Bringing a Christmas tree into the home is a cherished tradition for many families. For some children, particularly those with existing allergic conditions, respiratory or skin symptoms can worsen during the festive season.
Although commonly referred to as “Christmas Tree Allergy” or “Christmas Tree Syndrome”, this is not a formal medical diagnosis. However, research indicates that certain environmental exposures associated with real conifer trees may contribute to symptoms in susceptible individuals.
This article provides an objective, evidence-based summary for parents, drawing on findings from peer-reviewed research and clinical experience.
What the Research Shows
A key study involving 1,657 allergic patients found that 7% experienced respiratory or skin symptoms linked to exposure to conifer trees during the Christmas season (Waddington et al., 1970; PMC1930673).
Reported symptoms included:
- Sneezing
- Wheezing
- Transient skin rashes
- Nasal congestion
- Cough or airway irritation
Symptom onset was variable:
- Most developed symptoms within 24 hours,
- While 15% experienced delayed reactions appearing several days after exposure.
Environmental Findings
Environmental sampling in ten family homes demonstrated:
- Scrapings from pine and spruce bark contained mould species (Penicillium, Epicoccum, Alternaria), but these did not become airborne indoors in measurable quantities.
- Airborne fungal levels did not significantly change after trees were placed inside homes.
- Pollen particles – including grass pollens, weed pollens and tree pollens – were detected indoors once real Christmas trees were introduced.
Based on these observations, the study concluded that tree oleoresins, a component of balsam, may be the most likely trigger of symptoms associated with Christmas tree exposure.
Potential Triggers Associated with Real Christmas Trees
1. Pollen Particles
Stored pollens on bark and needles may be released indoors, potentially affecting children with allergic rhinitis or pollen-sensitive asthma.
2. Oleoresins and Terpenes
Real conifer trees emit volatile organic compounds (VOCs) such as alpha-pinene.
While not allergens, these compounds can irritate the airway, particularly in children with asthma or airway hyperreactivity.
3. Indoor Winter Environment
Closed windows and heating during winter months reduce air exchange, which may contribute to worsening respiratory symptoms in children with atopic conditions.
Children Most at Risk
Children may be more susceptible if they have:
- Asthma, especially those with irritant-triggered symptoms
- Allergic rhinitis
- Eczema, which may flare with airborne irritants
- A family history of atopy
- Reduced indoor ventilation during colder months
Understanding individual risk factors can help families anticipate and manage symptoms more effectively.
Practical Steps to Reduce Symptoms
These evidence-based measures may help families enjoy their festive tree while minimising potential indoor irritants.
For Real Christmas Trees
- Rinse or hose down the tree outdoors before bringing it inside.
- Allow it to dry fully before decorating.
- Position the tree in a well-ventilated space.
- Limit the duration the tree remains indoors to 7–10 days, where possible.
- Avoid placing the tree close to sleeping areas for children with asthma or allergic rhinitis.
General Measures
- Maintain indoor humidity between <50%.
- Use HEPA-filter vacuums to reduce airborne particles.
- Monitor symptoms closely and follow your child’s asthma or allergy management plan.
When to Seek Specialist Advice
A paediatric allergy review may be helpful if your child:
- Experiences recurrent symptoms every Christmas
- Has increased wheezing, coughing, or nighttime symptoms
- Experiences worsening eczema flares
- Has symptoms significant enough to affect sleep or daily life
- Requires clarification of environmental triggers
Our clinical team provides evidence-based assessment and personalised management plans for seasonal or year-round allergic conditions.
Get specialist allergy support for your child – book an appointment today.
Additional Christmas Allergy Tips for Parents
These guidance points are offered to support families in navigating the festive season safely:
1. Food Allergy Safety During Festive Meals
- Seasonal foods may contain unexpected allergens (nuts, egg, sesame, milk).
- Read ingredient labels carefully – recipes may change during the holiday season.
- Discuss food allergies early with hosts and bring safe alternatives.
- For children undergoing OIT: maintain dosing routines and avoid exercise/hot baths for 2 hours after dosing.
2. Advent Calendars & Festive Chocolates
- Many seasonal chocolates are produced on shared lines with milk or nuts.
- Consider allergen-safe or non-food calendar options.
- Keep packaging for ingredient verification if symptoms occur.
3. Pet Allergy Flares During Holiday Visits
- Visiting homes with pets may trigger reactions.
- Pre-treat with antihistamines if recommended.
- Keep pets out of sleeping areas; bring inhalers and eczema creams.
4. Winter Skin Care
- Cold air and indoor heating can worsen dry skin.
- Apply emollients frequently and use occlusive ointments at night.
- Watch for irritant fabrics in festive clothing (e.g., wool, sequins).
5. Eating Out or Travelling
Take your child’s personalised food allergy action plan. Bring essential medications and check it is in date:
- Two adrenaline auto-injectors if prescribed for food allergic reactions.
- Antihistamines.
- Inhaler and spacer if prescribed for food allergic reactions.
Under UK law, restaurants must provide written allergen information upon request.
6. School Events & Parties
- Request ingredient lists for foods served.
- Provide safe alternatives when needed.
- Younger children may benefit from allergy wristbands for visibility.
If you’re unsure whether your child is suffering from Christmas Tree Allergy or if other seasonal factors are contributing to their allergy symptoms, our specialists can help you understand the triggers and create a personalised plan. Book an appointment today.
References
- Waddington et al. Respiratory and Skin Allergies to Conifers. PMC1930673.
- UK Health Security Agency. Indoor Air Quality and Health: Evidence Review, 2020.
- Wolkoff P. Indoor Air Irritants, Terpenes, and VOCs. Indoor Air, 2013.
- Arlian LG. Humidity Requirements of House Dust Mites, 1992.