Late May in the DMV puts you in a hard spot. Your eyes itch. Your head pounds. Your joints ache. You're tired in a way two cups of coffee can't fix. The question is whether it's a heavy pollen week or something worse.

The Washington-Arlington area lands near the top of the Asthma and Allergy Foundation of America's "Allergy Capitals" list most years. Grass pollen across Northern Virginia peaks from mid-May into June. Humidity over the Potomac is settling in. You have every ingredient for headaches, fatigue, sinus pressure, and a general "off" feeling.

Late May is also peak activity for black-legged ticks across Virginia and Maryland. (That's the species that carries Lyme disease.) Nymphal ticks at this time of year are the size of a poppy seed. They sit in tall grass and leaf litter at the edges of suburban yards and along trails through Rock Creek Park, the C&O Canal, Manassas Battlefield, and the wooded parts of Loudoun, Fairfax, or Montgomery County.

Early Lyme disease can produce fatigue, headache, low-grade fever, and migrating joint aches. Those symptoms overlap with a bad allergy week. Lyme is one of the few conditions where early action changes the outcome. Catch it early and a short antibiotic course usually clears it. Catch it late and it can drag for months.

This is general information, not medical advice. If you have a new bullseye-shaped rash, an unexplained fever, or facial drooping after possible tick exposure, call your doctor today.

Three things stacking at once in May

Grass pollen (Bermuda, fescue, timothy) hits peak. Tree pollen (oak especially) tails off but lingers. Black-legged tick nymphs are out in force across the Mid-Atlantic, and you'll miss them because they're tiny. Humidity climbs and the dew point pulls tension headaches up with it.

Run the Mount Vernon Trail, walk the dog at Great Falls, garden in your back yard, let the kids loose at soccer in NoVA, and you touch all of these. So does your kid coming back from camp in the Shenandoah.

Allergy symptom profile

Pollen-driven seasonal allergies look like this:

Itchy, watery eyes, both eyes
Sneezing in bursts, runny nose, clear discharge
Stuffy nose and sinus pressure, often worse in the morning or after time outside
Scratchy throat
Headache that tracks with sinus pressure
Fatigue during a high-pollen stretch
No fever

The pattern is a tell. Allergies have a daily rhythm. Worse outdoors. Worse on dry, windy days. Better in clean indoor air. Better when antihistamines kick in. They flare in spring, settle, then flare again with ragweed in late summer.

Early Lyme symptom profile

Early localized Lyme disease shows up three to thirty days after a tick bite.

The famous sign is the erythema migrans rash, the "bullseye." Some caveats:

It shows up in about 70-80% of cases, so a meaningful share of people with Lyme never get a clear rash.
It doesn't always look like a perfect bullseye. Sometimes a solid expanding red patch. Sometimes a clearer center, sometimes not.
It appears at the bite site, and the bite site might be somewhere you didn't notice. Behind the knee. In the groin. On the scalp.
It expands over days to weeks. It's usually not itchy or painful.

Beyond the rash, early Lyme often brings:

Low-grade fever, usually under 102°F
Fatigue out of proportion to what you've been doing
Headache
Muscle and joint aches that migrate from one joint to another over days
Swollen lymph nodes near the bite area
Stiff neck

Later-stage Lyme, weeks to months in if untreated, can bring Bell's palsy (one-sided facial drooping), heart-rhythm changes, and persistent joint swelling, often in the knee. Any of those signs needs prompt medical attention even if you don't remember a tick bite.

The overlap zone

The fuzzy middle catches people.

Symptoms that point more to allergies than infection:

Itchy eyes (Lyme doesn't usually cause this)
Sneezing in clusters
Clear improvement with an antihistamine inside a day or two
Symptoms that track pollen forecasts

Symptoms that should make you take Lyme seriously, even with no remembered tick bite:

Any fever, especially with fatigue and headache
Any expanding rash, bullseye-shaped or not
Migrating joint or muscle pain
Bell's palsy (one side of the face drooping or feeling numb)
Fatigue much worse than your usual allergy season
Symptoms that started three to thirty days after time in wooded or tall-grass areas

Useful rule of thumb. Allergies don't cause fever. A low-grade fever alongside what you'd otherwise call "allergy symptoms" earns a call to your doctor, especially if you've been outdoors in tick country.

Tick basics every DMV resident should know

Things that lower your risk:

Wear light-colored clothing in tall grass. Ticks show up better.
Tuck pants into socks in tick-heavy spots. It looks silly. It works.
Use EPA-registered repellents (DEET, picaridin, or oil of lemon eucalyptus on skin; permethrin on clothing).
Do a tick check every time you come in. Scalp. Behind the ears. Armpits. Waistband. Behind the knees. Groin. That's where nymphs attach.
Shower inside two hours of coming in if you've been in tick habitat. It washes off unattached ticks and helps you spot ones that latched.
Check the kids and the dog. Pets bring ticks inside.

Found an attached tick? Use fine-tipped tweezers. Grasp it as close to the skin as you can. Pull straight up with steady pressure. Clean the bite area. Save the tick in a sealed bag in case your doctor wants to see it.

Lyme transmission risk grows the longer a tick is attached. The CDC notes that transmission usually requires 36 hours or more, so prompt removal matters.

Reasons to call your doctor

A few clear triggers:

A known tick bite where the tick was attached for an unknown length of time, especially in a high-incidence area
A new expanding rash on any part of the body
Unexplained fever during or after a known outdoor stretch
Bell's palsy or sudden facial weakness. Same-day medical attention.
"Allergy" symptoms much worse than your usual seasonal pattern, or symptoms that aren't responding to what's worked in past years

For uncomplicated tick bites without symptoms, some providers in high-incidence counties (Loudoun, Fauquier, Montgomery) offer a single-dose preventive antibiotic if you meet specific criteria. Worth asking.

Allergies vs. early Lyme is hard to sort out

The first few days of Lyme are mild and vague. The cost of missing it is asymmetric. Catching it late means a much longer, harder treatment course. Check rather than wait it out.

Symplicured is a free AI symptom checker for ambiguous, multi-symptom situations like this. Describe what you feel and what you've been doing outdoors. Get a quick read on whether your symptoms warrant a call to your doctor. Start your assessment at symplicured.com/chat.