Hayfever: the causes, symptoms and treatment

(11 May 2016)

Causes

There are more than 30 types of pollen and 20 types of spores that we know can trigger seasonal Hayfever (allergic rhinitis).  

*Grass pollen is the most frequent cause.

*Tree pollen can also cause problems.

Some people's symptoms are triggered by just one or two allergens, others are affected by more. The pollen season can last from early spring (tree pollen), through the summer months (grass peaking in June and July) and finish in the autumn (fungal spores).

 

Symptoms

The symptoms of hay fever occur when the immune system (the body's defense system) overreacts to a normally harmless substance, in this case pollen. When the body comes into contact with pollen, cells in the lining of the nose, mouth and eyes release a chemical called histamine. This triggers the symptoms of an allergic reaction.

Hay fever symptoms vary in severity and your symptoms may be worse some years than others, depending on the weather conditions and the pollen count (see below). Your symptoms may start at different times of the year depending on which types of pollen you are allergic to.

The symptoms of hay fever include:

Sneezing
runny or blocked nose
itchy, red or watery eyes (also known as allergic conjunctivitis)
an itchy throat, mouth, nose and ears

Less commonly, you may experience:

the loss of your sense of smell
facial pain (caused by blocked sinuses)
sweats
headaches
Sleep disturbance
A loss of concentration and a generally feeling unwell

 

Treating Hayfever

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.

If you are using OTC medicines, always read the manufacturer's instruction. If you are pregnant or breastfeeding, check with your Pharmacist before using OTC medicines to find out which ones are recommended.

The best way to decide what treatment is most appropriate for you is to speak to your Pharmacist. This is particularly important if you have asthma as well, because hay fever can often make asthma symptoms worse.

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 purchased in your local pharmacy. 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 also be taken. Ask your pharmacist for advice.

Steroid (Corticosteroid) nasal sprays and drops

Steroids Corticosteroids 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.

Some corticosteroid nasal sprays are available Over The Counter. It is important to ask your pharmacist for advice with using steroids.

Oral Steroids

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.

Injections

Long acting steroid injections have been used for treatment of Hayfever, but they are not recommended as routine management due to the risks of serious side effects and should only be used in exceptional circumstances.

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.

Your pharmacist can advise you on the different products to choose from as many are available Over The Counter. Check the ingredients as some decongestants also contain antihistamine. If they do, they may relieve other symptoms as well. If not, the decongestant will only relieve your blocked nose. Ask you Pharmacist for advice on all Over the Counter Medications.

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 Over The Counter 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 with your Pharmacist for the correct way to use them. Some may cause side effects, such as a stinging or burning feeling in your eyes.