How Often Should You Change Your Pillow If You Have Allergies?

The Asthma and Allergy Foundation of America (AAFA) suggests replacing pillows every 2 years. For people with dust mite or mold allergies, that’s a reasonable rule, because pillows sit right next to your nose and mouth all night and collect allergens over time. Research has found that used pillows can carry dust mite allergen and many types of fungi. A good pillow cover and regular hot washing matter just as much as replacement.

This guide covers what builds up in pillows, signs it’s time for a new one, and how to keep pillows cleaner between replacements. For more, see our dust mite and bedding guides.

Jump to: Quick answer · What builds up in pillows · Signs to replace · Choosing a pillow · Keeping pillows clean · FAQ

Quick answer

• Replace pillows about every 2 years, as AAFA suggests, and mattresses about every 10 years.
• Used pillows carry fungi: a UK study found 4 to 16 fungal species per used pillow, including the common mold Aspergillus fumigatus.
• Synthetic isn’t automatically better: synthetic pillows held about 7 times more dust mite allergen than feather pillows in a New Zealand study.
• Encase and wash: use an allergen-proof pillow cover and wash bedding weekly in water of at least 130°F (54.4°C) (Mayo Clinic).
• Replace sooner if a pillow is lumpy, flat, smells after washing or seems to worsen your symptoms.

What builds up in pillows

The fungal study authors noted this has implications for people with respiratory conditions, especially asthma and sinusitis. You may have seen claims that an old pillow’s weight is mostly dust mites; we couldn’t find good evidence for those figures, but the studies above show pillows do collect allergens.

Signs it’s time to replace your pillow

• It’s about 2 years old or more.
• It stays flat or lumpy after fluffing.
• It has stains or a smell that remains after washing.
• Your allergy or asthma symptoms are worse in bed or when you wake up.
• It can’t be washed and has no protective cover.

Choosing a pillow if you have allergies

• Washability matters most. A pillow you can wash in hot water, or one you keep inside a washable allergen-proof cover, is easier to keep clean.
• Feather vs synthetic: research doesn’t support choosing synthetic just to avoid dust mites. Avoid feathers only if you’re allergic to them.
• “Hypoallergenic” labels aren’t a guarantee; check what the claim is based on.

For comforters and blankets, see allergy-friendly comforters and blankets.

Keeping pillows clean between replacements

1. Use an allergen-proof zippered pillow cover. Mayo Clinic recommends encasing pillows, mattresses and box springs. Covers work best as part of a broader plan; see mattress and pillow covers.
2. Wash pillowcases and bedding weekly in water of at least 130°F (54.4°C).
3. Wash or dry the pillow itself as the care label allows. For items you can’t wash hot, Mayo Clinic suggests at least 15 minutes in the dryer above 130°F, then washing to remove allergens. See does a dryer kill dust mites?
4. Keep bedroom humidity below 50% to discourage dust mites and mold. See humidity control.
5. Let pillows dry completely after washing to avoid trapping moisture.

For a full bedroom routine, read how to sleep better with allergies.

This guide is general information, not medical advice. Read our medical disclaimer.

Frequently asked questions

How often should you replace your pillow?

AAFA suggests every 2 years. Replace sooner if it’s flat, lumpy, smells after washing or seems to worsen your symptoms.

Can an old pillow make allergies worse?

It can. Used pillows have been found to carry dust mite allergen and many fungal species, close to your nose and mouth all night.

Are feather or synthetic pillows better for allergies?

Synthetic pillows held more dust mite allergen in one study and more fungal species in another. Choose based on washability and avoid feathers only if you’re allergic to them.

How do I clean my pillow to remove allergens?

Use a zippered allergen-proof cover, wash pillowcases weekly in water of at least 130°F, and wash or hot-dry the pillow as its label allows.

Do pillow covers help with dust mite allergy?

They lower allergen in bedding, and work best combined with hot washing, humidity control and other steps.

Sources

• Woodcock AA, Steel N, Moore CB, et al. Fungal contamination of bedding. Allergy. 2006;61(1):140-142.
• Mills S, Siebers R, Wickens K, et al. House dust mite allergen levels in individual bedding components in New Zealand. N Z Med J. 2002;115(1151):151-153.
• Asthma and Allergy Foundation of America. Dust mite allergy.
• Mayo Clinic Staff. Dust mite allergy: Diagnosis and treatment. September 12, 2025.

Last reviewed: October 21, 2026.