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What Is Christmas Tree Syndrome?

What Is Christmas Tree Syndrome?
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Published on December 6, 2024
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If each holiday season you find yourself opening more tissue boxes than gifts, you may have Christmas tree syndrome, also called Christmas tree allergy. Christmas tree syndrome is the term for allergic reactions that some people experience after bringing a tree indoors.

Most people aren’t allergic to the tree itself; instead, they’re reacting to allergens like mold, dust, and pollen that come with the tree, says Kara Wada, MD, an allergist and immunologist at the Ohio State University Wexner Medical Center in Columbus.

Here’s what you need to know about the symptoms, causes, and treatments for Christmas tree syndrome, and expert advice on how to reduce your risk.

Overview

What Is Christmas Tree Syndrome?

Christmas tree syndrome refers to a set of symptoms triggered by exposure to natural Christmas trees or other seasonal plants like holly, pine, and fir. While anyone can experience symptoms when exposed to these allergens, it’s more likely to happen to people with existing allergies or asthma.

While Christmas tree syndrome is not a formally recognized medical condition, it’s a term that was first coined after a 1970 study found that a small percentage of people had an uptick in allergy symptoms after they set up their trees.

Signs and Symptoms of Christmas Tree Syndrome

Christmas tree syndrome symptoms usually appear when a person is in close proximity to a Christmas tree or other holiday plants, and may worsen as the tree dries out. Symptoms can range from mild to severe, often mimicking seasonal allergies, and can include the following:

  • Sneezing or coughing
  • Nasal congestion
  • Wheezing or shortness of breath
  • Itchy, watery eyes
  • Fatigue or headache
  • Worsening asthma
Some people can also have a skin reaction to Christmas trees, which could appear as a rash or inflamed, itchy bumps.

Causes and Risk Factors of Christmas Tree Syndrome

Christmas tree syndrome is linked to allergens and irritants commonly found in natural Christmas trees.

Mold Spores Experts believe that mold is the top cause of Christmas tree–induced respiratory allergy symptoms. Mold spores can grow on tree bark and branches, especially if the tree has been stored in damp conditions before coming indoors, says Dr. Wada.

Studies have identified more than 50 kinds of mold in Christmas trees.

Mold allergy symptoms can be similar to those of other respiratory allergies.

Pollen Pine pollen might be a factor, though most experts don’t think it’s the main trigger.

Volatile Organic Compounds (VOCs) Christmas trees can release VOCs, including terpene compounds, like pinene, which, while pleasant-smelling, can irritate sensitive airways.

VOCs are organic chemicals that turn into vapor easily, and the sharp scent of pine needles is caused by monoterpenes, which are a kind of VOC.

 VOCs can cause health effects such as eye, nose, and throat irritation and allergic skin reactions.

Dust Dust can trigger allergy symptoms. Even artificial trees and ornaments, if not stored properly or cleaned before use, can get dusty and trigger allergy symptoms.

Tree Sap and Needles Colophony, or rosin, is in the sticky sap of trees, and the rosin from Christmas trees 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 inflamed, itchy spots simply from tree needles poking the skin, similar to what might be caused by irritation from scratchy sweaters.

Who Gets Christmas Tree Allergy?

Some people are more likely to have a Christmas tree allergy, says Wada.

  • Those with preexisting respiratory allergies — such allergies to pollen, mold, or pet dander — are generally more susceptible to Christmas tree allergies.
  • Individuals with asthma or a history of allergic rhinitis (hay fever) may find themselves reacting to Christmas trees, especially when exposed to the allergens they carry.
  • Individuals with a history of seasonal allergies or sensitivities are more likely to develop symptoms.

How Is Christmas Tree Syndrome Diagnosed?

Christmas tree syndrome isn’t an actual diagnosis, but rather a collection of symptoms triggered by the trees.

If you already take medications for allergies or asthma, tell your provider if your symptoms have worsened. For people who don’t have a history of allergies, your healthcare provider may ask about your symptoms and potential exposure to trees, plants, or environmental triggers.

Treatment and Medication Options for Christmas Tree Syndrome

Treatment for Christmas tree syndrome focuses on relieving symptoms and preventing exposure to allergens or irritants.

Medications

For mild allergic reactions, there are several good options to manage symptoms, says Wada.

  • Antihistamines: Over-the-counter antihistamines can help reduce sneezing, runny nose, and itching.
  • Decongestants: These medications can relieve a stuffy or runny nose.
  • Nasal corticosteroids: Over-the-counter nasal sprays can reduce swelling and mucus, and help with allergic rhinitis symptoms.
  • Inhalers: For those with asthma, inhaled corticosteroids or bronchodilators may be prescribed to help open airways, says Wada.
  • Corticosteroid creams: For skin irritation or rashes, topical steroids may be used.

