Hay fever (or seasonal allergic rhinitis) is caused by an allergy to grass or hay pollens. Grass pollen is the most common cause (May to July). However, the term is sometimes used for allergic reactions caused by other pollens, e.g. tree pollens (March to May). Symptoms occur when the immune system reacts to pollen. Cells on the lining of the nose and eyes release histamine and other chemicals when they come into contact with pollen, causing inflammation in the nose (rhinitis) and eyes (conjunctivitis).
Who is affected?
Hay fever is very common, often first developing in the teenage years. Symptoms return for a season each year, but in many cases it eventually goes away or improves – often after having had symptoms each season for several years.
What are the symptoms?
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.
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. The pollen count is often given with the weather forecast and it may help to try the following when the pollen count is high:
- Stay indoors as much as possible and keep windows and doors shut
- Avoid cutting grass, stay away from large grassy areas and don’t go camping
- Shower and wash your hair after being outdoors
- Wear wrap around sunglasses when you are out
- Keep car windows closed. Consider buying a pollen filter for the air vents in your car
Have you had medication to help with your hay fever before? If you need some more then you can download this form and send it to The Health Centre – you should not need an appointment but please allow us a couple of days before you come to collect your prescription.
If you have never had any medication for hay fever before but think you may need some, please make an appointment with one of our nurses.
Please download the following questionnaire which you will need to complete and take with you: Unity_Health_Hay_Fever_Questionnaire 2015
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 though. The antihistamine works by blocking the action of histamine, one of the chemicals involved in the allergic reaction. The spray can be used as required for mild symptoms, or taken regularly to keep symptoms away. There are several different brands available from pharmacists.
Oral antihistamines (tablets or liquid) are an alternative to the spray. They ease most of the symptoms but may not be effective at relieving nasal congestion. You can expect the medication to start working within an hour of taking it. For mild symptoms that come and go the medication can be taken as required, or, if your symptoms are more regular, you can take a regular does to prevent an attack.
A pharmacist can advise you on the different brands and types of antihistamines that are available. Some of the older types work well but can cause drowsiness. There are newer ones available that are less likely to cause drowsiness.
Steroid nose sprays are available and work 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 unclear 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. It can 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 steroid spray can often be reduced to a low ‘maintenance’ 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 leaflet for details).
Eye Drops can be used in addition to other treatments. Antihistamine eye drops work quickly so can be used to ease a flare up of eye symptoms. You can use them regularly if needed and several brands are available from pharmacies.
Treatment for severe symptoms
Rarely a short course of steroid tables is prescribed when other treatments have been ineffective. 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.
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, it 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).