Hay Fever

What causes hay fever

Hay fever is an allergic reaction to pollen, typically when it comes into contact with your mouth, nose, eyes and throat. Pollen is a fine powder from plants.

Hay fever is usually worse between late March and September, especially when it's warm, humid and windy. This is when the pollen count is at its highest.

Symptoms of hay fever include:

  • sneezing and coughing
  • a runny or blocked nose
  • itchy, red or watery eyes
  • itchy throat, mouth, nose and ears
  • loss of smell
  • pain around your temples and forehead
  • headache
  • earache
  • feeling tired

If you have asthma, you might also:

  • have a tight feeling in your chest
  • be short of breath
  • wheeze and cough

Hay fever will last for weeks or months, unlike a cold, which usually goes away after 1 to 2 weeks.

How to treat hay fever yourself

There's currently no cure for hay fever and you can't prevent it. But you can do things to ease your symptoms when the pollen count is high.

Do

  • put Vaseline around your nostrils to trap pollen
  • wear wraparound sunglasses to stop pollen getting into your eyes
  • shower and change your clothes after you've been outside to wash pollen off
  • stay indoors whenever possible
  • 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 special HEPA filter

Don't

  • cut grass or walk on grass
  • spend too much time outside
  • keep fresh flowers in the house
  • smoke or be around smoke – it makes your symptoms worse
  • dry clothes outside – they can catch pollen
  • let pets into the house if possible – they can carry pollen indoors

The best way to control most allergies is to avoid the trigger substance. However, it is very difficult to avoid pollen, particularly during the summer months when you want to spend more time outdoors.

A range of products is available to treat the symptoms of hay fever. Some may be prescribed by your GP, but others are available over-the-counter (OTC) in most pharmacies.

The best way to decide what treatment is most appropriate for you is to speak to your GP. This is particularly important if you have asthma as well, because hay fever can often make asthma symptoms worse. Your GP may advise you to increase the dosage of your asthma medication.

Antihistamine tablets or nasal sprays

Antihistamines treat hay fever by blocking the action of the chemical histamine, which the body releases when it thinks it is under attack from an allergen. This prevents the symptoms of the allergic reaction from occurring.

Antihistamines are usually effective at treating itching, sneezing and watery eyes, but they may not help a blocked nose.

Oral (to be swallowed) antihistamine tablets can be prescribed by your GP or bought OTC. These are usually taken daily or several times a day. In the past, antihistamines caused drowsiness, but most newer types do not.

Antihistamine nasal (nose) sprays containing azelastine may be prescribed by your GP. They can taste bitter if you do not use them correctly.

Corticosteroid nasal sprays and drops

Corticosteroids (steroids) are used to treat hay fever because they have an anti-inflammatory effect. When the pollen triggers your allergic reaction, the inside of your nose becomes inflamed. Corticosteroids can reduce this inflammation and prevent the symptoms of hay fever.

Your GP may prescribe corticosteroid nasal sprays or drops instead of antihistamines if:

·        you have persistent hay fever,

·        your main symptom is a blocked nose, or

·        you are pregnant or breastfeeding.

Corticosteroids are more effective than antihistamine tablets at preventing and relieving nasal symptoms, including sneezing and congestion. They can also relieve itchy, watery eyes. They are most effective if you start using them a couple of weeks before your symptoms usually begin, and work best when used regularly.

Using too much or using it incorrectly can cause side effects, such as dryness and irritation in the nose and throat.

Oral corticosteroids

If your hay fever symptoms are so severe that they impair your quality of life, your GP may prescribe a 5-10 day course of oral corticosteroids. These will quickly relieve your symptoms, but can cause side effects, such as an increase in appetite, weight gain and mood changes, including irritability or anxiety.

Nasal decongestants

Hay fever can cause a blocked nose. A decongestant, in the form of a nasal spray, can relieve this. Decongestants reduce the swelling of the blood vessels in your nose, which opens your nasal passage and makes breathing easier. 

Nasal decongestants should not be used for longer than seven days. They may cause dryness and irritation in your nasal passage, and if used on a regular basis for more than 7 days they can make the symptoms of decongestion worse and harder to treat.

Eye drops

Eye drops are available OTC to treat the hay fever symptoms that affect your eyes, such as redness, itchiness and watering (allergic conjunctivitis). These drops contain antihistamine to reduce the inflammation in your eyes, which will relieve the symptoms.

Eye drops containing the active ingredient sodium cromoglicate are the most widely used. Check the patient information leaflet for the correct way to use them. Some may cause side effects, such as a stinging or burning feeling in your eyes.  

Immunotherapy

If you have persistent hay fever symptoms which are not relieved by the above treatments, your GP may refer you for immunotherapy treatment. This involves gradually introducing you to small amounts of the allergen (the substance that you are allergic to), such as pollen, and monitoring your allergic reaction.

This treatment is only carried out in specialist medical centres in case a serious allergic reaction occurs. The allergen will be given to you as an injection into your skin or a tablet that dissolves under your tongue. You will then be monitored for up to an hour.

As you get used to the allergen, the amount used is slowly increased and your allergic reaction to it should get less severe. This has been shown to improve people's tolerance of the allergen, improve their quality of life and has long-term results.

Immunotherapy may take months or even years to be effective. There is a risk of anaphylaxis (anaphylactic shock), which is a severe allergic reaction. It is not recommended for people who have persistent asthma and hay fever.

Alternative therapies

Some alternative therapies, such as acupuncture, homeopathy and herbal remedies, claim to relieve or prevent hay fever symptoms. However, the lack of evidence supporting their effectiveness means that more research is needed before they can be recommended.

If you decide to use herbal remedies, check with your GP first as some remedies, such as St John's Wort, can react unpredictably with other medication or make it less effective.

Nasal spray technique

·        Gently blow your nose to try to clear it.

·        Shake the bottle of nasal spray well.

·        Close off one nostril by holding your nostril shut with your finger.

·        Put the spray nozzle in the other nostril.

·        Tilt your head forward slightly and keep the bottle of spray upright.

·        Squeeze a fine mist into your nose while breathing in slowly. Do not sniff hard.

·        Breathe out through your mouth.

·        Take a second spray in the same nostril, then repeat this procedure for your other nostril.

Nasal drop technique

·        Gently blow your nose to try to clear it.

·        Shake the container of nasal drops well.

·        Tilt your head backwards.

·        Place the drops in your nostril. You may need to gently squeeze the container to release some drops.

·        Keep your head tilted back and sniff gently to let the drops make their way into your nose.

·        Repeat for your other nostril if required.

If you are using over-the-counter (OTC) medicines, always read the patient information leaflet that comes with them. If you are pregnant or breastfeeding, check with your GP which OTC medicines are suitable.

 

Adapted from hse.ie and nhs.uk