigger and discuss with patients if allergy shots are appropriate.

While sinus headache and migraine are two distinct ailments, Nye said it is possible to suffer from both simultaneously.

“People want to do something to alleviate the pain,” she said, “but in many cases, over-the-counter medications do not help with migraine.”

However, a neurologist who specializes in headaches, such as Nye, can work with patients to develop an effective treatment plan.

“Many people think that headaches are simply an annoyance, but they can be so much more,” she said. “Migraine can be debilitating, and I am working with advocacy groups to decrease the stigma and with my own patients to restore their quality of life.”

Media contact: 

Joe McCloskey,