It’s that time of year again when my surgery waiting room starts to fill up with people sneezing, rubbing their eyes and generally looking more miserable than usual. Hay fever — also known as seasonal allergic rhinitis — typically starts around now, although for some people it can occur at any time of year depending on their sensitivity to certain pollens, grasses and fungal spores. About 10 million people in Britain are believed to suffer from it to some degree but the exact figure remains unclear due to people self-treating or not reporting their symptoms, with most developing hay fever before the age of 20.
Hay fever, asthma, food allergy and eczema are related allergic conditions and the tendency to develop them seems to run in families. This inherited predisposition is called atopy and it means your body produces a certain type of antibody in response to allergens which isn’t produced in non-allergic people.
Symptoms of hay fever can vary in type and intensity but most people have one or more of these symptoms — sneezing, a blocked or runny nose (rhinitis), itchy eyes, nose and throat and headaches. As a result of these symptoms, you may find it difficult to concentrate or sleep properly and children taking school exams can have their academic performance significantly affected if suffering from serious hay fever. In some people, hay fever allergens may also trigger asthma.
When you come into contact with pollen or the spores of moulds or fungi that you’re allergic to, your body produces an antibody called immunoglobulin E (IgE). Antibodies are usually only released to fight infection, but in this instance your body believes the substance you’re allergic to is harmful.
When there’s a lot of the substance you’re allergic to in the air, the IgE antibodies will trigger the release of chemicals from certain cells in your nose, throat and eyes. One of these chemicals is histamine, and as a result of histamine in your system, you’ll experience the symptoms of hay fever.
Common causes of hay fever include grass pollen, tree pollen, moulds and fungi. The time of year can affect when symptoms are at their worst, with spring and summer being the seasonal peaks.
Along with most doctors, I diagnose hay fever from the history and symptoms alone. Most people do not need to have special tests but occasionally a doctor may advise you to have a skin-prick allergy test to help determine if you’re allergic to specific substances.
There are many ways of reducing hay fever symptoms apart from taking medication and these include:
- Staying indoors on days when the pollen count is high — this limits the contact you have with the allergens you’re sensitive to.
- Keeping doors and windows closed when the pollen count is high. If your child is affected, expect the symptoms to be worse if they are playing outside during hay fever season.
- Staying away from areas where there’s more pollen such as grassy parks, especially in the early morning and late afternoon and evening when the pollen count is highest.
- Not mowing the grass, and staying inside when it’s being mowed by someone else.
- Wearing wrap-around sunglasses to keep pollen out of your eyes.
- Taking a shower and washing your hair after going outside when the pollen count is high.
- Removing house and garden plants that trigger your hay fever.
- Not drying washing outside if the pollen count is high — pollen may get trapped in the fibres of clothes and bed linen.
- Putting Vaseline on the inside of your nostrils to prevent pollen from entering your nasal passages.
Other ways to help include avoiding cigarette smoke, cleaning your house regularly to keep dust and mould counts low – wear a mask, dust with a clean, damp cloth and vacuum instead of sweeping — removing items that easily trap dust, such as stuffed animals, dried flowers and curtains, and considering using low-allergy bedding products.
There are a range of treatments available for hay fever. You can get some of these over-the-counter in pharmacies, while others require a prescription from your doctor — get advice from your pharmacist or doctor before starting any medication, even if you don’t need a prescription for it. Let them know if you’re taking any alternative or complementary treatments for hay fever or any condition as these can sometimes interact with other medications. Ask your pharmacist for advice if you are pregnant or think there’s a possibility you may be pregnant.
Antihistamines are the main treatment for hay fever and can quickly help reduce symptoms of sneezing and a runny nose. They are available as tablets or syrups but if you only get hay fever symptoms now and again, and they only affect your nose, you could try an antihistamine nasal spray or drops.
A steroid nasal spray can be helpful in reducing or preventing the inflammation in the nose that occurs in hay fever. It works best if you take it before your symptoms start and then on a daily basis throughout the hay fever season. You can use it even if you have no symptoms while the pollen count remains high. If you don’t feel it’s controlling your symptoms well, don’t take more than the recommended dose. Instead, ask your doctor or pharmacist for advice.
You can buy corticosteroid nasal sprays over the counter from your local pharmacy. Your doctor can also prescribe stronger nasal sprays.
If you suffer from itchy or sore eyes, eye drops that contain antihistamines or sodium cromoglicate can help. Using a daily combination of eye drops and a nasal steroid is an option if you would rather not take oral medications.
Immunotherapy is one type of possible treatment for very severe cases but its availability is patchy and is only given by specialist teams. Here, people with hay fever are exposed to increasing amounts of the allergen with the aim of boosting their immunological tolerance, but identifying the allergen is crucial and treatment usually needs to be given for at least three years.
Fortunately, for about 20 per cent of sufferers, hay fever spontaneously resolves itself over time. But spare a thought for those at this time of year who open their curtains to a lovely sunny day and groan at the thought rather than smile.