What is hay fever?

It is an allergy to pollen. An allergy is an exaggerated reaction by the body to protect itself against a foreign substance. About 1 in 10 people suffer from hay fever. The symptoms are a combination of sneezing, a runny and blocked nose, watering and itching of eyes and throat and sometimes wheezing. Since most plants produce their pollen in spring and summer this is when people suffer from it most.

What causes hay fever?

The commonest cause is grass pollen, but tree and shrub pollens are also responsible. The timing of the hay fever varies according to the pollens that cause it: tree pollen allergy in spring, grass pollen in June/July, shrub pollen from spring to autumn. In grass pollen allergy symptoms rarely start before the first week of June.

Who gets hay fever?

Allergies tend to run in families. If you have an allergic parent you have a 1 in 3 chance of developing an allergy. Later exposure to the allergy-producing substances increases your chances of developing hay fever.
It usually starts in childhood or early adult life. Symptoms can disappear at any time, it often improves in middle life.

Can hay fever be avoided?

Exposure to pollen cannot be avoided but it can be reduced if you:
Avoid the open air around noon when pollen counts are at their highest, and keep windows shut at that time when indoors.
In cars in the countryside keep the windows closed and shut down the ventilation system (or get an efficient air filter ventilator system).
In towns avoid open spaces and keep to built up areas.
In tall buildings keep windows shut. The wind swirls high (carrying pollen) over tall buildings.
Avoid country holidays in the pollen season. Sea breezes are sometimes (but not always) pollen free.

What treatments are available for hay fever?

Various drugs can suppress the symptoms but not cure it.

Tablets:
Antihistamine tablets are the commonest treatment and are effective. Many can be bought from a pharmacist without a prescription. Check with your pharmacist that they are safe to take with other medication.The benefits of some of the older drugs (like chlorpheniramine- e.g. Piriton) were often offset by the drowsiness they caused. Newer antihistamines rarely cause drowsiness but are more expensive and can have severe side effects, e.g.: terfenadine and astemizole can cause heart rhythm disorders particularly if mixed with other medication.

Tablets available without a prescription 'Over the Counter'

Cetirizine e.g. Zirtek
Loratidine e.g. Clarityn
Astemizole e.g. Hismanal, Pollon-eze
Clemastine e.g. Tavegil

Prescription Only

Acrivastine e.g. Semprex
Terfenadine e.g. Triludan, Aller-eze, Histafen, Seldane
Fexofenadine e.g. Telfast
Nasal Sprays
Beclomethasone (e.g. Beconase) and Flunisolide (e.g. Syntaris) which are available without a prescription or budesonide (e.g. Rhinocort) and mometasone (e.g. Nasonex) which is available on prescription, are usually very effective in removing nasal symptoms. These are corticosteroids. They must be used every day to be effective. These sprays will not be effective if the nose is blocked so a nasal decongestant (xylometazoline - e.g. Otrivine), available without a prescription, may also be necessary, but should not be used for more than a week. An increase in symptoms can occur for a short while after the decongestant is stopped. Sodium cromoglycate sprays (e.g. Rynacrom) are also available, as are combination sprays.
Eye drops
Xylometazoline eyedrops (e.g. Otrivine-Antistin) may help quickly and Sodium cromoglycate drops (e.g. Opticrom) may take a few days to become effective. Both are available over the counter for sore eyes.
Lodoxamide (e.g. Alomide) eye drops need a prescription from your doctor.
Corticosteroid eye drops (available on prescription) can also be used for severe symptoms.
Corticosteroids by mouth or injection
These powerful drugs can have side effects and are only available from your doctor. They will only be prescribed if all these other treatments do not help.

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