Developing allergies after moving to Spain

Terms used

• Médico de cabecera — The médico de cabecera is your family doctor (GP) in the public health system.
• Centro de salud — The centro de salud is your local public health centre, where your GP sees you.
• Alergología — Alergología is the allergy specialty; an allergist is the doctor who diagnoses and treats allergies.
• Tarjeta sanitaria — The tarjeta sanitaria is the public health card that gives you access to state healthcare.

Key rules

• Timing: Allergy can appear after months or years in Spain, often in your second or third season.
• Wheeze or cough: See a doctor if allergy symptoms come with wheeze or cough.
• Public route: Your GP at the centro de salud refers you to the allergist, and you need a tarjeta sanitaria.
• Private route: You can book a private allergist directly, without a referral.
• Pharmacy: A pharmacist can advise on non-prescription antihistamines, nasal rinses and eye drops.

Why you can develop allergies here

You can become allergic in Spain even if you never had an allergy before. You meet pollen your body does not know: olive, cypress, plane tree, Parietaria and Mediterranean grasses. Your body can take months or years of repeated contact to react, so symptoms often start in your second or third season.

Several things make it worse:

• Seasons are long and mild, and warmer winters stretch them out.
• Air pollution, such as ozone and diesel particles, irritates your airways and makes pollen more allergenic.
• Dust mites in humid coastal homes and mould spores add to the load.
• You are more at risk if allergy, asthma or eczema runs in your family, or if you have asthma or eczema yourself.

Allergy or cold?

Think allergy if you have itchy eyes, nose, throat or palate, repeated sneezing, clear watery nasal discharge, or watery, red eyes. Allergy does not cause fever or real body aches.

Think cold if you have a sore throat, thicker or coloured mucus, fever or aches. A cold builds up and fades within about a week to ten days. Allergy lasts weeks, comes back in the same season each year, and is worse outdoors, on windy or dry days, and in the morning.

The timeline and checklist below walk you through what to notice.

Get it checked

Start with your GP (médico de cabecera) at your centro de salud. They assess your symptoms, may start treatment, and can refer you to an allergist (alergología). To use the public route you need your tarjeta sanitaria. Waiting times vary by region, from weeks to many months.

If you do not want to wait, you can book a private allergist directly, with no referral. You can go through your insurer's panel, which may need prior authorisation, or pay yourself. A consultation usually costs tens of euros, and tests are extra.

The allergist takes your history and usually runs skin prick tests with standard pollen and mite extracts. They can add blood tests for specific IgE and spirometry if asthma is a concern. Treatment can include immunotherapy (allergy vaccines).

See a doctor promptly if you have wheeze or cough. That can point to asthma.

Manage symptoms in the season

Avoiding pollen helps as much as medicine:

• Check the daily pollen forecast.
• Keep windows closed in the morning and evening.
• Shower and change clothes after being outdoors.
• Wear wraparound sunglasses.
• Dry laundry indoors.
• Use filters in your car.
• Avoid being outdoors on dry, windy days.

Pharmacies sell several treatments without a prescription: second-generation antihistamine tablets (such as cetirizine, loratadine, bilastine or ebastine), saline nasal rinses, and eye drops (cromoglicate or antihistamine). Steroid nose sprays are mostly prescription-only, though a few may be sold over the counter.

Ask the pharmacist which product suits you, and about drowsiness and interactions with other medicines. If you are pregnant, or the patient is a child, get pharmacist or doctor advice first. Which products need a prescription can change, so the pharmacist is the right person to ask. Go to a doctor if symptoms are severe, include wheeze, or do not respond.

Timeline and deadlines

• A cold builds up, peaks and fades: within about 7 to 10 days

• See a doctor if symptoms continue and look like allergy: itchy eyes, repeated sneezing, clear watery nose: after more than 10 days of symptoms

• Notice whether the same symptoms return in the same season: each year, over weeks rather than days

Checklist

• Check whether you have itchy eyes, nose, throat or palate, repeated sneezing and clear watery discharge, with no fever or body aches.

• Note whether symptoms last longer than 10 days and return in the same season each year.

• Notice if symptoms are worse outdoors, on windy or dry days, and in the morning.

• Book a visit with your GP at the centro de salud if symptoms continue, or if you have wheeze or cough.

• Ask your GP for a referral to the allergy specialist, or book a private allergist directly.

• Ask a pharmacist which antihistamine, nasal rinse or eye drops suit you, and about drowsiness and interactions.

• Check the daily pollen forecast and keep windows closed in the morning and evening.

• Shower and change clothes after being outdoors, and dry laundry indoors.

What to watch out for

• Allergy can start in your second or third season: Mild symptoms in your first year do not mean you are safe. Exposure to new pollen such as olive, cypress, plane tree, Parietaria and Mediterranean grasses can sensitise you over time, and pollution, dust mites and mould can make it worse. Start avoidance measures early in the season and see your GP if symptoms return in the same season each year.

• Wheeze or cough can mean asthma: Wheeze or a cough alongside hay fever symptoms may point to asthma, which over-the-counter products do not treat. See a doctor, and ask a pharmacist to refer you if symptoms are severe or do not respond to treatment.

• Buying the wrong medicine: Some antihistamines cause drowsiness or interact with other medicines, and children and pregnant women need extra care. Ask the pharmacist before buying, and get doctor advice for children or if you are pregnant.

Frequently asked questions

Can I develop an allergy even if I never had one before moving to Spain?

Yes, you can develop a pollen allergy after moving, because sensitisation can build up after months or years of repeated exposure to pollen you have not met before. Symptoms often start in the second or third season. A family history of allergy, asthma or eczema raises the risk.

Do I need a referral to see an allergist in Spain?

In the public system yes, you need to see your GP at the centro de salud first, who refers you to the allergy specialist, and you need a tarjeta sanitaria (public health card). Privately you can book an allergist directly without a referral, and an insurer may ask for prior authorisation. Public waiting times run from weeks to many months.

What tests will an allergist run?

The allergist usually takes your history and runs skin prick tests with standard pollen and mite extracts. A blood test for specific IgE antibodies can be added, and a breathing test called spirometry if asthma is suspected.

Can I buy allergy medicine at a pharmacy without a prescription?

Yes, pharmacies sell oral second-generation antihistamines such as cetirizine or loratadine, saline nasal rinses and allergy eye drops without a prescription. Steroid nasal sprays are mostly prescription-only. Ask the pharmacist about drowsiness and interactions, and take extra advice for children or if you are pregnant.