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Birch Pollen – Allergy, Symptoms & Treatment

Birch pollen are tiny particles released by birch trees during flowering and are among the most common triggers of hay fever in Central Europe, causing sneezing, itchy eyes, and breathing difficulties.

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Things worth knowing about "Birch Pollen"

Birch pollen are tiny particles released by birch trees during flowering and are among the most common triggers of hay fever in Central Europe, causing sneezing, itchy eyes, and breathing difficulties.

What Is Birch Pollen?

Birch pollen consists of microscopic grains released by birch trees (genus Betula) during their flowering period. It is one of the most potent allergens in Central Europe and one of the leading causes of seasonal allergic rhinitis, commonly known as hay fever.

Pollen Season

In Central Europe, the birch pollen season typically runs from March to May, depending on weather conditions and geographic location. In mild winters, pollination can begin as early as late February. Pollen counts are particularly high on warm, dry, and windy days, intensifying allergy symptoms.

Allergen and Mechanism

The main allergen in birch pollen is the protein Bet v 1. In sensitized individuals, the immune system mistakenly identifies this protein as a threat, producing IgE antibodies. Upon re-exposure, these antibodies trigger the release of inflammatory mediators such as histamine, causing the characteristic symptoms of an allergic reaction.

Symptoms of Birch Pollen Allergy

Frequent sneezing and runny nose
Itchy, red, and watery eyes (allergic conjunctivitis)
Nasal congestion and inflammation of the nasal mucosa
Itching or tingling in the throat and palate
In sensitized individuals: asthma attacks or shortness of breath

Cross-Reactions with Foods

A clinically important phenomenon is Oral Allergy Syndrome (OAS). Many people allergic to birch pollen also react to certain foods, as their proteins are structurally similar to the Bet v 1 allergen. Common cross-reactive foods include:

Apples, pears, cherries, and peaches
Hazelnuts and almonds
Carrots, celery, and parsley
Soy products

Typical symptoms include tingling, itching, or swelling of the lips, mouth, and throat shortly after eating these foods.

Diagnosis

A birch pollen allergy is diagnosed through:

Medical history: Assessment of symptoms and their seasonal pattern
Skin prick test: A small amount of birch pollen extract is applied to the skin to observe a local reaction
Specific IgE blood test: Detects birch pollen antibodies in the blood
Nasal provocation test: Used in specific cases to confirm the diagnosis

Treatment

Symptomatic Therapy

Several medications are available to relieve symptoms:

Antihistamines: Block the effects of histamine, reducing sneezing, itching, and eye irritation
Corticosteroid nasal sprays: Effectively reduce inflammation of the nasal lining
Cromoglicate eye drops: Protect the eyes from allergic reactions
Decongestant nasal sprays: Provide short-term relief for nasal congestion (not for long-term use)

Allergen Immunotherapy (Desensitization)

The only causal treatment for birch pollen allergy is Allergen Immunotherapy (AIT), also known as desensitization or hyposensitization. The immune system is gradually trained to tolerate the allergen through regular administration of increasing doses of birch pollen extract. It is available as subcutaneous injections (SCIT) or as sublingual tablets or drops (SLIT) and typically lasts 3 years.

Prevention Tips

Monitor pollen forecasts and seasonal pollen calendars
Keep windows closed on high pollen count days
Change clothes and wash hair after spending time outdoors
Use pollen filters in your car and pollen-proof mattress covers
Consider holidays in low-pollen areas (e.g., coastal or high-altitude regions) during peak season

References

Allergologie, Taschenatlas. Karow, T. & Lang-Roth, R. (2022). Deutscher Apotheker Verlag.
Wahn, U. et al. (2018): Allergologie. Springer Verlag, Berlin/Heidelberg.
European Academy of Allergy and Clinical Immunology (EAACI): Guidelines on Allergen Immunotherapy. www.eaaci.org (accessed 2024).

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