Symptoms of hay fever include:
- a blocked or runny nose (rhinorrhoea)
- itchy eyes, nose, throat and roof of your mouth (palate)
- red or watery eyes
- postnasal drip (mucus dripping down your throat from the back of your nose) – this might make you cough
- headache, caused by a stuffy nose
- swollen eyelids – but this is less common
These symptoms can make it difficult for you to concentrate or sleep well. In some people, pollen may also trigger asthma.If you have hay fever-like symptoms all year round, you may also be allergic to house dust mites, pet hair or moulds. This is called perennial allergic rhinitis.
If you have hay fever, you will probably be familiar with your symptoms and may not need to see your GP. You can try and manage your symptoms with help from a pharmacist.
If you do see your GP, they will usually be able to easily diagnose your hay fever, simply by asking about your symptoms. They may look inside your nose and examine your eyes. If your symptoms are difficult to control, your GP may arrange for you to have an allergy test. You’ll see an allergy specialist, who may do a skin-prick allergy test or blood tests. The blood test is to measure the level of immunoglobulin antibodies for a specific allergen in your blood.
Self-help and prevention
Here are ten ways to help reduce your hay fever symptoms.
- Keep an eye on the pollen count. If you know it’s going to be high, you can take action before your symptoms get too bad or even start.
- Stay indoors, and keep doors and windows closed.
- Keep car windows closed when you’re driving.
- Fit a car pollen filter.
- Stay away from grassy areas, especially during the early morning and evening when the pollen count is highest.
- Don’t mow lawns or rake leaves.
- Wear wrap-around sunglasses to keep pollen out of your eyes.
- Take a shower and wash your hair after going outside.
- Don’t dry your washing outside. Pollen can get trapped in the fibres of your clothes and bed linen.
- Apply a balm around the inside of your nostrils to reduce how much pollen gets into your nose – petroleum jelly works for some people.
If it’s been raining, or is raining, the pollen count should be lower, so your symptoms will probably ease on these days. The pollen count is usually higher on warmer, dry days.
A range of treatments are available to ease the symptoms of hay fever. You can buy most of these in shops and supermarkets. For others, you’ll need a prescription from your GP. Be sure to read the patient information leaflet that comes with your medicine. If you have any questions, ask your pharmacist or GP for advice. Be aware that some hay fever treatments aren’t suitable if you’re pregnant or breastfeeding.
If your hay fever is mild, you might find that antihistamine tablets are all you need to ease your symptoms. These include cetirizine and loratadine. Antihistamines usually reduce sneezing and a runny nose, but may not help as much with a blocked nose.
Some antihistamines can make you feel drowsy. Even those labelled ‘non-drowsy’ can still make some people feel tired, so don’t drive or operate heavy machinery if you get this side-effect. Always read the patient information leaflet that comes with your medicine. If you’re unsure about anything, ask your pharmacist.
If you have persistent or more severe symptoms, a steroid nasal spray, such as beclometasone or fluticasone, may be a good option for you. These are available as over-the-counter medicines from a pharmacy. They can improve and prevent all nasal symptoms, such as sneezing and a blocked nose.
However, a steroid spray may take some time before it starts to work. Use it at least two weeks before your symptoms usually start and then every day during the hay fever season. Make sure you take the lowest dose that works for you. You may have some mild side-effects, such as irritation in your nose or nosebleeds. If your hay fever is mild, try an antihistamine nasal spray, such as azelastine. There are also sprays available on prescription that contain both steroid and antihistamine if your symptoms are more severe.
If you have itchy or sore eyes, you can use eye drops. Sodium cromoglicate drops usually work well and are available without a prescription from your local pharmacy. Lodoxamide, nedocromil and antihistamine drops are other options if sodium cromoglicate doesn’t help.
Steroid tablets are rarely prescribed for hay fever, unless you have very severe symptoms. If you’re prescribed them by your GP, it will only be a short course of treatment.
If all other treatments don’t work, your GP may refer you to see an allergy specialist, who may offer you immunotherapy. This is sometimes called desensitisation.
Immunotherapy involves having doses of the pollen you’re allergic to over a period of three years. It helps ‘reset’ your immune system, so it no longer thinks the specific allergen you’re allergic to is a threat. It’s available either as injections, or as drops or a tablet which dissolves under your tongue (sublingual therapy).
