Many Austinites dread the return of “cedar fever,” and we often groan about pollen counts and the inability to breathe in the spring. But, a new study shows that Austin's allergy woes don't come close to the suffering seen in other Texas cities.

The Asthma and Allergy Foundation of America has released its list of the allergy capitals in the U.S., and the sniffling masses of Austin will be surprised that Houston, San Antonio and Dallas rank much higher.

Austin ranks No. 50 on the list of the most challenging cities to live in with allergies, far behind our neighbors. Houston ranks No. 28, San Antonio ranks No. 15, McAllen ranks No. 10, and Dallas ranks highest in the state at No. 7.

The list uses three different factors to determine rankings: average pollen count in the air, the use of allergy medications by local patients, and the number of board certified allergists available to local patients. Sanaz Eftekhari, the external affairs manager of the AAFA, explained that the purpose of the rankings is to prepare citizens for allergy seasons.

“As you can see, the South dominates the list,” Eftekhari tells CultureMap. “And each city’s ranking is relative to the top city, Louisville, Kentucky, which is given a score of 100, but among the top there’s a small difference between each city. If one city has a year with just a slight increase in the amount of pollen, it will jump ahead.”

Texas cities saw a major increase in allergy rankings this year. Austin jumped 14 spots, Dallas climbed 16 spots, and Houston leapfrogged Austin by moving up 30 spots.

Eftekhari says there’s no definitive answer as to why Texas cities are experiencing substantial increases in allergies, but she does note that weather can have a major effect on how potent an allergy season can become.

“Nature and weather have a great impact on the spread of pollen, which can easily travel via wind for up to 500 miles,” she says. “But no matter where you fall on the list, it’s important to see your physicians. This list is meant to make people more proactive. Most allergy medications are meant to be prophylactic, in that they prevent allergy reactions beforehand.”

For the complete rankings of America’s Allergy Capitals and for more resources about preventing allergies, visit AAFA’s official website.