Hay Fever

What is hay fever?

Hay fever, also called allergic rhinitis, is an allergic inflammation of the nasal airways. It occurs when an allergen, such as pollen, dust mites, mould or animal hair is inhaled by an individual with a sensitized immune system. It is common in spring because it is often caused by an allergy to grass pollen. Hay fever can occur at any time of the year. This is known as perennial allergic rhinitis. Symptoms include a running nose, sneezing and itchy, watering eyes. The most effective way to control hay fever is to avoid exposure to the allergen (if identified), but this is not always possible. Medication including corticosteroid nasal sprays, antihistamines and staying indoors can help symptoms. Allergen immunotherapy may be a suitable treatment for some people.

Symptoms and triggers of hay fever

Your nose acts as a filter. The tiny hairs and mucus that line the nasal passages trap dust, pollens and other microscopic particles. A person with hay fever is allergic to some of the particles that get trapped in the nose, such as pollen. An allergic reaction means the immune system treats a harmless substance as if it is dangerous, and launches an ‘attack’. The nasal passages become inflamed and more mucus is produced. Some of the symptoms include:

  • sneezing
  • a runny or stuffy nose
  • itchy ears, nose and throat
  • red, itchy or watery eyes
  • headaches.

You may be at an increased risk of experiencing hay fever if you have another allergy such as asthma or eczema, a family history of the condition, or if you were exposed to tobacco smoke during childhood.In some cases, the symptoms of hay fever can be so severe that a person can’t sleep or concentrate, and may feel tired or unwell.

Treatment and management of hay fever

The goal of allergic rhinitis treatment is to prevent or reduce the symptoms caused by the inflammation of affected tissues. Allergy testing may reveal the specific allergens to which an individual is sensitive. Skin testing is the most common method of allergy testing. This may include a patch test to determine if a particular substance is causing the rhinitis, or an intra-dermal, scratch, or other test. Some medications may help the symptoms of hay fever.  Speak to your doctor about which, if any, treatment is appropriate for you.  You may be advised to try:

  • Antihistamine tablets or syrups – these may be useful to help to reduce symptoms (sneezing, itchy and irritating eyes), but they are not as effective as intra-nasal corticosteroid sprays in controlling severe nasal blockage and limiting the frequency of attacks.
  • Intra-nasal corticosteroid sprays (INCS) – these nasal sprays contain very low-dose steroids and have a potent action on inflammation when used regularly (like asthma preventer medications). They need to be used regularly as directed but are one of the most effective and preferred treatments for allergic rhinitis.
  • Decongestant nasal sprays – are useful for quick relief to unblock and dry the nose, but should not be used for more than a few days as they can cause long term problems in the nose and lead to rebound congestion.
  • Decongestant tablets – unblock and dry the nose, but should be used with caution as they can have ‘stimulant’ side effects like tremors, trouble sleeping, anxiety or an increase in blood pressure. People with high blood pressure should not take this medication.
  • Eye drops – may relieve itchy, swollen or runny eyes. Ask your doctor or pharmacist for advice on choosing the correct eye drops.
  • Natural products – such as salt water nasal sprays or rinses can be effective in relieving symptoms.

Suggestions to prevent or limit symptoms revolve around identifying all possible allergens with testing and avoiding exposure to them as much as possible. They include:

  • Stay indoors as much as possible in spring, on windy days or after thunderstorms.
  • In your garden, choose plants that are pollinated by birds or insects, rather than plants that release their seeds into the air.
  • Replace your lawn with types of artificial grass, bricked or paved areas.
  • Splash your eyes often with cold water to flush out any pollen.
  • Reduce your exposure to dust and dust mites, animals and animal hair.

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