Even after a recent dusting of that pesky white stuff, everyone can feel that spring is upon us, beginning to bloom.

Got itchy eyes? Sneezing? Runny nose? The Centers for Disease Control and Prevention reports that allergies are the sixth leading cause of chronic illness in the U.S., with more than 50 million Americans suffering from allergies each year.

According to Dr. Jordan Scott of Northeast Allergy, Asthma and Immunology, April and May are typically the toughest months for spring allergy sufferers, with May being an extremely busy month for his practice.

"Patients have been reporting early symptoms this year, often mistaking allergies for a cold," explained Scott. "The spring allergy season started early because of the heavy precipitation over the winter and we are already experiencing higher than usual pollen counts."

With so many people wondering whether they are suffering from spring allergies or a cold, Scott explains that classically allergies make you itchy -- itchy, runny nose and itchy, watery or swollen eyes. The number one symptom for both colds and allergies, he maintains, is congestion.

"We generally tell our patients to start their allergy medicines in mid-March, a couple of weeks before the onset of the spring allergy season so that the meds are already working in their systems," says Scott. He points out that many over-the-counter allergy medicines are available, including antihistamines and nasal sprays, which are usually enough to control allergy symptoms. If a patient is not responding, allergy shots may be an option.

Soon the region will see greenish-yellow pine tree pollen blanketing porch tables and cars. This is actually not the pollen that makes people sick. The worst offender for allergy sufferers is birch tree pollen. Other tree pollens that cause significant allergies are oak, elm and maple. It won't help to go chop down the birch trees in the yard because the pollen is in the air everywhere. Scott offers some helpful tips to manage spring allergies:

* Start allergy medicines in mid-March, before the onset of spring allergy season

* Keep windows closed and limit outdoor activities when pollen counts are high

* If you have to be outside, when you come back in, take a shower right away and change your clothes (especially before going to bed) to get the pollen off that causes allergy symptoms

* Run an air purifier with a HEPA filter

* Dry clothes in a clothes dryer versus line drying them outside this spring

If patients are chronically congested for a long while, they may develop sinus or chest infections in extreme cases. Asthma patients can experience shortness of breath, coughing and wheezing during allergy season and may benefit from using an inhaler. Scott said patients who start allergy shots at a young age are less likely to develop asthma as adults. Asthma is the leading cause of hospitalization at Boston Children's Hospital.

Scott reiterates that for most people, antihistamines are enough to control symptoms, however, he says that some antihistamines can make people sleepy, so they should use caution when driving. There are also a number of nasal sprays; however, he said that some can actually be addictive if used for more than three days.

By June, the tree pollen should be decreasing and then it's on to grass pollen over the summer, and ragweed pollen from late summer through fall. To check the local pollen count, there are many pollen reports available online, including one at WCVB Boston (wcvb.com/weather/pollen-report). The Weather Channel also features a "PollenCast" where one can type in your zip code to get a four-day pollen forecast (weather.com/health/allergy/main).

"Some patients may find that if they are very tree pollen allergic, they may get an itchy mouth from eating apples, peaches, carrots or celery," said Scott. "Most of the time these reactions are limited to the mouth and are called Oral Allergy Syndrome." If a more severe reaction occurs, he advises patients to seek medical treatment. Scott explained that these foods have proteins similar to birch pollen. He said patients can tolerate applesauce and cooked carrots, celery and peaches.

In addition to pollens, other common allergens include foods, insect stings and medications. Environmental allergens are breathed in through the air or they can enter through the skin with direct physical contact. In the case of food allergens and medications, they are usually ingested.

Scott is medical director at NEAAI and also sees patients at Boston Children's Hospital. He is a clinical instructor in allergy/immunology at Harvard Medical School and a clinical instructor in community medicine for the UMASS/Memorial family practice program.