Despite the lingering chilly temperatures and persistent threats of snowfall, millions of Americans have started heading to their doctors with itchy, watery eyes, runny noses, headaches, difficulty breathing and more of the classic symptoms of seasonal allergies.

For the nearly 45 million Americans who suffer from seasonal allergies, the joy of springtime can be significantly dampened. But to help them plan ahead, the Asthma and Allergy Foundation of America (AAFA) has once again compiled a list of the most challenging places to live for people with allergies this spring — should it ever arrive.

In fact, because of the sporadic warm days followed by snowfall, mold may be a bigger issue this year in addition to pollen, according to the AAFA. “No matter what time of the year it is, and no matter what Mother Nature sends our way, people with allergies need to be prepared,” Dr. Clifford W. Bassett, M.D., medical director of Allergy and Asthma Care of NY and an ambassador for the AAFA said in a statement.

Being prepared can include medications, but people with allergies can also cope with a handful of simple lifestyle strategies such as leaving shoes and jackets outside, keeping windows closed, washing hair before bed and staying inside when pollen counts peak.

To calculate the Allergy Capitals report, the AAFA tallied local pollen levels, use of over-the-counter and prescription allergy medication and number of board-certified allergists in each area. Then, each city is assigned a score out of a total of 100 points. Virginia Beach made the biggest jump from last year’s rankings, up to 20 from 66. And Los Angeles dropped the most, from 38 to 77.

Below, you’ll find the 10 worst U.S. cities for spring allergies. Head over to the AAFA site for the full list of 100.

  • 10
    McAllen, Texas
     Getty
    Rank last year: #4
    Total score: 87.61
  • 9
    Birmingham, Alabama
     Flickr:Max Wolfe
    Rank last year: #14
    Total score: 87.71
  • 8
    Richmond, Virginia
    Rank last year: #22
    Total score: 88.68
  • 7
    Dallas, Texas
    Rank last year: #23
    Total score: 88.82
  • 6
    Chattanooga, Tennessee
     Flickr: Space Ritual
    Rank last year: #3
    Total score: 90.18
  • 5
    Jackson, Mississippi
     Flickr / Ken Lund
    Rank last year: #1
    Total score: 90.61
  • 4
    Oklahoma City, Oklahoma
    Rank last year: #9
    Total score: 91.19
  • 3
    Baton Rouge, Louisiana
    Rank last year: #10
    Total score: 91.93
  • 2
    Memphis, Tennessee
    Rank last year: #8
    Total score: 97.10
  • 1
    Louisville, Kentucky
    Rank last year: #5. This is Louisville’s third #1 ranking in 12 years.
    Total score: 100.00

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March 31, 2014
huffingtonpost.com