If you would like to know more about hayfever symptoms and diagnosis, and about hayfever treatments, read the following article for more information.
Hay fever is caused by an allergy to pollen. Common symptoms are a runny nose, itchy nose, blocked nose, sneezing, and itchy eyes. Common treatments are an antihistamine nose spray or medicine and/or a steroid nose spray. Other treatments are sometimes used if these common treatments do not work so well.
What is hay fever?
Strictly speaking, hay feveray to July). However, the term is sometimes used when allergies are caused by other pollens such as from tree pollens (March to May). Symptoms are due to the immune system reacting to the pollen. Cells on the lining of the nose and eyes release histamine and other chemicals when they come in contact with pollen. This causes inflammation in the nose (rhinitis) and eyes (conjunctivitis).
Who gets hay fever?
Hay fever is very common. It often first develops in the teenage years. Symptoms return for a season each year, but it eventually goes away or improves in many cases (often after having had symptoms each season for several years).
What are the symptoms of hay fever?
- Common symptoms are a runny and itchy nose, blocked nose, sneezing, itchy and watery red eyes, and an itchy throat. In some cases only nose symptoms occur, and in some cases only the eye symptoms occur.
- Less common symptoms are loss of smell, face pain, sweats, and headache.
- Asthma symptoms such as wheeze and breathlessness may get worse if you already have asthma. Some people have asthma symptoms only during the hay fever season.
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Will it help if I avoid pollen?
It is impossible to totally avoid pollen. However, symptoms tend to be less severe if you reduce your exposure to pollen. The pollen count is often given with TV, radio, internet, or newspaper weather forecasts. The following may help when the pollen count is high.
- Stay indoors as much as possible, and keep windows (also called seasonal allergic rhinitis) is caused by an allergy to grass or hay pollens. Grass pollen is the most common cause (M and doors shut.
- Avoid cutting grass, large grassy places, and camping.
- Shower and wash your hair after being outdoors, especially after going to the countryside.
- Wear wrap-around sunglasses when your are out.
- Keep car windows closed, and consider buying a pollen filter for the air vents in your car.
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What are the commonly used treatments?
The commonly used treatment options for hay fever are: antihistamine nose sprays, antihistamine tablets, steroid nose sprays, and eye drops.
Antihistamine nose sprays
A dose from an antihistamine nose spray can rapidly ease itching, sneezing and watering (within 15 minutes or so). It may not be so good at easing congestion. Antihistamines work by blocking the action of histamine. This is one of the chemicals involved in allergy reactions. A spray can be used 'as-required' if you have mild symptoms. It can also be taken regularly to keep symptoms away. There are different brands.
Antihistamine tablets (or liquid medicines)
Antihistamines taken by mouth (tablets or liquids) are an alternative. They ease most of the symptoms but may not be so good at relieving nasal congestion (blocked nose). A dose usually works within an hour. Therefore, one can be taken 'as required' if symptoms are mild, or come and go. One can also be taken regularly if symptoms occur each day.
There are several brands of antihistamines that you can buy at pharmacies or get on prescription. Older brands such as chlorphenamine work well, but make some people drowsy. There are several newer ones that cause less drowsiness. Ask the pharmacist for advice.
Steroid nose sprays
A steroid nose spray usually works well to clear all the nose symptoms (itch, sneezing, watering and congestion). It works by reducing inflammation in the nose. A steroid nose spray also tends to ease eye symptoms. It is not clear how it helps the eye symptoms - but it does!
It takes several days for a steroid spray to build up to its full effect. Therefore, you will not have an immediate relief of symptoms when you first start it. In some people it can take up to three weeks or longer to be fully effective. So do persevere. (It is best to start taking it a week before the hay fever season begins if you know that you have hay fever.)
A steroid nose spray tends to be the most effective treatment when symptoms are more severe. A steroid nose spray can also be used in addition to antihistamines if symptoms are not fully controlled by either alone.
You need to take it each day over the hay fever season to keep symptoms away. However, once symptoms have gone, the dose of a steroid spray can often be reduced to a low 'maintenence' dose each day to keep symptoms away. There are several brands which you can buy at pharmacies, or get on prescription. Side-effects or problems with steroid nose sprays are rare (read the packet page for details).
Other treatment options
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Eye drops
If necessary, you can use eye drops in addition to other treatments.
- Antihistamine eye drops work quickly, so you can use them 'as required' to ease a flare up of eye symptoms. You can also use them regularly if needed. There are several brands.
- 'Mast cell stabilisers' are another type of eye drop. There are different brands. They are thought to work by stopping the release of histamine from certain cells (mast cells). You need to use them regularly to prevent symptoms.
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Other nose sprays
The following are sometimes used. They tend to be used if there are problems with any of the above treatments. Sometimes one is used as an 'add on' treatment in addition to one or more of the above treatments if symptoms are not fully controlled.
- Sodium cromoglicate nose spray. Like steroid sprays, it takes a while to build up its effect, and needs to be taken regularly. It is thought to work by stopping the release of histamine from certain cells. One disadvantage is that it needs to be taken 4-5 times a day (steroid sprays are taken 1-2 times a day).
- Ipratropium bromide nose spray may be worth a try if you have a lot of watery discharge. It has no effect on sneezing or congestion.
- Decongestant nose sprays that you can buy at pharmacies are not usually advised for more than a few days. They have an immediate effect to clear a blocked nose. However, if you use one for more than 5-7 days, a 'rebound', more severe congestion of the nose often develops. One may be useful for a few days to clear a blocked nose when you first use a steroid nose spray. The steroid can then get to the lining of the nose to work.
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Treatment for severe symptoms
Rarely, a short course of steroid tablets is prescribed. For example, for students sitting exams who have severe symptoms which are not eased by other treatments. Steroids usually work well to reduce inflammation. A short course is usually safe. However, you should not take steroid tablets for long periods to treat hay fever as serious side-effects may develop.
Immunotherapy (desensitisation)
This treatment is sometimes used, mainly in cases where symptoms are not helped by other treatments. It is done using a series of injections to 'desensitise' the immune system. Another technique is being developed which involves placing the allergen under the tongue.
Asthma and hay fever
If you develop asthma symptoms during the hay fever season you may be prescribed an inhaler. If you already have asthma, your asthma may become worse in the hay fever season. You may need an increase in the dose of your usual inhalers (or other treatment that you take for asthma).
©EMIS and PIP 2005 Updated: May 2005 CHIQ Accredited PRODIGY Validated
