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Thomas Lupoli, D.O.

When to Contact an Allergist vs ENT

when to see jacksonville allergy specialist or ent

Updated: May 2025

It’s common for people with sinus or nasal symptoms to consider seeing either a board-certified Allergist/Immunologist or an Ear, Nose, and Throat (ENT) specialist. But which specialist should be seen first? As trained surgeons, ENTs play a crucial role in evaluating and correcting structural issues such as blocked sinus cavities, severely deviated septum, or advanced nasal polyps. However, nasal and sinus symptoms—such as daily congestion, facial pressure, post-nasal drip, and even chronic cough—are often caused by allergies and do not require surgical treatment. Additionally, patients may continue to have recurrent sinus/nasal symptoms after having surgery and require additional interventions if the underlying cause is not thoroughly addressed.  Board-certified Allergist/Immunologists are uniquely trained to diagnose and fully address the underlying causes of these symptoms through non-surgical means and personalized care. Consulting with an Allergist/Immunologist first can often result in effective and long-lasting relief—often without the need for surgery in most cases.

If you’re wondering whether your symptoms require visiting an Allergist or ENT doctor, continue reading to help decide the right course of action for you.

When to See an Allergist First for Sinus and Breathing Issues

Why non-surgical treatment may be your best, first step.

Allergists/Immunologists are highly trained specialists who diagnose, treat, and manage all forms of allergic inflammation through nonsurgical methods. The path to becoming a board-certified Allergist includes four years of medical school, followed by three to four years of medical residency, and then two to three years of an Allergy and Immunology fellowship specifically focused on the nonsurgical management of nasal and sinus conditions.

Allergies are caused when the immune system decides that an otherwise harmless substance is now a threat to the body (i.e. pollens, mold, dust mite, pet dander and foods). Allergic reactions to environmental substances are very common and usually cause recurrent nasal congestion, uncomfortable facial pressure, abundant nasal drainage, coughing, throat clearing, and/or sneezing. Many people with environmental allergies frequently complain of having chronic “sinus headaches,” sinus pain, and nasal blockages.

There is no doubt that allergies can have a major impact on the quality of life for people of all ages. Unfortunately, many people struggling with allergic nasal or sinus problems do not realize their symptoms are due to allergies and believe that their condition is untreatable. Additionally, allergic symptoms often mimic sinus infections, often leading to the unnecessary use of antibiotics.  Fortunately, these symptoms can usually be effectively managed or even prevented with an Allergist’s help.

It is important for patients to know if allergic triggers are causing symptoms, so that they may be effectively avoided. Allergy testing can detect relevant allergies and allows the Allergist to determine the most effective therapies to improve the person’s quality of life. Such therapies include focused allergen avoidance measures, appropriate medication use and, in some cases, allergen immunotherapy. Allergen immunotherapy is a very important tool and is the ultimate allergy treatment, which retrains the immune system to stop reacting to allergens– thereby preventing allergic symptoms in the first place and decreasing the need for medications.

By addressing the root causes of nasal and sinus inflammation, Allergists can help reduce symptoms which may eliminate the need for surgery. This personalized care can also result in fewer medications and lower long-term medical costs.

Of course, inhaled allergens can affect other parts of the body other than the nose including the skin, eyes, lungs, inner ears, and sinuses. Allergists are the experts who treat all allergic symptoms, no matter which part of the body is affected. Before heading straight to an ENT for chronic sinus pressure, it may be best to consult with an Allergist particularly if you have a family history of allergies or asthma.

Common reasons to see an Allergist/ Immunologist include:

When an ENT is the Right Choice for Structural Sinus Problems

Understanding when surgery may be needed.

According to the American Academy of Otolaryngology– Head and Neck Surgery, otolaryngologists (ENTs) specialize in dealing with disorders and conditions of the ear, nose, and throat, including related areas of the neck and head. ENT doctors are experts in surgical and medical management of:

  • Ear: ENT specialists treat ear disorders or conditions such as ear infections, hearing loss, balance disorders (vertigo), pain in your ear, or ringing in the ears (tinnitus). ENT doctors can also treat ear disorders you were born with.
  • Head and Neck: If you experience cancerous tumors, deformities, trauma, or diseases of the neck, face, and head, ENT doctors can do cosmetic and reconstructive surgery in these areas. Problems with nerves in the head and neck controlling smell, sight, hearing, and facial movements can also be managed.
  • Nose: ENT doctors often manage and treat issues affecting the nose, sinuses, and nasal cavity. These issues may affect your breathing, smell, or physical appearance.
  • Throat: An ENT doctor can help manage and treat conditions or disorders of the throat can affect your eating, swallowing, digestion, speech, and even singing.

Common reasons to see an ENT specialist include:

  • Cancer and tumors in the head and neck
  • Nerve problems, pain, or injury to your ears, nose, or throat
  • Breathing problems originating in nose or throat
  • Tonsil or adenoid infection
  • Dizziness and balance issues
  • Tinnitus
  • Chronic sinusitis
  • Ear infections
  • Hearing impairment
  • Swallowing or voice problems
  • Cleft palate
  • Deviated septum
  • And more

Limitations of Allergy Services

Allergist/Immunologists and ENTs frequently collaborate to bring meaningful relief to patients. ENTs commonly refer patients to Allergists to diagnose and optimize control of allergic symptoms before considering surgical interventions.  While some ENT practices offer allergy testing and allergy care, their approach may not encompass the full range of diagnostic tests and treatment options typically provided by board-certified Allergist/Immunologist specialists. Additionally,  patients who begin allergy testing elsewhere and are later referred to an Allergist for more comprehensive testing and treatments may face insurance limitations that restrict coverage for additional allergy testing— further delaying care.