Immunotherapy is expensive and time-consuming so you will only be considered for this type of treatment if your hay fever symptoms are very severe.
If you have hay fever, your body produces a type of antibody called immunoglobulin E (IgE) when you come into contact with pollen. Antibodies are only usually released to fight harmful intruders, such as viruses. But with hay fever, your body believes that the harmless pollen is actually harmful. IgE triggers the release of certain substances from cells in your nose, throat and eyes. One of these substances is histamine, which sets off the symptoms of hay fever.
You may be allergic to one or more types of pollen – this will determine when your symptoms are most severe. Some possible causes include:
- grass pollen
- tree pollen
- weeds, such as nettles, dock and mugwort
- fungal spores
More than nine out of 10 people in the UK who have hay fever are allergic to grass pollen. Different trees produce pollen at different times of the year. One in four people in the UK with hay fever are allergic to birch tree pollen.
Allergen Time of year when
symptoms are worst
Tree pollen Spring Grass pollen
End of spring and beginning of summer Weeds
Early spring to late autumn
The time and length of the pollen season can be different depending on where you live. It usually starts earlier in the year and lasts longer in Southern and Central UK.
The pollen count is the average number of pollen grains in one cubic metre of air over 24 hours. There are pollen counts for grass, tree and weed pollen, and fungal spores.
The pollen count is classed as low, moderate, high or very high.
- Low is less than 30 (pollen grains per cubic metre of air).
- Moderate is 30 to 49.
- High is 50 to 149.
- Very high is 150 or more.
Keeping an eye on the pollen count can help you manage your hay fever symptoms. If you know it’s going to be high, you can take medicines and try self-help measures. See our Treatment section for more information. The weather can affect the pollen count too – it’s generally higher on dry, sunny days and lower on rainy days.
Experts aren’t yet sure. Some people find complementary therapies for hay fever helpful. However, scientific research that’s been done hasn’t yet proven one way or another how well they work. This is because the results have been mixed.
Complementary therapies can be used alongside conventional medicines, such as those you get in a pharmacy or prescribed by your GP. They include acupuncture, homeopathy and herbal medicines. Some practitioners claim that these complementary therapies can relieve your hay fever symptoms or even prevent them. Some studies have shown promise. For example, acupuncture has helped improve hay fever symptoms in some people. However, there isn’t a large enough amount of evidence to recommend these treatments and more research is needed
Some people find that complementary therapies work for them. However, they can sometimes affect how other medicines work or cause side-effects. Do your research and if you’re unsure, contact your GP for some advice before trying anything new.
Yes, supermarket own-brand products contain the same active ingredients as branded antihistamines, so they work in exactly the same way.
Most branded antihistamines are available as non-branded products. These are known as ‘generics’. Exactly the same ingredients are available, in the same dose, in unbranded products or pharmacy or supermarket own-brands. They can be up to 90 percent cheaper than the original branded version.
Generic medicines sold in the UK have to meet the same quality and safety standards as the branded equivalent. Therefore, the active ingredient of the generic product will be chemically the same and have the same effect in your body as the branded one.
There is no need to pay more for an advertised or more smartly-packaged product. Always read the patient information leaflet that comes with your medicine and if you have questions, ask your pharmacist for advice.
You might do. It depends on which country you visit and at what time of year you go.
The hay fever season happens at different times in different countries. This depends on the climate and type of plants and trees that grow there. If you get severe hay fever, it’s best to go on holiday somewhere where the pollen count is low all year round. Alternatively, you could visit places that aren’t in their peak pollen season.
There is generally less pollen in coastal areas. So, if you visit the seaside, your hay fever symptoms shouldn’t be as severe. This is because the sea breeze blows pollen inland and brings fresh air with it.
One thing to remember is that there are different pollen types abroad that might trigger hay fever symptoms, such as olive pollen or ragweed. Also, some years, seasons can come earlier or later, or unexpected weather can produce pollen when you might not expect it.
The best advice is to check the pollen count before you travel and take medicines with you. The National Pollen and Aerobiology Unit has a list of low pollen destinations month by month, which is worth checking before booking a holiday.
- Allergy UK
01322 619 898
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- About generics. British Generics Manufacturers Association. www.britishgenerics.co.uk, accessed 9 July 2015
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- Allergy UK
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