The millions of people who suffer from seasonal allergies each year are too familiar with symptoms like sneezing, wheezing, and sniffling. But many don't realize there are lots of other, more unusual ways allergies can show up. “People have a preconceived notion of what allergies are, but there's so much outside just itchy eyes or sneezing,” says Dr. Purvi Parikh, an allergist and immunologist at NYU Langone Health. “It can mimic a lot of infections—people think they’re getting sick with something, but it’s actually allergies.”

We asked allergists to share some of the lesser-known symptoms they see in their offices, from black eyes to nasal creases.

A sore throat
Perhaps you suspect you’re coming down with strep throat. It could actually be seasonal allergies. Blame it on post-nasal drip, that lovely sensation of mucus sliding down the back of your throat. “When your nose is all blocked up or inflamed, inflammation has nowhere to go, so it starts draining down your throat,” Parikh explains. “That’s what causes the sore throat, or having to clear your throat often.”

Read More: Why You Suddenly Have Allergies

There are a few ways to zero in on the likely culprit: If you have severe throat pain that begins suddenly and is paired with a fever and swollen tonsils, strep throat is certainly a contender. But if your symptoms are more gradual, and you’ve also noticed hoarseness or a chronic cough, consider making an appointment with an allergist.