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Hayfever
What is it?
Hayfever is an allergic reaction to pollen which causes inflammation and irritation to the lining of the eyes, nose and throat. Pollen from trees and grass is a common allergen and can affect sufferers at specific times of the year. It is therefore known as “seasonal allergic rhinitis”, because of when pollen sensitivity occurs.
Allergy seasons
| Grass pollen: | May - July/August |
| Tree pollen: | Feb – June (depending on whether allergic to early or late flowering trees) |
| Nettle/weed pollen: | August – September |
Grass pollens affect most sufferers but if the allergy extends beyond this to a tree pollen allergy then the hayfever season is very prolonged. Hayfever symptoms that continue all year are called “perennial allergic rhinitis” and commonly relate to indoor allergens, such as house dust mites, pets and possibly indoor moulds.
Symptoms
In an attempt to rid the body of allergens the immune system overreacts and releases chemicals which cause inflammation. Hayfever causes itchy, watery, red eyes (known as seasonal allergic conjunctivitis, or “allergic eyes”), frequent sneezing and a constantly dripping nose. Consequently, sufferers struggle to breathe through their nose properly and find it hard to rid the itchy sensation in the nose, ears and back of the throat.
Symptoms are often worse amongst young people, peaking between the ages of 20 and 30, and later tailing off as the body adapts.
Hayfever is often trivialised by non sufferers as “a bit of a sniffle” but studies have shown that it severely affects people’s quality of life. It disturbs sleep, impairs daytime concentration and work performance (important as exams may be in the hayfever season) and is a significant cause of absenteeism from school and work
Treatment
Hayfever can be managed by:
- avoidance of the allergic trigger (pollens);
- treatments that suppress the symptoms; and
- treatments that try to fundamentally alter the tendency to allergy.
The latter is the ideal but has not yet been achieved, although desensitisation is an approach that attempts to do this.
Desensitisation has been tried in a variety of forms, such as injections or drops under the tongue (sublingual therapy). To date, the most effective treatment is a course of injection immunotherapy for grass pollen allergy, which can have long lasting benefits. The effects of sublingual treatments are still being assessed, but early results look promising. As immunotherapy is so intensive and time consuming, it is only those with extreme symptoms uncontrolled by regular topical steroids plus antihistamines, who receive this therapy.
Allergen avoidance is difficult for pollen allergy as the tiny pollen spores are windborne and travel for miles on air currents. Wearing dark glasses outdoors helps prevent pollen settling on the eyes and limits the eyes response to the sun. This is helpful because the eyes are often sensitive to bright light, if inflamed, and this can trigger watering.
One mode of treatment is an antihistamine, usually in tablet form (liquids are also available). There are a large range of antihistamines; some associated with a tendency to induce drowsiness and some that are free from this effect. You should not be taking a sedating antihistamine on a regular basis for hayfever so check that the antihistamines you are given are of the non-sedating type. This form of treatment can be all that is needed in some people and is most effective for an itching, sneezing and runny nose but less so for a blocked nose.
If your symptoms are persistent despite this, or you have found such treatment not fully effective in previous seasons, then the regular use of a nasal-spray containing a topical steroid is a more effective option and will have greater effect at relieving symptoms, especially if a blocked nose is a problem. Nasal sprays that contain decongestants may be useful but should not be used regularly. They will have a rebound effect that makes the blocked nose worse.
For those with severe eye symptoms, some eye drops are available over-the-counter, or your GP can prescribe stronger drops. There may be other types of treatments that your doctor will discuss with you but these are the main orthodox options.
If you know when your hayfever is likely to start each year, you should start taking your treatment shortly before your symptoms normally begin. It is more difficult to control symptoms that are already well established. Preventative treatments should be taken daily to have the best effect rather than intermittently only when symptoms are troublesome.
Self help tips
- Monitor pollen forecasts daily and stay indoors wherever possible when the count is high.
- Limit outdoor trips to rural areas. Sea breezes blow pollen inland, so escape to the sea instead.
- If you go out in the countryside, shower and wash your hair on return, and change your clothing before coming back into the living room or bedroom.
- Keep windows closed when indoors and overnight whilst you are sleeping. This is most important in the early mornings, when pollen is being released, and in the evening. If you still suffer symptoms indoors, a good air filter should help.
- Avoid mowing lawns or raking leaves. If you must perform these tasks, use a face mask.
- Wear wraparound sunglasses when outdoors to keep allergens out of your eyes.
- Avoid line-drying clothes and bedding when pollen counts are high.
- Keep car windows closed when driving. Some cars are fitted with an effective pollen filter.
- Try not to rub itchy eyes; washing your face and hands can help.
- Apply Vaseline around the edge of each nostril. Gel nasal sprays are sometimes helpful; they act as a barrier to trap pollens.
- Choose hypo-allergenic eye make-up, especially mascara.
- Don’t let pets get close to your face as they can carry pollen in their fur.
- Use goggles when swimming, whether in the sea or in a pool.
- Use eye drops regularly during the season, as recommended by your doctor.
- If you wear hard or gas permeable contact lenses you can use eye drops as normal. If you wear soft contact lenses, eye drops should not be used while the lenses are being worn, unless the drops are specifically formulated for this purpose.
If anything in these instructions is unclear, ask your physician for help or advice, or call the Allergy UK Helpline on 01322 619 898 (9am to 5pm Monday to Friday).