Q. What is hay fever?
A. An allergy to grass or hay pollen is known as hay fever. The term 'hay fever' is now also widely used to include allergies to other pollens (such as trees and weeds). Hay fever affects about 1 in 5 people in the UK. Approximately 80 per cent of people with asthma tell us they also have a pollen allergy (which means their asthma symptoms are triggered by pollen).
Q. How is hay fever diagnosed?
A. Your GP can work out whether or not you have hay fever by considering your symptoms, finding out about your family history and environment and examining you physically. You may be given a referral for a skin prick test and/or blood test to confirm which pollens set off your hay fever.
Q. Can I tell if I'm allergic to specific pollens?
A. If your GP refers you for a skin prick test and/or blood test, the results will confirm which type or types of pollen set off your hay fever. Also, if you keep a diary of symptoms for a couple of years you might notice patterns. For example, if your symptoms start as early as January or February and continue until late March, it may be that you're allergic to early flowering trees, such as the hazel and alder. Bear in mind, though, that the season and severity of each type of pollen changes each year according to that year's weather conditions.
Q. How is hay fever treated?
A. Treatment for hay fever depends on how severe your symptoms are. There are several different types of medicines. Some are available in a pharmacy. Some are available on prescription. Speak to your GP or pharmacist about the medicine(s) best suited to treat your symptoms.
Steroid nasal sprays help to prevent or reduce inflammation in the lining of the nose and some can help to relieve watery eyes. Don't be put off by the fact that the spray contains a steroid as the dose is tiny and only goes where it's needed (it isn't absorbed into the rest of the body). Unlike other hay fever treatments, they can take a few days to start working, so try to start using them at least seven days before you expect the pollen season to start.
Antihistamines help to relieve a runny nose, sneezing, itching and watery eyes. Some types of antihistamines make you drowsy and are best taken before bed. Newer antihistamines (known as nonsedating antihistamines) are less likely to make you drowsy and are a common choice for children and people with milder or occasional symptoms of hay fever. Antihistamines are available as tablets, in liquid form or as a nasal spray.
Decongestant nasal sprays are used to unblock the nose. They should never be taken for more than a few days at a time. If your symptoms continue, speak to your GP.
Eye drops are available in a pharmacy and can be used to treat itchy or watery eyes.
Steroid tablets are occasionally prescribed if other treatments aren't effective.
Salt water (saline) solutions are available in various types - speak to your GP or pharmacist about what they recommend for you.
Sonia Munde, Head of Asthma UK helpline & Nurse Manager, says: “Seasonal or year-round rhinitis causes inflammation of the lining of the nose. We sometimes suggest nasal douching – a simple procedure where you sniff saline solution into your nostrils to remove any debris, clear away any allergens, prevent infection, and keep your nose clean and healthy.”
Immunotherapy involves giving you gradually increasing amounts of whatever you're allergic to, by injection or with tablets, over a number of years. Over time, this reduces your immune system's tendency to overreact to the allergen. Immunotherapy is usually only considered for people with severe hay fever and asthma. Ask your GP if this treatment might be suitable for you. If it is, you'll be referred to a specialist.
What's the best way to use a nasal spray?
A. There's a right way and wrong way to use a nasal spray. It's worth taking a bit of time to make sure you learn the right way as it can make a huge difference to how effective it is and also helps to reduce any potential side effects.
Make sure your nasal spray is effective:
- Before you start taking a nasal spray, read the instructions that come in the box and check with your GP or pharmacist that you know how to use it correctly.
- Clear your nose by blowing into a tissue.
- Put your chin to your chest.
- Hold the spray in your right hand for spraying into your left nostril and put the nasal spray into your nostril – make sure it's pointing into the side of your nose towards your ear.
- Spray the nasal spray while breathing in slowly through your nose. But DO NOT sniff when you breathe in as this will take the spray into your throat and you'll swallow it, rather than keep it in your nose.
- Take the dose as directed.
- Take as often as directed.
- Keep using the nasal spray even if your symptoms don't improve straight away. Sometimes it can take a while to make a difference.
- Use it every day as directed - even if you don't have any symptoms. This is because it can help to prevent as well as relieve symptoms.
- See your GP or pharmacist after you've been using it for two to four weeks to confirm that this is the right treatment for you.
