What is hay fever?
Hay fever is a common allergic reaction to pollen from grass (May to mid July), trees (February to April) and weeds (August to September).
- The start of pollen season and the pollen count is very dependent on the weather. Warmer weather causes more pollen to be released in the air therefore your symptoms will be worse on hot sunny days.
- You can be allergic to more than one type of pollen. In this case your symptoms can last from early spring to late summer or early autumn.
- Plants with bright coloured flowers and strong scent do not cause hay fever – their pollen grains are large, heavy and sticky and they don’t float in the air for long time/over long distances.
What are the symptoms of hay fever?
- Itchy, runny and/or blocked nose
- Itchy, watery or red eyes
- Itchy throat
- Feeling of discharge at the back of the throat
- Need to clear the throat
- Feeling tired
- Symptoms of hay fever are similar to those of a cold, only that they last for weeks or months while a cold usually goes away after 1-2 weeks.
If you have asthma in addition to hay fever, you may also have asthma symptoms during the pollen season. These can be particularly worse when you go out in the fields/forest or when you exercise or at night.
- a tight feeling in your chest
- be short of breath or difficulty breathing
- cough which is usually dry
Tips to manage your hay fever
Remember that hay fever cannot be cured. You will continue to experience symptoms for as long as the pollen is present in the air. The only way to keep your symptoms under control is with treatment.
Most people however would be able to control adequately their symptoms following these two simple rules:
- Take your treatment every day until the end of the pollen season even when you have mild symptoms.
- Treatments do not cure hay fever but in most people symptoms can be kept well under control if the treatment is taken daily.
- Often people stop taking medications as soon as their symptoms get better; this leads to a return of their symptoms, making some people think that the treatment is not working.
- Start taking medication 2-4 weeks before the start of the pollen season.
- This will give time for the treatment to become effective before the high pollen counts occur and will be more effective in keeping your disease under control.
- Make a note your diary of when your symptoms started this year as a guide for next year. Mark a reminder in your calendar to start taking the treatment 2-4 weeks before that date.
Non-medical measures that can help to reduce your symptoms
Reduce your pollen exposure. Pollen cannot be avoided completely but there are a few things that can help to reduce the amount of pollen you come in contact with:
- Keep windows and doors shut as much as possible
- Watch the pollen counts – don’t go out on days with high counts
- Shower (including hair) and change clothes after you have been outside
- Put barrier balm, for example Vaseline, around your nostrils to trap pollen
- Wear wrap-around sunglasses to stop pollen getting in their eyes
- Don’t sleep with open windows at night as most plants release their pollen in the early hours of the morning
- Don’t drive with your car windows open
- Don’t dry your clothes and bedding outdoors in the summer – they will get loaded with pollen that you then carry inside the house
- Remember also that if your pets go out they can carry pollen indoors
Hay fever medicines
Most hay fever medicines are available over the counter and will control hay fever symptoms well if they are taken daily
There are 3 types of medicines which can treat hay fever. The choice of medicine that will work for you best depends on your symptoms.
Nasal douching with salty water such as NeilMed Sinus Rinse
- This is very effective in removing the pollen grains stuck on your linings and will also wash the constant discharge and postnasal drip from your nose
- It does not contain any medication so you can use it as many times a day as you want.
- NeilMed Sinus rinse is available this over the counter in any pharmacy or on-line.
- These are useful for washing the pollen that has landed on the lining of eyes.
- Again you can use them as many times a day and as you need as they do not contain any active medication
- They can also bought over the counter. Ask your local pharmacy for advice.
Antihistamines. These medications are very effective in treating sneezing, itching, runny nose and eye symptoms such as itchy, runny eyes. They might also relieve nasal blockage but they are not as effective as nasal steroids for this symptom. There are two types of antihistamines
- Once a day, non-drowsy antihistamines such as cetirizine fexofenadine or loratadine. Fexofenadine and cetirizine are the strongest antihistamines. There are no stronger ones that can be given on prescription. All antihistamines are available over the counter.
- Old antihistamines such as chlorpheniramine (piriton) may make people drowsy, tired and reduce attention and concentration and ability to drive. They were shown to cause students to drop their summer exam grades. These risks should be considered carefully before taking these antihistamines.
Nasal steroid sprays are usually recommended when antihistamines are not controlling the symptoms completely or for people with more severe symptoms, in particularly severely blocked nose. They are also effective for treatment of eye symptoms so you might not need to take eye drops.
- Flixonase and Beconase are nasal steroids available over the counter.
- Be aware that nasal steroid sprays don’t start working immediately – it takes few days to feel a significant improvement in symptoms. To help get over this period you can take a short course of antihistamines together with the nasal spray for the first 2 weeks. After this you can try to stop the antihistamines – if your symptoms do not get worse you can continue just with the nasal spray.
- You can always add an antihistamine to the steroid spray on the days when your symptoms are worse!
- Taking your spray correctly is very important. Please watch this helpful video.
- If you are also using the nasal douching you should use this first and then apply your spray 5-10 minutes later.
Anti-allergic eye drops. Use these if your eye symptoms are not well controlled just with the nasal steroid spray. There are several type of drops you can use. They contain antihistamines or cromoglicate.
- You can use these even if you are taking a tablet antihistamine and/or a nasal steroid.
- They need to be used 3-4 times a day to be effective.
- All antiallergic eye drops are available from your local community pharmacy.
When to contact your GP?
In adults if you have tried all measures listed above and you have taken your treatment daily for a minimum of four weeks without improvement in your symptoms it’s time to contact the GP to discuss further treatment measures.
If you are seeking treatment for a child that is already on antihistamines (eg cetirizine) and you feel that they require a nasal spray, these are only available on prescription for under 18 years.
For further information on hay fever in children please visit Healthier Together.
Things that will not help your hay fever.
Nasal decongestants. These are available over the counter in form of tablets, nasal or eye drops. Whilst they can give immediate relief especially with symptoms like nasal blockage but if you use them for more than 3 days they will cause dependence which means that your nose will become severely blocked again as soon as the effect of the drug has worn off and you will need larger and larger amounts to treat the blockage. Ultimately you might end in having your nose severely blocked all the time with the drug not working anymore.
Steroid injections. In the past when the medication available to treat hay fever was very limited, people with severe symptoms were sometimes treated with injections with long acting steroids (Kenalog). However, nowadays, when so many new hay fever drugs are available, these steroids are not used anymore because of their risk of causing brittle bones, diabetes and high blood pressure in long term is too high compared to the benefits you are getting out of it.
Honey and Bee Pollen. There is a popular myth that taking honey or bee pollen daily every day hoping that this will render the tolerant to pollen. This however is not true help because honey is made of pollen of the brightly coloured plants which does not cause allergy. If you like your local honey keep eating it but don’t expect it to cure your allergy.
Visit Allergy UK for further information