Hay Fever

What is hay fever?

Hay fever (also called seasonal allergic rhinitis) is caused by an allergy to pollens or moulds. Grass pollen is the most common cause (May to July). Less common causes are tree pollens (March to May), and moulds (July to September).

Who gets hay fever?

At least 1 in 10 people in the UK have hay fever. It usually first develops before the age of 20. Symptoms return for a season each year, but it eventually goes away or improves in many cases.

What are the symptoms of hay fever?

• Common symptoms are a runny and itchy nose, blocked nose, sneezing, itchy and watery red eyes, and sore throat. Sometimes only nose symptoms, or only eye symptoms occur.
• Less common symptoms are loss of smell, facial pains, sweats, and headache.
• Asthma symptoms such as wheeze and breathlessness may get worse if you 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 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 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.
• Bring in washing, and close windows before the evening when pollen falls as the air cools.
• Keep car windows closed, and consider buying a pollen filter for the air vents in your car.

What are the treatment options for hay fever?

Antihistamine tablets or liquid medicines
Antihistamines work by blocking the action of histamine. A dose usually works within an hour or so to ease symptoms. Therefore, they can be taken 'as required' if symptoms are mild, or come and go. You can also take antihistamines regularly if you have symptoms every day.

Antihistamines ease most of the symptoms, but may not be so good at clearing a blocked nose (nasal congestion). There are several brands of antihistamines which you can buy at pharmacies or get on prescription. Older brands such as chlorpheniramine (Piriton) work well, but make some people drowsy. Newer brands tend to cause less drowsiness. Ask the pharmacist for advice.
 

A steroid nose spray is usually the most effective treatment for all the nose symptoms (itch, sneezing, watering, and blocked nose). It works by reducing inflammation in the nose. It takes several days for a steroid spray to build up to its full effect. Therefore, you will not have immediate relief of symptoms when you first start it. (It is best to start taking it a week before the hay fever season begins if you know that you have hay fever.) You need to take it each day over the hay fever season to keep symptoms away. There are several brands which you can buy at pharmacies, or get on prescription. Steroid nose sprays also tend to ease eye symptoms. It is not clear how they help the eye symptoms - but they do!
 

Eye drops
If necessary, you can use eye drops in addition to other treatments.

Treatment for severe symptoms
Rarely, a short course of steroid tablets is prescribed. For example, to clear symptoms for students sitting exams who have severe symptoms which are not eased by other treatments. Steroids 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.

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).

Follow up
Treatment works well in most cases. Tell your doctor if symptoms persist, despite treatment. A change in treatment, or an alteration in the dose of a current treatment may be an option to ease symptoms which persist.

BP/June05