Can Allergies Cause a Sore Throat? Signs and Remedies

Yes, allergies can cause a sore throat. It usually comes from postnasal drip, the extra mucus that allergies send down the back of your throat, and Cleveland Clinic says that mucus irritates the throat. An allergy sore throat tends to feel irritated or itchy, and it shows up alongside sneezing, a runny nose or itchy eyes. It doesn't come with a fever. If your throat hurts and you're running a fever, an infection such as a cold or strep throat is the more likely cause.

When to get care right away

A throat that feels tight or is swelling is different from a sore throat. Call 911 if you have trouble breathing or swallowing, swelling of your tongue or face, or a voice that turns very hoarse or whispery. MedlinePlus lists these as signs of anaphylaxis, a severe allergic reaction, and says to use epinephrine right away if you have it. Swallowing that hurts so much you drool, or a muffled voice, also needs emergency care, according to the American Academy of Otolaryngology's ENT Health site.

How allergies cause a sore throat

Postnasal drip. Your nose and throat make one to two quarts of mucus a day, and you normally swallow it without noticing, Cleveland Clinic explains. Allergies are one of the most common reasons that flow increases. When it does, you feel it: a sore throat, a lump in your throat, hoarseness and the urge to keep clearing your throat. ENT Health's post-nasal drip page adds that the throat usually isn't infected, though the tonsils and nearby tissue can swell. Treating the drip usually clears up the throat.

Itching. The American College of Allergy, Asthma and Immunology (ACAAI) lists itching of the nose, mouth, eyes or throat as a hay fever symptom. That itchy, tickly feeling is one of the clearest signs your sore throat is allergic.

Mouth breathing. A stuffy nose can leave you breathing through your mouth, especially asleep. Cleveland Clinic lists breathing through your mouth while you sleep as a cause of sore throats.

The usual triggers are pollen, dust mites, pets and mold, per Cleveland Clinic. Pollen allergies come in spring, summer and early fall, while dust mites and pet dander can keep symptoms going all year, according to the ACAAI.

Sore throat: allergies, a cold or strep?

These clues can help you decide what to mention to a doctor. They can't tell you what you have, and only a test can confirm strep.

Most sore throats aren't strep. The CDC says only about 1 in 10 adults and 3 in 10 children with a sore throat have it. For a cold, the NIH rates a sore throat as common. For allergies, it says "sometimes." If you're still unsure whether you're dealing with allergies or a cold, our guide to allergies vs. a cold walks through the rest of the symptoms.

Why an allergy sore throat is often worse at night

Many people notice an allergy sore throat at night or first thing in the morning. Cleveland Clinic says the cough that comes with postnasal drip tends to be worse at night, and its sore throat page names breathing through your mouth while you sleep as a cause in its own right. A nose that's stuffed up at bedtime sets up both.

Your bedroom may also be part of it. Dust mites and pet dander are year round allergens, per the ACAAI. Our dust mite allergy guide has five steps for the bedroom, and our article on cat allergy symptoms explains why pet allergen lingers in a home.

Allergy sore throat remedies

1. Gargle with warm salt water. MedlinePlus suggests 1/2 teaspoon of salt in 1 cup of warm water, several times a day.
2. Drink warm liquids. Tea with lemon and honey or a cup of broth may help a dry, scratchy throat, Cleveland Clinic says. The CDC suggests honey for a cough, for anyone age 1 or older. Lozenges and ice chips also help, but skip lozenges for young children because of the choking risk.
3. Rinse your nose with saline. The ACAAI lists saline nasal sprays, which you can use as often as needed, and saline rinses among hay fever treatments. If you use a neti pot, the FDA says to use distilled or sterile water, or tap water boiled for 3 to 5 minutes and cooled. Plain tap water isn't safe in your nose.
4. Try a steroid nasal spray. The ACAAI calls nasal corticosteroids the single most effective drug class for allergic rhinitis. They treat the nose, where the drip starts, rather than the throat itself.
5. Pick a non-drowsy antihistamine. Antihistamines ease sneezing, a runny nose and an itchy throat. ENT Health notes that older sedating antihistamines can thicken mucus, while newer non-drowsy ones don't.
6. Run a clean humidifier at night. The CDC recommends a clean humidifier or cool mist vaporizer, and Cleveland Clinic says it's most useful in the bedroom. No humidifier? Warm drinks and a salt water gargle before bed also help.

When to see a doctor

See a provider if your sore throat lasts longer than a week, the pain is severe, or you have a fever, especially one above 100.4°F, according to Cleveland Clinic. It also lists blood in your saliva or phlegm, a rash, and a visible bulge at the back of your throat. The CDC adds a sore throat that isn't improving after a few days or keeps coming back.

Antibiotics won't fix an allergy sore throat. The ACAAI says they don't help allergic rhinitis, and the CDC says they don't help viral sore throats either. If your sore throat shows up every spring or every fall, an allergist can find out which allergens are behind it with a skin test or blood test.

Longer term options for allergies

Allergy medicine handles the day to day: steroid nasal sprays, antihistamines and saline. It helps while you use it but doesn't change the allergy.

Allergy shots retrain your immune system over time. The AAAAI describes shots about once or twice a week for four to six months, then every two to four weeks for about three to five years.

Allergy tablets dissolve under the tongue at home. The ACAAI notes they're approved only for certain grass and ragweed pollens and dust mites.

ILIT (intralymphatic immunotherapy) is the shortest immunotherapy course, and for some people a faster alternative to allergy shots. An allergist injects FDA approved allergen extract into a lymph node in the groin (just below the waist, near the hip), an off label use of the extract that our Learn About ILIT page explains. The 2008 trial that established ILIT gave three injections over two months for grass pollen allergy, compared with 54 shots over three years. The research is promising but smaller than for allergy shots, and results vary from person to person.

Our comparison of allergy shots, allergy drops and ILIT sets the options side by side. If a scratchy throat is part of every allergy season for you, talk with an allergist now about treating the allergy itself. You can find an ILIT provider near you by zip code.