Complementary and Integrative Therapies

  • Saline nasal irrigation: There’s some evidence that nasal irrigation can help flush allergens from the nasal passages. Experts recommend using distilled or boiled water to prevent rare infections.

  • Air purifiers: Use an air purifier and place the tree in a well-ventilated space to minimize the spread of irritants, says Wada.

Prevention of Christmas Tree Syndrome

To prevent symptoms of Christmas tree syndrome, consider these measures.

  • Cover your skin while decorating. Wear long sleeves and gloves to avoid needles and sap, and change clothes once you’re finished decorating.

  • Wash your hands. If you choose not to wear gloves, wash your hands to remove sap or pollen after you touch your tree.
  • Use an artificial tree. Especially in severe cases, avoiding a live tree may be necessary, says Wada.
  • Give your tree a bath. “Hose down the tree outdoors and let it dry completely before bringing it inside. This can wash away some pollen and reduce mold spores,” she says.
  • Don’t keep your tree too long. Because mold can continue to grow on trees even once they are indoors, experts suggest getting rid of them soon after the holiday.

     Wada suggests one or two weeks, max.

How Long Does Christmas Tree Syndrome Last?

It’s best to throw away or recycle your Christmas tree soon after the holidays. Your symptoms will go away once you don’t have the tree in your house anymore.

Conditions Related to Christmas Tree Syndrome

Christmas tree syndrome shares similarities with several other conditions, including:

Allergic Rhinitis Also called hay fever, this allergic reaction causes sneezing, congestion, itchy nose, and watery eyes. It can be triggered by airborne allergens like pollen and mold.

Asthma A chronic condition where the airways become inflamed, often triggered by environmental factors. The same things that trigger allergic rhinitis (including mold) may also cause asthma symptoms.

Atopic Dermatitis Also called eczema, this chronic skin condition causes inflammation, itching, and rash, which may worsen with exposure to allergens. People with hay fever or asthma are more likely to have atopic dermatitis.

The Takeaway

  • Christmas tree syndrome is an allergic reaction to mold, pollen, or dust in Christmas trees, leading to respiratory or skin issues.
  • Symptoms of Christmas tree syndrome include sneezing, coughing, wheezing, skin rashes, and asthma flare-ups.
  • People are more likely to have the syndrome if they have preexisting allergies or asthma.
  • With steps to reduce the allergens in Christmas trees and manage symptoms, most people can continue to enjoy fresh evergreen decorations.

Common Questions & Answers

What causes Christmas tree syndrome?
It's caused by allergens like mold, pollen, and chemicals found in natural Christmas trees.
While artificial trees don't carry the same allergens, dust and other particles may still cause symptoms in sensitive individuals.
Treatment includes antihistamines, decongestants, and asthma medications, along with avoiding exposure to trees or other triggers.
Yes, the condition is often referred to as Christmas tree allergy, though it may involve other irritant reactions as well.
Yes, but you may need to take steps, such as choosing a mold-free tree and ensuring your home is properly ventilated.

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Jon E. Stahlman, MD

Medical Reviewer
Castle Connolly Top Doctor

Jon E. Stahlman, MD, has been a practicing allergist for more than 25 years. He is currently the section chief of allergy and immunology at Children’s Healthcare of Atlanta's Scottish Rite campus and the senior physician at The Allergy & Asthma Center in Atlanta. He served as the president of the Georgia Allergy Society, has been named a Castle Connolly Top Doctor, and was listed as a Top Doctor by Atlanta magazine. His research interests include new therapies for asthma and allergic rhinitis as well as the use of computerized monitoring of lung function.

He received his bachelor's and medical degrees from Emory University. He completed his pediatric residency at Boston Children’s Hospital and his fellowship in allergy and clinical immunology at Harvard University’s Boston Children’s Hospital and Brigham and Women’s Hospital. After his training, Dr. Stahlman conducted two years of clinical research at Boston Children’s Hospital and was part of the faculty at Harvard Medical School, where he taught medical students and allergy and immunology fellows.

Stahlman is board-certified and recertified in allergy and clinical immunology. He served as a principal investigator on phase 2 through 4 studies that are responsible for most of the U.S. Food and Drug Administration–approved therapies for allergies and asthma available today.

Outside of the office, he centers his interests around his wife and three daughters, coaching soccer for many years, and his hobbies include cycling and triathlons.

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Becky Upham, MA

Becky Upham

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Becky Upham has worked throughout the health and wellness world for over 25 years. She's been a race director, a team recruiter for the Leukemia and Lymphoma Society, a salesperson for a major pharmaceutical company, a blogger for Moogfest, a communications manager for Mission Health, a fitness instructor, and a health coach.

Upham majored in English at the University of North Carolina and has a master's in English writing from Hollins University.

Upham enjoys teaching cycling classes, running, reading fiction, and making playlists.

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Resources
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