What Is an Allergy Headache?

Headaches are the most common type of pain. They're a major reason many people miss school or work. While some headaches—like cluster headaches and tension headaches—can occur on their own without a specific reason, other headaches can be related to outside circumstances, like allergies.

Allergy headache itself isn't a real diagnosis—but that doesn't make the pain any less real. This pain can be described as a sense of pressure in the face. While the sinuses often get blamed as the cause of this headache, many times it's a migraine instead. Here you'll find out how headaches are related to allergies and what you can do about them.

Types of Allergy Headaches

Medically, allergy headaches aren't a thing. They will likely be classified as either a migraine or sinus headache. Migraines and sinus headaches can both produce facial pain.

Sinus Headaches

Sinus headache is a very broad term. Generally, it's used for any facial pain because that's where the sinuses are located.

Sinuses are air-filled spaces around your eyes and nose. The tissue lining these cavities can become inflamed or swollen. Medically, inflammation of the nose and sinuses is called rhinosinusitis or sinusitis. Patients with rhinosinusitis sometimes describe having a sinus headache. True rhinosinusitis is caused by an infection.

Your sinuses can become irritated from allergens, a condition called allergic rhinitis. Also called hay fever or seasonal allergies, allergic rhinitis will make your nose stuffy, but that may not be what's causing your headaches.

More often than not, patients who think they have a sinus headache are told by an ear–nose–throat (ENT) specialist that they actually have chronic migraines.

Chronic Migraines

Migraines can be mistaken for sinus headaches because they occur in similar locations. Migraines, not sinus headaches, are often what's going on if you've got allergies.

In fact, allergies seem to be pretty common in people with migraines. One study found that half of the migraine patients had allergies, compared to less than one-third of healthy individuals. Another finding from this research was the patients with allergies had migraine attacks more often than migraine patients without allergies. Environmental factors like allergens appear to be involved in triggering migraines.

Symptoms of Allergy Headaches

The symptoms of rhinosinusitis are similar to those of a migraine—but with some key differences. It's pretty common to think you have a sinus headache when you actually have a migraine. About 90% of patients who believe they have a sinus headache are diagnosed with migraine instead.

A true sinus headache, aka rhinosinusitis, is rare and is usually due to another cause like a viral or bacterial infection. The facial pain and headache should go away within seven days after you stop having symptoms or after treatment. Symptoms of sinus headaches include:

• Facial pain and pressure
• Headache
• Nasal and sinus congestion
• Possibly fever
• Reduced or no smell
• Thick, discolored nasal discharge

Migraines have a different range of symptoms, in addition to pain over the sinuses:

• Headache worsened by activity
• Interference with daily activities
• Moderate to severe headache
• Nausea
• Possibly watery eyes and runny nose, but with clear fluid
• Pulsing or throbbing pain
• Sensitivity to light and/or noise
  

What Causes Allergy Headaches?

An allergy headache will have different causes depending on whether it's rhinosinusitis or migraine.

Sinus Headaches

Rhinosinusitis is most often caused by viruses. About 90% of people with a cold have some degree of viral inflammation in the sinuses.

Inflammation can be caused by bacteria as well. However, headaches due to sinusitis from bacterial infections are rare.

Sinus inflammation is also common in people with allergies. Rhinosinusitis can be triggered by the same irritants that set off your allergies—animal dander, polluted air, smoke, and dust.

Whether rhinosinusitis is what's causing headaches is up for debate, however. Constant blockage of nasal passages from allergic inflammation is definitely annoying, but it may not be giving you headaches.

Migraines

Migraines occur when nerve fibers in the blood vessels of the brain become activated. These nerve fibers can become activated by a number of different triggers, which vary from person to person:

• Anxiety
• Bright or flashing lights
• Depression
• Emotion
• Hangover
• Head trauma
• Hormonal changes
• Loud or sudden noises
• Low blood sugar
• Motion sickness
• Overexertion
• Skipped meals
• Some medications
• Stress
• Strong odors or fumes
• Sudden changes in weather or environment
• Tobacco
• Too much or too little sleep

Another link between migraines and allergies is their causes are closely related. Histamine is released in allergic rhinitis, causing inflammation and irritation of nasal passages, which could also trigger migraines. People with inflammation caused by allergies are more than 10 times as likely to have migraine.

Migraines can occur in children and adults, and females are about three times more likely to experience them than males. Medical conditions, depression, anxiety, bipolar disorder, sleep disorders, and epilepsy can also affect migraines.

How Are Allergy Headaches Diagnosed?

Getting the right diagnosis is crucial. If you say you have an allergy headache or a sinus headache, your healthcare provider will want to know a few things before making a diagnosis.

A true sinus headache is rare and is accompanied by a viral or bacterial sinus infection. You'll have thick, discolored nasal discharge, a loss of or no sense of smell, and sometimes fever in addition to facial pain and pressure.