- Speak to your GP or pharmacist if you experience any side effects (such as an unpleasant lingering taste or smell, nose bleeds or intense sneezing).
Q. What can I do to reduce the risk of an asthma attack?
A. There are two key things you can do to help manage your asthma well and reduce the risk of an asthma attack
1. Take the asthma attack risk checker. Most people don't think they're at risk of a potentially fatal asthma attack. But in reality, 75 per cent of people with asthma are not in control of their symptoms, and every day three people die from an asthma attack. In just 60 seconds, this test will reveal your risk of having an asthma attack and explain how you can reduce it.
2. Have a written asthma action plan. Everyone who has asthma should have a written asthma action plan. Your GP or asthma nurse should help you to complete it. The plan will contain information about your asthma medicines and how to manage your symptoms, how to tell when they're getting worse and what you should do about it. It should include emergency information on what to do if you have an asthma attack. It will also remind you to see your GP or asthma nurse to ask if you can reduce your medicines when your symptoms are getting better.
Q. What's the difference between hay fever, pollen allergy, rhinitis and seasonal allergic rhinitis?
A. Hay fever, strictly speaking, means an allergy to grass pollen, but the term is now widely used to include allergies to other pollens.
Pollen allergy is the term used for an allergy to any pollen (grass, trees and/or weeds).
Rhinitis is the term used to describe a collection of symptoms (such as a runny, blocked nose, sneezing and itching). Put simply, there are two types of rhinitis: allergic and nonallergic. Nonallergic rhinitis is often caused by a virus, such as a cold. Allergic rhinitis is often triggered by an allergy to pollen, but can also be triggered by other allergens, such as mould or house dust.
Seasonal allergic rhinitis is the term doctors often use for hay fever. The word 'seasonal' is linked to the fact that pollen is typically released during certain months of the year, but this can be misleading because:
- the start and end of each type of pollen season varies each year
- some trees start to release their pollen in January; some weeds release pollen until the end of September so some people are affected by pollen almost all year round (not just during one season).
Q. Is it safe to take medicines for asthma and hay fever at the same time?
A. Research shows that if you have asthma and hay fever, it's better to treat both conditions at the same time and that it is safe to do so. Speak to your GP or pharmacist if you're worried about taking a combination of medicines.
Q. Does taking antihistamines increase the risk of dementia?
A. A recent study found a link between the long-term use of antihistamines and an increased risk of dementia. Reassuringly for many people, though, the increased risk was only found in people over the age of 65 and in people who took these medicines at the equivalent of once every day for more than three years. No link was found if people took lower levels. Also, the study was considering prescribed antihistamines (not over-the-counter ones) and a particular type of antihistamine ('anticholinergics' known to cause drowsiness, not the newer ones that don't cause drowsiness).
It's also worth taking into account that your individual risk of dementia is affected by many factors (family history, diet, lifestyle, for example) not just the medicines you take. If you are still worried about taking antihistamines, though, speak to your GP.
Q. I have severe asthma that's triggered by pollen. Do you think having Xolair injections might help?
A. For some people who experience severe asthma symptoms triggered by allergies that can't be well managed with inhaled steroids or steroid tablets, Xolair injections may be an option. Usually given every two or four weeks, Xolair is a steroid-free medication that works by blocking a substance your body makes that plays a key role in the body's allergic response. Speak to your GP or asthma nurse about whether Xolair is suitable for you.
Q. Is there a vaccine to prevent hay fever symptoms?
A. People who talk about a ‘hay fever vaccine’ are usually talking about immunotherapy or desensitisation. Kenalog (a steroid injection) isn’t usually recommended in the UK as the general view is that a short course of oral steroids is just as effective, and safer.
Q. Will I have hay fever for the rest of my life?
A. Not necessarily. Many people with hay fever find that their symptoms improve as they get older. Around half of people report some improvement in symptoms after several years. In around 10 - 20 per cent of people, symptoms go away completely.
Q. Can you develop hay fever in your 40s?
A. Yes. Although most people diagnosed with hay fever are in their teens or early 20s, older people can develop symptoms too. Book an appointment with your GP to discuss your symptoms.
Last reviewed June 2016
Next review due June 2019