What is Christmas tree syndrome?

Itchy, red bumps when you string lights on your real Christmas tree.

A stuffy nose when you bring pine inside your home in December.

More frequent use of an asthma inhaler over the holidays.

Are you allergic to your Christmas tree?

People who notice their allergies worsening this time of year might experience what’s sometimes called Christmas tree syndrome, or Christmas tree dermatitis if you get the rash.

Many of you are undoubtedly among die-hard fans of the real Christmas tree tradition (my husband included). Let’s break down what might aggravate your allergies or asthma and outline a plan to handle those irritants so you hopefully can continue to enjoy fresh evergreen.

The causes of Christmas tree allergies might surprise you, and be warned: A fake tree can come with its own allergy problems.

There was an article about Christmas tree syndrome tacked up in allergy exam rooms at the Ear and Eye Institute at The Ohio State University Wexner Medical Center. I was surprised how many patients said, “Hey, that happens to me.”

I get the sense that the problem is likely more prevalent than we know. Some patients wondered whether they are allergic to pine trees.

But it turns out that the pine pollen, a common allergen other times of the year, is not the main irritant lurking in your fresh-cut tree.

Mold growing on the Christmas tree is most likely to blame for watery eyes, runny noses or trouble breathing.

Dust on branches and some lingering pollen from the pine or other plants could contribute, to a lesser extent.

Here’s a telling statistic: More than 50 kinds of mold where found on samples researchers brought in from their own Christmas trees for a 2011 study published in the Annals of Allergy, Asthma and

Immunology. Many common culprits for allergies were among the bunch.

If mold and dust are behind Christmas tree syndrome, guess what that means for artificial trees:

A fake tree might not be any better, if it’s dusty or stored in a damp basement or humid garage or attic where mold could grow.

And what’s behind skin breakouts that hit some people after they carry a fresh tree or hang ornaments on it?

People with rashes might be allergic to a component of the Christmas tree’s sap.

The irritating material that comes from the sticky sap is called colophony or rosin, and it can cause a rash similar to one from poison ivy, developing in the day or two after touching the tree.

Additionally, some people with sensitive skin could get red, itchy spots simply from needles poking the skin, similar to how some of us are more prone to irritation from scratchy sweaters.

Here’s what I tell patients trying to prevent Christmas tree allergies:

Give your tree a shower

To knock off mold, pollen and dirt, hose down your real tree before you bring it inside and let it dry for a few days in a garage (or outside, if it’s warm enough). Use the service at tree lots where a machine shakes off dirt and dead needles.

Dust your artificial tree and ornaments, and wash off the stand. Try a vacuum or leaf blower to dislodge dust.

Cover skin when decorating

Wear long sleeves and gloves to avoid needle pricks and sap. Change clothes when you’re done.

Consider a storage upgrade

Cardboard boxes and open bags stuffed with strands of lights allow dust to accumulate. Switch to storage containers that keep out dust mites. Can you make space to store your artificial tree in a temperature-controlled part of your home to cut down on moisture?

Relocate air purifiers

I hesitate to recommend buying air purifiers because of the uncertainty of their benefits for the price. However, if you own one, put it in the room with your Christmas tree to see if that makes a difference.

When all else fails, try an artificial tree next year

Consider it an experiment to find out whether going fake causes fewer allergy problems.

If your tree makes you sneeze or wheeze, try this three-fold plan:

1. Minimize exposure
   Follow the steps above and don’t keep your tree up as long.
2. Find the right treatment
   Some suggestions:
   
   • Nasal washes to clear sinuses and to soothe inflammation
   • Allergy drops for eyes
   • Long-lasting, non-drowsy antihistamines for sneezing or runny noses
   • Nasal steroid sprays for stuffy noses
   • Hydrocortisone cream for rashes (though you might need stronger treatment)
3. Investigate prescription options

If you try the steps I’ve recommended and over-the-counter medicines aren’t cutting through your allergies, consider immunotherapy treatments. You’re exposed to small doses of substances you’re allergic to through oral drops or shots, with the goal of becoming less allergic over time.

For a rash, you might need a prescription steroid ointment or oral steroid. Get to a doctor if your condition keeps you from sleeping, interferes with work or school, or causes you to need your asthma rescue inhaler more than twice a week.