Migraines present differently. Think about your headaches recently and ask yourself these questions:

• In the last three months, have your headaches been disabling or interfering with your ability to function (at work, at school, or during family activities)?
• Do you ever have nausea with your headaches?
• Do you notice sensitivity to light with your headaches?

If you answered yes to two of these, the cause will likely be a migraine about 93% of the time. If you answered yes to all three, you can be about 98% sure it's a migraine.

Treatments for Allergy Headaches

The goal of treating headaches is to relieve symptoms and prevent additional attacks. The treatment itself will vary depending on the type of headache.

Sinus Headaches

Treating the infection relieves symptoms. Treatment varies depending on whether it's a viral, bacterial, or fungal infection. Sometimes rhinosinusitis goes away on its own, and when it does, the headache should too.

Migraines

You may have tried a number of over-the-counter (OTC) allergy medicines aiming to reduce sinus inflammation. If you're not seeing success, your headaches could be migraines instead.

Here are some quick steps you can take to treat your symptoms the next time a headache comes on:

• Drink lots of fluid, especially if you've been vomiting
• Nap or rest with your eyes closed in a quiet, darkened room
• Place a cool cloth or ice pack on your forehead
• Try a small amount of caffeine when the migraine is starting

OTC treatments like ibuprofen, aspirin, or acetaminophen, can help relieve symptoms, as can prescription medications and combined treatments. If migraines are frequent or severe, preventative medicines may help.

Natural treatments include vitamin B12 (riboflavin), magnesium, coenzyme Q10, and a medicinal plant called butterbur. Other treatments like biofeedback and relaxation training can help you learn how to control or cope with the pain and your body's response.

How To Prevent Allergy Headaches

Not everyone who has allergies will experience headaches. If you do get headaches, there are ways to get relief. Good allergy management can help keep inflammation levels low, which can reduce migraine headaches.

Allergies can be treated with OTC or prescription medications, as well as allergy shots. You may be able to prevent allergies by avoiding triggers. Contact an immunologist or allergist if you don't already know what you're allergic to.

Preventing migraines can also include making adjustments to your lifestyle. Plant these SEEDS of headache prevention now to reap the benefits of migraine management in the future:

• Sleep: Migraines can make sleep difficult. A regular sleep schedule can help you manage migraines. This means going to be at the same time every night and getting the same number of hours of sleep every night. Aim for seven to eight hours of sleep every night. Most importantly, be consistent.
• Exercise: Getting exercise can help you reduce the frequency, severity, and duration of migraine attacks. Aim for 30 to 50 minutes of moderate-intensity exercise three to five times a week. Find something fun that you enjoy so you'll stick with it.
• Eat: Food and hydration can affect migraines. Keep blood sugar levels steady by eating six small meals a day. The best foods for migraine management are high in protein, fiber, and healthy fats. Avoid highly processed foods and fasting. Also, make sure you're staying hydrated by drinking plenty of water.
• Diary: Keep a diary of your headaches. This will help your healthcare provider make an accurate diagnosis. You may start to recognize patterns that are popping up around your headaches to pinpoint where you can make changes.
• Stress: Check in with your stress levels. Stress can trigger migraines. Know and avoid the things in your life that cause you stress—and prioritize activities that decrease your stress.

If you're experiencing sinusitis, you can prevent it by cleaning your hands, getting your recommended vaccines, and avoiding contact with people who have a cold or other upper respiratory infections. Avoid smoking and secondhand smoke. Using a humidifier can also help because it moistens the air.

Living with Allergy Headaches

In most cases, allergy headaches are actually migraines. If you have frequent bouts of sinusitis, contact a healthcare provider or ENT specialist to see what might be causing them.

Migraine headaches can be severely disruptive to daily life. Headache hygiene means adjusting your lifestyle to prevent headaches. You may not see your symptoms disappear completely, but you could see a big reduction by maintaining regular sleep patterns, getting regular exercise, eating meals regularly, managing stress, and avoiding triggers.

Some headaches can be triggered by diet and managed through a well-balanced diet. Generally, you'll want to get some protein in your meal or snack and stay away from high-sugar foods to prevent a "hunger headache."

Keeping a food diary can be helpful. Have a column for time, food(s) eaten and the amounts, and any headache symptoms. Reactions can occur anywhere from half an hour to 72 hours after you had the triggering food or beverage.

If you're taking a monoamine oxidase (MAO) inhibitor, you'll be advised to avoid the amino acid tyramine. Tyramine is found in many foods, especially aged and fermented foods.

People who get periods may be extra sensitive to migraine triggers when they're premenstrual. Foods you eat the week after your period may not trigger a headache, but easily could the week before.

A Quick Review

An allergy headache isn't a true medical diagnosis. If you're experiencing a sense of pressure in your sinus area, it could be sinusitis, but it's more likely a migraine. Treatment will be different depending on what's causing it.

Talk to a healthcare provider if you experience headaches frequently. OTC medications and home remedies can be effective, as can other treatments. Knowing what your triggers are and making lifestyle adjustments may be able to help prevent migraines—or at least lessen the symptoms.