The term hay fever, which was first used in the mid-19th century, describes the seasonal catarrh and associated symptoms that generally appear in spring and summer. It is a type of allergic rhinitis and is caused by an allergy to a variety of grass, tree and weed pollen or spores.
The pollen season can, however, start as early as late January and last until November. The timing of symptoms appear helps to determine the likely culprit or allergen:
- Tree pollen is the most common cause of hay fever between late March to mid May.
- Grass pollen is the most common cause of hay fever between mid May to July.
- Weed pollen is the most common cause of hay fever from the end of June until September.
A pollen calendar on the Met Office website showing the average pattern of release of the main allergic pollen in the UK.
Some sufferers are symptomatic for most of the year which is one reason why doctors no longer use the term seasonal rhinitis to refer to hay fever.
Allergic rhinitis is now classified as either:
- Intermittent Allergic Rhinitis – symptoms present for up to four days per week or for up to four weeks in a row.
- Persistent Allergic Rhinitis – symptoms are present for more than four days over a week or for ore than four weeks in a row.
For those who suffer hay fever, exposure to the pollen causes irritation to the nose and eyes leading to a number of symptoms including:
Nose – blockage/stuffiness/runny, itchiness, sneezing
Eyes – dryness, itchiness
By taking a careful and thorough history of symptoms and when they occur, a diagnosis of hay fever can be made. Occasionally, if the history is not clear, allergy testing, either as a skin prick if a blood test, can help to confirm and identify the specific allergens.
- The treatment of hay fever relies on minimising and controlling the symptoms, which is best achieved by avoiding exposure to the allergen by checking the pollen forecast available on the Met Office website.
- keeping windows closed at home, especially at night and in the morning and also in the car, especially when driving past grass verges in rural areas
- using an air filter at home and ensuring that a suitable air filter is used in the car
- Protecting the eyes with sunglasses when outside.
Medication to control the symptoms including:
- Anti-histamines, a variety of which are available over the counter by prescription, The most commonly used anti-histamines only need to be taken once a day and, unlike older versions, are unlikely to cause drowsiness. They are especially helpful in reducing itchiness, sneezing and a runny nose.
- Nasal steroid sprays can be purchased over the counter or by prescription and can be helpful in improving the blocked or stuffy nose and other symptoms to a lesser extent. They must be used on a daily basis to be most effective.
- Cromoglicate eye drops are very helpful to control dry, itchy eyes but cannot be used if soft lenses are worn.
- Saline nasal douches can also be useful
Discussion with a pharmacist or your GP, especially for patients taking other medication, will help determine the most appropriate medication(s). Medication is usually most effective if used daily and at least an hour or two before any potential exposure to allergens.
If symptoms are not controlled then referral to a specialist may be required to consider other treatments e.g. immunotherapy.