What is hay fever?
Hay fever is the term used for an allergy to pollen from plants, like grasses, trees, and weeds.
Your GP can work out whether or not you have hay fever by talking to you about your symptoms (for example, sneezing, coughing, itchy eyes) and when they're worse.
You may be given a referral for a skin prick test and/or blood test to confirm which pollens set off your hay fever.
Most people are diagnosed with hay fever in their teens or early 20s, but you can develop hay fever when you’re older too. It affects about one in five people in the UK.
Around half of people report some improvement in symptoms after several years. And in around 10-20% of people, symptoms go away completely.
Why it's important to treat your hay fever if you have asthma
Approximately 80% of people with asthma tell us they also have a pollen allergy (which means their asthma symptoms are triggered by pollen).
If you have asthma and you also have hay fever it's really important to treat your hay fever. Research shows that if you treat your hay fever, as well as your asthma, you’ll cut your risk of going to hospital with an asthma attack.
How is hay fever treated?
Treatment for hay fever depends on how severe your symptoms are. There are several different types of medicines. Some are available in a pharmacy and some are available on prescription. Speak to your GP or pharmacist about the medicine(s) best suited to treat your symptoms.
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 are less likely to make you drowsy. These 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 from the pharmacy and can be used to treat itchy or watery eyes.
Steroid tablets are occasionally prescribed if other treatments aren't effective.
Immunotherapy involves giving you a little of whatever you're allergic to (the allergen) by injection or with tablets, and gradually increasing amounts over a number of years. Over time, this means you won't react so much 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.
Salt water (saline) solutions are available in various types - speak to your GP or pharmacist about what they recommend for you.
- “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.” Sonia Munde, Head of Asthma UK Helpline and Nurse Manager
Steroid nasal sprays help to cut down inflammation in the lining of the nose. 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. It's a good idea to start using them at least seven days before you expect the pollen season to start.
What's the best way to use a nasal spray?
Make sure you know the best way to use a nasal spray. It can make a big difference to how effective it is. It also helps to reduce any possible side effects.
Video: How to use a nasal spray for hay fever and allergiesAsthma UK expert nurse Suzanne shows you how to use a nasal spray.
Transcript for 'How to use a nasal spray for hay fever and allergies'
0:05 Hay fever can cause your nose to be really blocked up and uncomfortable and it can also have an impact on your asthma symptoms.
0:12 When using a nasal spray, there is a particular technique to get the best from the medication inside.
0:19 So, what we do, we start by using some tissue to blow our nose and completely make sure that our nose is as clear as we can get it.
0:27 Then you take your nasal spray, remove the cover there. Take the nozzle - and that's going to go into one nostril.
0:36 When you put it into your nostril, point it towards your ear so it will be at that angle.
0:42 To start with, you put your head all the way down - so tilt your head forwards, pop it into your nostril and point it towards the ear.
0:52 Hold this nostril gently and then just do a gentle push of the spray
0:58 And then just slightly breathe it in.
1:01 It needs to work on the nasal lining there.
1:04 And then you do the same thing with the other side - so you tilt your head down, pop it in so it's pointing to the other ear.
1:13 Cover this nostril very slightly, and spray.
1:19 And then just breathe in gently.
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).
Hay fever treatments Q&A
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. 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 remembering that your risk of dementia is affected by many factors (family history, diet, lifestyle, for example) not just the medicines you take. If you're 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. If you get severe asthma symptoms triggered by allergies, and you can't manage your symptoms well with inhaled steroids or steroid tablets, Xolair injections may be an option.
Xolair works by blocking a substance your body makes that plays a key role in the body's allergic response. Injections are usually given every two to four weeks. 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 - the general view is that a short course of oral steroids works just as well, and is safer.
Last reviewed February 2018
Next review due June 2019