Hay Fever (Allergic Rhinitis)

Hay fever or allergic rhinitis is caused by allergy to grass and/or tree pollen. It usually occurs in spring and summer when tree and grass pollen counts are high. Exposure to the pollen causes irritation of the lining of the nose, eyes and throat. Asthma and eczema can also be worse during the pollen season.

Some people with hay fever are very “atopic”. Atopy is the tendency to have allergies (including eczema, asthma, allergic rhinitis and food allergy) this tendency is partly determined by genes and exposure to pollen.

Hay fever usually affects both the nose and eyes. Symptoms may be confused with the common cold.

• nose symptoms include itching, sneezing, watery nasal discharge (runny nose), blockage and poor smell
• eye symptoms include itchy, red swollen eyes
• the throat may also be itchy. Some people may also suffer from headaches.

People tend to be allergic to only some plants or grasses, and skin prick or blood tests done by your doctor can confirm the cause of the allergy.

Avoiding pollen is difficult. However the following may help when the pollen count is high.

• Check local pollen counts, avoid being outdoors in the early morning and evening, or after a thunder storm when pollen levels are highest.
• Sleep with the bedroom window closed
• Keep car windows shut when travelling
• Travel to beaches rather than open grassy areas during the pollen season
• After being outdoors, remove and wash clothes, shower and wash your hair to rinse away pollen
• Bathe eyes with water
• Avoid hanging clothes on washing lines during high pollen count days
• Take holidays to regions with lower pollen counts than home.

• non-drowsy antihistamine (cetirizine or loratadine; not Piriton which is sedative) is easy to take and often provides immediate relief. If you still get symptoms despite taking one dose, you can safely take a second dose within 24 hours.
• nasal steroid sprays act as preventers. For most benefit, the sprays should be used from when symptoms start and continued regularly throughout the pollen season. They are more appropriate in older children. Advice on how to use the device can be given during your clinic appointment or found on our website.
• eye drops can be helpful for patients with eye symptoms. There are many different types. Sometimes nasal steroid sprays also help eye symptoms.
• specific immunotherapy (allergy shots) may be considered by an allergy specialist if symptoms are still troublesome and poorly controlled with the above medicines.

Hay fever symptoms are more common in young people and can be less troublesome as you get older. At present, it is not possible to predict whose hay fever will get better and whose will remain. Some patients will also suffer from asthma and require inhalers.

People with hay fever do not have allergies to all pollens. Pollen from different plants vary during the year. Tree pollen tends to be highest in spring, grass pollen is highest in summer and many weed pollens are highest in autumn:

• tree pollen (e.g. Hazel, Yew, Alder, Elm, Birch) counts highest in February and March
• grass pollen counts highest in May to August.
• weed pollen (e.g. Rape seed, Nettle, Mugwort) counts highest in May to September