Hay fever

Hay fever is when the body makes allergic antibodies (IgE) to seasonal allergies such as pollen. Contact of pollen with your mouth, nose, eyes or throat causes an allergic reaction. People with a pollen allergy are also more likely to develop other allergies, such as food intolerances.

Other triggers may be allergens such as house dust mites, mould or tiny flecks of skin and saliva shed by cats, dogs, and other animals with fur or feathers (pet dander).

You are more likely to develop hay fever if you have a family history of allergies, particularly asthma or eczema. This article is about hay fever or allergic rhinitis.

Symptoms of hay fever

Symptoms of hay fever can start at different times of the year, depending on what you are allergic to. Tree pollen is common in early spring, whereas grass pollen is common in late spring and summer.

If you are allergic to common pollen you will have more severe symptoms when the pollen count is high.

Common symptoms include:

• Nasal symptoms – sneezing, postnasal drip, itchy nose, blocked nose, runny nose
• Watery eyes, itchy eyes, red eyes
• Itchy throat

Severe symptoms may include:

• Sweats, Headaches
• Loss of smell and taste
• Facial pain caused by blocked sinuses
• Allergic conjunctivitis
• Itchiness spreads from the throat to the nose and ears

You may have other symptoms such as tiredness, irritability, and difficulty sleeping. If you have asthma you may also experience more wheezing and breathlessness symptoms.

When does hay fever season start?

Hay fever season usually starts around March and lasts until November in the UK. Different types of pollen are released at different times of the pollen season. Tree pollen is common in early spring. Grass pollen is common in late spring and summer. Different pollens are released at certain times of the day. Tree pollen is more common in the evening around dusk. Also, the pollen count is at its highest when it’s humid and warm.

Allergy testing may help you find the specific allergens to which you are sensitive. A skin prick test is the most common method of allergy testing. This may include a patch test to determine if a particular substance is causing your rhinitis, or an intradermal, scratch, or other tests.

For those who are not able to undergo skin testing the RAST (Radioallergosorbent) blood test may be helpful in determining specific allergen sensitivity.

Treatment for hay fever

A pharmacist is the best healthcare professional to ask for advice. They can give lots of over-the-counter advice and suggest the best treatments to help improve your quality of life. If it persists and becomes bad it may be worth seeing your GP to explore other options. Sometimes, a combination of two or three treatments is best. These include:

Antihistamine sprays or tablets – these stop the release of the chemical histamine. They usually relieve symptoms of a runny nose, itching, and sneezing, but will not unblock congested sinuses. Older antihistamines such as chlorpheniramine and cetirizine can cause drowsiness. Loratadine a newer antihistamine will not cause drowsiness.

Eye drops – often contain cromoglycate to reduce itching and swelling in the eyes.

Nasal corticosteroids – steroid sprays treat the inflammation caused by hay fever, they may take a few days to start working, but they offer a safe and effective long-term treatment e.g. beclomethasone (Beconase).

Nasal spray decongestants – relieve nasal congestion by reducing the swelling of the blood vessels in your nose, which helps open your nasal passage and makes breathing easier. Some decongestants also contain antihistamines. If they do, they may relieve other symptoms as well. Nasal decongestants should not be used for longer than 7 days. They may make the symptoms of congestion worse.

Oral corticosteroids – severe hay fever may respond to prednisone tablets, prescribed by a doctor. These are for short-term use only.

Immunotherapy can provide long-term relief by gradually desensitizing the immune system to allergens. It is usually received in the form of allergy shots or sublingual drops. Immunotherapy may lead to lasting remission of allergy symptoms and it may help prevent the development of asthma and new allergies. Injections are given by a doctor, sublingual drops can be taken at home.

Tips to reduce your hay fever symptoms

There’s currently no cure for hay fever and you cannot prevent it, but you can do things to ease your symptoms when the pollen count is high.

• Put Vaseline around your nostrils to trap pollen
• Wear wraparound sunglasses to stop pollen from getting into your eyes
• Shower and change your clothes after you have been outside to wash pollen off, especially on high pollen days
• Avoid drying washing on a clothes-line outside when pollen counts are high
• Monitor pollen forecasts daily and stays indoors wherever possible when the count is high. Rain washes pollen from the air so counts should be lower on cooler wet days
• Keep windows and doors shut as much as possible
• Vacuum regularly and dust with a damp cloth
• Buy a pollen filter for the air vents in your car and a vacuum cleaner with a HEPA filter
• Avoid caffeine… caffeine can trigger histamine release which might make your hay fever symptoms worse
• Garlic helps to block the production of histamine and soothe hay fever symptoms
• A spoonful of honey daily is one of the most delicious remedies for hay fever and is highly recommended
• Reduce dairy – people with hay fever can find cow’s milk makes their symptoms worse. It can be worth trying an alternative, such as almond, rice or oat milk
• Ditch sugary snacks as refined sugar can trigger a blood sugar spike which in turn will activate histamine release
• Eat Vitamin C rich foods which will support your nasal lining and reduce the amount of histamine in the blood
• Don’t smoke – cigarette smoke is an allergen and will irritate the lining of your nose, eyes, throat and airways
• Shining a red light up your nose can increase blood flow circulation, reduce histamine production and calm inflammation

Sources

• Treatment – NHS