Hay fever

What is hay fever?

Not everyone suffers hay fever (also known as allergic rhinitis). If you do it means your immune system recognises one or more of these substances as foreign to the body and as a result, launches an attack.

People with hay fever often have other conditions that may also involve allergy, such as asthma and atopic dermatitis (eczema).

We call it hay fever because it is most prevalent during the ‘haying’ season—spring—thanks to the increase in airborne pollens released from grass during this time of year. But hay fever can strike during any season when other common allergens including house dust mites are present, as well as chemical irritants that can worsen hay fever, such as cigarette smoke.

What are the signs and symptoms of hay fever?

Hay fever typically affects your nose, as this is where the allergic response occurs. When an allergen gets trapped in your nose, your body releases a substance called histamine, which causes redness and swelling of the nasal passages, and increased mucus in the nose. Nearby organs, such as the ears and eyes, may also be affected.

Some of the symptoms of hay fever include:

• Sneezing, often uncontrollably
• A runny or stuffy nose
• Itching or tickling sensation in the ears, nose, throat or roof of the mouth
• Irritating cough
• Red, puffy, itchy or watery eyes
• Loss of taste or smell of food
• Headaches

Symptoms often first occur in childhood or adolescence, although for some people it emerges in adulthood. Symptoms can vary in intensity and can be unpredictable, especially if your hay fever is unrelated to the seasons. For some people, their symptoms become so severe that they can’t sleep or concentrate, and they may feel tired or unwell.

Diagnosis:

If you’re experiencing symptoms of hay fever, see your GP as he or she can investigate your symptoms, assess their severity and frequency, and help to identify the allergens involved.

Hay fever is diagnosed as either seasonal allergic rhinitis (when symptoms only occur during spring and summer, usually due to pollen) or perennial allergic rhinitis (when symptoms are experienced all year around, usually due to exposure to house dust mite, mould or animals).

If your GP thinks you need further tests, you may be refered to a specialist. Allergy specialists commonly suggest ‘skin scratch’ tests, which are useful in checking your sensitivity to different allergens. This involves placing a small quantity of an allergen-based substance on your skin, then lightly scratching that area with a needle, to test your body’s reaction.

Complementary medicine and lifestyle approaches

Once you’ve identified your allergens, managing your hay fever involves reducing exposure to them, or avoiding them all together. A number of things can be done to help prevent a bout of hay fever or reduce symptoms, such as:

• Staying indoors as much as possible in spring, when the pollen count forecast is high, and on windy days or after thunderstorms.
• Choosing plants for the garden that are pollinated by birds or insects, rather than plants that release their seeds into the air.
• Smearing petroleum jelly (try Vaseline) inside your nose to stop pollen from touching the nose’s inner lining.
• Frequently splashing the eyes with cold water to flush out any pollen.
• Reducing mould in the home
• Reducing your exposure to dust, dust mites, animals and their fur.

Some people use complementary therapies such as acupuncture or herbal medicines to treat their symptoms. However, although there is some anecdotal evidence to suggest that these may be effective, there is little scientific evidence to show that they work. Speak to your doctor before making a decision about taking herbal or natural medicines, as some can interfere with other medicines.

Traditional medicine-based treatment

There are some medicines that can be used to reduce symptoms. Have a chat to your doctor or pharmacist to find the best option for you. A combination of medicines may be required for some people.

Medicines used for hay fever include:

• Corticosteroid nasal sprays
These medicines reduce inflammation and decrease mucus in the nose, and are usually the first medicine of choice used when hay fever is severe. They start to provide relief from symptoms such as a blocked or runny nose within 3–7 hours, although they need to be used regularly over a period of several days to get the full benefit.

• Antihistamines
These medicines, often found in tablet, or syrup form, may help to control sneezing, itching and a runny nose. However, they’re not as effective as corticosteroid nasal sprays for relieving nasal symptoms. For this reason, people who choose an antihistamine might also need a decongestant to control their symptoms.

• Decongestants
These medicines, which come in variety of forms including syrup, nasal spray or drops,, liquid capsules, and tablets, reduce nasal congestion but don’t work on other symptoms. They may be useful as short-term treatment (4–5 days) when congestion is a problem. If you’re using a decongestant nasal spray, it’s important to use it for no longer than a few days as this can actually lead to a blocked or stuffy nose (known as rebound congestion). It’s also important to know that oral decongestants often cause side effects like insomnia and irritability, and are unsuitable for some people, such as those with heart conditions or high blood pressure.

The Therapeutic Goods Administration (TGA) in Australia has warned against the use of combined antihistamine-decongestant medicines in children younger than 2 years old, but there have been reports of severe side effects in other children who have used decongestants, particularly those younger than 6.

Other medicines are sometimes used for hay fever, for example, eye drops to relieve red, swollen and itchy eyes, and other types of nasal sprays that may be useful in preventing hay fever (e.g. cromoglycate nasal spray), or in relieving a runny nose when this is the main symptom (e.g. ipratropium nasal spray).

Another type of treatment, known as desensitisation, may help if other strategies don’t work. This is a long-term treatment, which changes how the immune system responds to allergens by giving the body regular, increasing amounts of allergen extracts slowly over time, either as injections or drops under the tongue.

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