With allergy season in full swing, the Asthma and Allergy Foundation of America (AAFA) has released its 2023 list of “Allergy Capitals.”

“Allergy Capitals” are the worst cities for seasonal allergies in the U.S., and North Texas claimed one of the top spots.

Dallas ranked No.2, only coming in behind Wichita, Kansas, making it the worst city in Texas for allergies and the second worst in the whole country.

The study looked at three different factors to determine the rankings of the 100 most-populated U.S. metropolitan areas: pollen scores of trees, grass, and weeds, the use of over-the-counter allergy medicines, and the amount of available board-certified allergists and immunologists in a city.

Cities in the high range for each criterion ranked highly for allergies.

Here are the top 10 Allergy Capitals:

  1. Wichita, Kansas
  2. Dallas
  3. Scranton, Pennsylvania
  4. Oklahoma City, Oklahoma
  5. Tulsa, Oklahoma
  6. Sarasota, Florida
  7. Cape Coral, Florida
  8. Orlando, Florida
  9. Des Moines, Iowa
  10. Greenville, South Carolina

The complete list can be found here.

The AAFA highlighted the climate’s influence on allergy season.

“About 81 million people in the U.S. have seasonal allergic rhinitis, which is most often caused by pollen allergies,” said Kenneth Mendez, CEO and president of AAFA, in a press release.

“From 1990-2018, the plant growing season extended an average of 20 days … putting people with pollen allergies at risk of more symptoms for longer periods,” the press release states. “Allergies can also trigger asthma episodes or attacks. Around 60-80% of the nearly 26 million people in the U.S. with asthma have allergic asthma.”

Aside from the weather, there are other more personal reasons that your allergies may be getting worse. Allergies may worsen as you age because you have been exposed to allergy triggers for longer, Dr. Purvi Parikh told Prevention.

Additionally, stress can exacerbate the symptoms of allergies, as it “creates inflammation,” according to Parikh. Often, allergies have similar symptoms to stress, meaning that your allergies may feel twice as bad when you are stressed.

As a precautionary step, the foundation encourages the use of more pollen sensors in the U.S. Pollen sensors are used to monitor the amount of pollen in an area and help with the diagnosis and treatment of allergies, study why pollen count is increasing, and aid those who do suffer from seasonal allergies to better forecast and prepare for high pollen count.