Hay fever: Are you on the best treatment?

General health
A woman in a field of flowers blowing her nose.

For many who live in the UK, summer is a time of spending more time outdoors. But for the 16 million people who suffer from hay fever, the summer months can be a miserable haze of streaming eyes, an itchy throat, congestion and tiredness. One of our world-leading consultant respiratory physicians provides all the information patients need to know to help best control their symptoms.

What are the symptoms of hay fever?

The term 'hay fever' can be misleading since it is not caused by hay and there is no fever. Also known as 'seasonal allergic rhinitis', hay fever may be caused by a sensitisation to pollen causing a form of allergy.

An allergy is when your immune system (your body’s natural defence) incorrectly identifies a harmless substance, like pollen, as harmful and responds to it as though it is fighting an infection. This immune response causes the symptoms you experience with hay fever.

It can feel very similar to a cold, but rather than lasting 1 to 2 weeks, hay fever can last for months.

Common symptoms of hay fever can include:
-    sneezing and coughing
-    itchy, red or watery eyes
-    itchy throat, mouth, nose and ears
-    runny or blocked nose
-    headache
-    earache
-    loss of smell
-    feeling tired.

If you have asthma, there may be additional symptoms of tightness in your chest and shortness of breath.

What is hay fever caused by?

An older woman gardening on a sunny day.

Hay fever is one of the most common allergic conditions and there has been a marked increase over the last four decades, with one in four people in the UK now suffering from the condition.

Although hay fever is commonly associated with the summer months, it can occur in spring and autumn due to various types of pollen that can trigger it. These include:

-    tree pollen – released during spring
-    grass pollen – released between late spring and early summer
-    weed pollen – released in late autumn.

Certain risk factors can increase your chances of having hay fever. These include having other allergies, asthma or eczema, as well as having a blood relative such as a parent or sibling with allergies or asthma (your genetics). If you live or work in an environment with constant exposure to allergens (substances that can cause an allergic reaction) such as dust mites and animal dander, this can also increase your risk.
 
Many people with hay fever find that their symptoms improve as they get older, with around half reporting some improvement after a few years. In 10-20% of people, symptoms completely disappear.

How is hay fever diagnosed?

"If you have hay fever, the best thing you can do to control your symptoms is to identify exactly what allergen is causing it. This will help create an action plan such as avoiding exposure to certain types of pollen, as well as taking the best treatment for you,” explains Dr Jaymin Morjaria, consultant in respiratory medicine at Royal Brompton & Harefield Hospitals Specialist Care.

Your pharmacist should normally be able to diagnose hay fever from a description of your symptoms and when they most occur. However, in some cases you may be advised to speak to a doctor for allergy testing.

Allergy testing is normally conducted when your symptoms are particularly severe or your symptoms appear at unusual times of year that are not consistent with hay fever, such as in the winter. This may be due to other allergens causing your symptoms such as dust mites, animal dander or certain foods such as fruits and nuts.

A skin prick allergy test being performed.
A skin prick allergy test.

“There are two main types of allergy test. This includes a skin prick allergy test and a blood ‘IgE antibody’ test. They both work to help your doctor identify exactly which allergens are responsible for your symptoms,” explains Dr Morjaria.

Both types of allergy test are available privately at our hospitals as part of our rapid access diagnostics service.

How is hay fever treated?

Man placing eye drops in eyes.
Eye drops with antihistamines can help with itchy, watery eyes.

“There are various treatments available for hay fever depending on the type and severity of your symptoms. You should speak to your doctor if you would like advice and support with your treatment – particularly if your current treatment is not working. Hay fever treatment works best when it is personalised to you,” explains Dr Morjaria.

Below are some of the treatments you may be offered.

Antihistamines

Antihistamines act to block the release of the chemical ‘histamine’ that is released by your immune system in response to exposure to an allergen like pollen.

Antihistamines can help alleviate itchy eyes and sneezing and can be used when you experience symptoms. They can also be used to prevent symptoms from occurring if for example there is a high pollen count expected that day. However, antihistamines may not help with a blocked nose.

Corticosteroids (steroids)

Corticosteroids come in the form of nasal sprays, drops and tablets. They can suppress the inflammation that occurs when your immune system is triggered by pollen.

Your GP may prescribe corticosteroids instead of antihistamines if you experience persistent symptoms of hay fever that are not alleviated by antihistamines, a blocked nose is your main symptom, or you are pregnant or breastfeeding.

Eye drops and nasal decongestants

As hay fever can cause a blocked nose, you may find a nasal decongestant useful. It comes in the form of a nasal spray and works to reduce the swelling of blood vessels in your nose to help open your nasal passages and make breathing easier.

Eye drops containing antihistamines can be taken to specifically reduce hay fever symptoms in your eyes, such as itchiness or watering.  

Both eye drops and nasal decongestants can be provided by your pharmacist.

Immunotherapy

If you have persistent symptoms of hay fever that cannot be relieved by any of the treatments listed above, your doctor may recommend immunotherapy.

Immunotherapy involves gradually exposing you to small amounts of allergen, such as pollen, in a specialist medical centre where your health can be continuously monitored in case you develop a severe allergic reaction. The allergen can be injected into your skin or given as a tablet that dissolves under your tongue.

You will continue to receive immunotherapy to reduce your sensitivity to the allergen. For long term hay fever relief, three years of immunotherapy is recommended.  What else can you do to prevent hay fever?

The following tips can help you avoid pollen and reduce the severity of hay fever symptoms.

Monitor the pollen count

Grass pollen blowing in the wind.
If your hay fever is triggered by grass pollen, it is best to stay clear of it during the spring and summer months.

Keep an eye on the pollen count and stay indoors when the pollen count is high (between 50 and 150). If you know which plants and trees you are allergic too, using an online pollen calendar can help you determine when these might be flowering and what they look like so that you can avoid them.

Shut the windows

Make sure you shut the windows whilst driving, and if the windows have been opened during the night at home, shut them first thing in the morning to prevent pollen from getting in. You can also use pollen filters in the car to prevent it from coming in.

Avoid grass

If grass pollen is one of your triggers, avoid large grassy areas and get someone else to mow the lawn. Grass allergies may result a more severe reaction such as hives and difficulty breathing.

Protect your eyes and nose

Wearing wrap-around sunglasses can prevent pollen from getting in your eyes, whilst using a nasal spray, or smearing a nasal barrier balm or dab of petroleum jelly just inside your nostrils can help trap some of the pollen.

Wash your hair and clothes

Pollen is sticky and can often get in your hair or stick to your clothes. Washing your hair and changing your clothes regularly can reduce symptoms, and also prevent pollen from being transferred into the home.

Keep the house clean

Pollen can stick on many household items and can become trapped in the fibres of the carpet. To prevent the pollen from becoming airborne, make sure you vacuum regularly and dust with a damp or microfibre cloth.


Get in touch

If you would like specialist support for your hay fever symptoms, such as an allergy test, or to help identify the best treatment plan for you, get in touch with our customer services team  to book an appointment with one of our world-leading consultants.