When surgery isn’t the solution or when allergies are suspected,  patients should consider seeking a formal allergy evaluation with a board-certified Allergist/Immunologist who can evaluate for allergic causes and thereby reduce the need for medications and invasive procedures over time.

Putting it all together

Allergists/immunologists and ENT’s often work together to maximize control of nasal/sinus congestion and it’s entirely possible you may require evaluation from both specialists. Allergists will often refer patients to ENT’s when surgery is needed and ENT’s often refer patients to allergists when a formal allergy assessment is required.

Allergies are not the only cause of nasal symptoms. So if you have a known structural problem or suspect one, then an ENT specialist would be a good first choice.  But if you suspect that you have a sinus or breathing issues related to allergies or asthma, consider seeing a Board Certified Allergist/Immunologist who can help diagnose, treat, and effectively control your symptoms through non-surgical methods.

More Questions People Also Ask — Allergist or ENT for Sinusitis Treatments:

Chronic sinusitis and allergies. What kind of doctor do you see for allergy testing?

Board-certified Allergists are highly trained physicians who specialize in the diagnoses and nonsurgical treatment of chronic sinus issues and allergies. They also specialize in the management of asthma since most asthmatics have allergic triggers that affect their breathing. Allergists focus on the underlying cause of the symptoms (such as the facial pressure, watery eyes, nasal congestion, etc)  to lessen the need for medications and surgery. In doing so, Allergists are like medical detectives who take a comprehensive and integrated approach to treatment.  Through the appropriate use of allergy testing, Allergists can help patients to understand their triggers and teach patients the environmental strategies needed to avoid their triggers. Allergists use allergy test results to decide which medications would be the most effective. Allergists can also guide patients through allergen immunotherapy to help relieve persistent nasal and sinus symptoms when medications are not helpful or when patients wish to minimize the need for medications.

Can an Allergist help with sinusitis?

Absolutely. Board-certified Allergists are physicians who have received substantial training in the nonsurgical treatment of chronic sinus issues. Sinusitis, is due to an inflammation in the tissue of the sinuses that can be caused by allergies or microbes, and sometimes both.  When sinuses become obstructed, germs fester and can cause an infection, congestion, and facial pressure. Your allergist can help diagnose the root causes of your symptoms and provide a regimen of non-surgical treatments to prevent recurring sinus infections or allergic reactions.

Can all sinus issues be treated with non-surgical methods?

No. Some patients have a structural problem within their nose or sinuses that cannot be adequately treated with medications or allergen avoidance measures. In these cases, Allergists will refer the patient to their surgical colleagues, ENTs (Ear, Nose, Throat), who treat a variety of anatomical ailments affecting the head and neck.

How do I know if I need to see the Allergist or ENT?

ENTs are highly proficient surgeons who specialize in structural disorders of the ears, nose, and throat such as head and neck tumors, facial reconstruction and plastic surgery, chronic sinusitis, deviated septum, hearing impairment, and dizziness/balance problems. Board-certified Allergists optimize control of nasal and sinus problems though nonsurgical means. ENTs and Allergists commonly work together to treat conditions where allergies are causing problems in the ears, nose, sinuses and throat regions. ENTs often refer patients to Allergists when surgery is not indicated. Likewise, Allergists will refer patients to ENTs for surgical options when medications and allergen avoidance are not adequately controlling symptoms.

What kind of tests does an ENT do?

ENTs employ a wide variety of tests in helping them determine the causes of a patient’s ear, nose, and throat discomfort. Visual, tactile examination and endoscopy all provide a baseline from which additional tests like laboratory analysis and imaging can confirm. Appropriate treatment is then provided for the given diagnosis.

What will ENT do for a sinus infection?

Sinusitis has varying degrees of severity. For a mild sinus infection, an ENT may advise using conservative care including a decongestant and/or nasal spray. More serious infections may require the use of antibiotics, nasal irrigations, steroids and even surgery. Chronic sinusitis symptoms can be alleviated by avoiding triggers which may include allergens or fungi.

What can an ENT do for chronic sinusitis?

When symptoms of sinusitis prolong past the 12-week mark despite receiving treatment, the condition moves from acute to chronic. Chronic sinusitis is best treated utilizing a holistic approach – targeting both the trigger of the condition as well as effectively treating any ensuing infection. ENT’s can correct anatomical or structural problems that are contributory to chronic sinus infections. When the symptoms are tied to an allergy, a Board-certified Allergist can help guide treatment options and lessen the long term need for medications through allergen immunotherapy.

What can I do if I am prone to sinus infections?

Ways to help mitigate the symptoms of chronic sinusitis include:

  • Consult with a Board-certified allergist to help determine if allergies are a cause for your symptoms.
  • Application of a warm towel to the head, neck, and face to ease pain and pressure.
  • Use of saline spray to keep nasal passages clean and decongested.
  • Use of OTC decongestants, although these are not recommended as part of a long-term treatment plan.
  • Use of a vaporizer or humidifier, especially during the dry winter months. Just be sure to clean the unit routinely, as unclean it poses more risks than benefits.
  • Get a better understanding and management plan for allergies, which can be a trigger.
  • Try to avoid smoke like cigarettes or even cars, which can inflame the nasal passages.

How do you know if it is a sinus infection or allergies?

Even if you know you have a sinus infection, an allergy test can help determine if allergies are contributing to the symptoms, which helps you make smart choices about changes in your environment that can decrease the odds of repeat infections. A Board-certified Allergist can clarify if allergies are contributing to your symptoms or if nonallergic factors are causing your problem.

Are you wondering if you may be suffering from allergies?

Call the experts at the Allergy & Asthma Specialists of North Florida to schedule an appointment today.

Sources: American Academy of Allergy, Asthma & Immunology and American Academy of Otolaryngology– Head and Neck Surgery