By Albert S. Hartel, M.D
Rochester ranks among the most challenging places in America for both allergies and asthma.
In the latest Asthma and Allergy Foundation of America rankings, our region placed fifth worst nationally for pollen allergies and second worst for asthma.
High tree, grass and ragweed pollen levels, combined with cold winters, indoor allergens and occasional wildfire smoke, create a perfect storm for inflamed airways.
Asthma is rarely just a lung problem. In many patients, underlying allergic inflammation drives chronic airway swelling, making the lungs hyper reactive to infections, cold air, exercise and irritants. Identifying and treating those allergic triggers is often the missing piece that improves long-term control with fewer long-term medications!
Environmental measures form the foundation of care. Simple steps — using allergen-proof mattress and pillow covers, washing bedding weekly in hot water, keeping indoor humidity below 50%, running HEPA air filters and limiting pet access to bedrooms — can meaningfully reduce exposure to dust mites and animal dander. During peak pollen seasons, keeping windows closed, showering after outdoor activity and monitoring local pollen counts help limit triggers. These strategies do not replace medication but reduce the overall burden on the airways.
For patients whose asthma remains uncontrolled despite environmental changes and standard inhaled therapies, two advanced options stand out. Allergy shots (allergen immunotherapy) are the only treatment that retrains the immune system. By building lasting tolerance to specific allergens such as pollen, dust mites, mold or pet dander, shots can reduce asthma symptoms, lower medication needs and, in many cases, prevent allergic rhinitis from progressing into asthma. Benefits often continue for years after a typical five-year course.
When asthma is moderate to severe and driven by allergic or eosinophilic inflammation, biologic therapies offer another powerful tool. These targeted injectable medications can dramatically cut exacerbations, improve lung function and reduce the need for oral steroids and their long-term side effects.
The goal is not lifelong reliance on daily systemic medications. With accurate allergy testing, personalized environmental guidance, immunotherapy when appropriate and biologics for more severe disease, most patients can achieve better control, fewer flares and improved quality of life.
If asthma or allergies are limiting your daily activities despite current treatment, a comprehensive evaluation by a board-certified allergist can help identify the specific drivers and create a plan tailored to Rochester’s unique challenges. Better breathing and an active full life are possible.
Physician Albert S. Hartel specializes in pediatric and adult allergy and immunology. He is the president of Allergy Asthma Immunology of Rochester. For more information, visit https://aair.info or call 585-442-0150.