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Every summer, up to 1 in 5 people in Britain are affected by hay fever. Also known as seasonal allergic rhinitis, hay fever is caused by an allergy to pollen and fungal spores. The allergy typically occurs in the mucous membranes of the nasal passages and eyes, explaining the occurrence of the symptoms described below such as sneezing, itchy eyes and a blocked or runny nose.
Pollen affects a hay fever sufferer because their body’s immune system over-reacts to it, as if it were a toxic substance. The symptoms of hay fever usually start to occur when the pollen count, the number of pollen grains per cubic metre of air, exceeds 50. As a result, the weather can affect how severely a sufferer experiences symptoms – sun can raise the pollen count, wind can spread pollen and rain can lower the count.
For many, the symptoms of hay fever are irritating in every sense. Different people react in different ways, but the most common symptoms are watery or itchy eyes, sneezing, a runny or blocked nose, coughing, an itchy feeling in the throat and wheezing.
As hay fever is a chronic condition, there is no ‘cure’. In most people the symptoms of hay fever will ease, to some extent, as they get older. In up to 20% of people they can disappear completely.
As mild to moderate hay fever can usually be effectively controlled with over-the-counter medicines and advice from the pharmacy, no formal diagnosis is usually necessary. However, if symptoms are severe, they occur indoors or during winter or cause other complications, a formal diagnosis and further investigations by a doctor are necessary. Allergy testing by either a skin prick test or a blood test can help to reveal the cause of the allergy and help to form a management plan.
Hay fever is more common in people with eczema and other skin conditions, those who suffer with asthma, have a family history of hay fever and in those subjected to tobacco smoke at a young age.
If you would like any help diagnosing hay fever please Contact Us.
The chemical Histamine is released into the body when the immune response is triggered by an allergen. It is this response that causes the symptoms of an allergic reaction like in hay fever. Antihistamines work by blocking the action of Histamine and in turn relieving these symptoms. This group of tablets are proven effective for treating sneezing, itching and watery eyes. If one of the symptoms you suffer is a blocked nose then they you may wish to combine them with a nasal spray. Different antihistamines include:
- Cetirizine (Piriteze, Zirtek, Benadryl One-a-Day)
- Loratadine (Clarityn)
- Chlorphenamine (Piriton)
- Acrivastine (Benadryl)
- Promethizine (Phenergan)
- Fexofenadine (Telfast - Prescription Only)
Generally one-a-day antihistamines such as loratidine and cetirizine are non-drowsy whereas chlorpehamine and promethazine are much more likely to result in drowsiness. For most people taking a one-a-day antihistamine every morning during pollen season is enough to keep symptoms under control without causing any unwanted side effects. Once daily antihistamines should be started just before pollen season to allow them to build up in your system and should be taken regularly, even if the pollen counts are low, to help prevent the onset of symptoms.
Most nasal sprays for hay fever contain corticosteroids (steroids), which have an anti-inflammatory action. When pollen causes an allergic reaction, the inside of the nasal passage becomes inflamed. Steroid preparations can reduce this inflammation and ease the symptoms of hay fever. If your hay fever is persistent and doesn’t respond well to antihistamines, or your main symptom is a blocked nose then corticosteroids may prove a more suitable choice. They are more effective than antihistamines when it comes to relieving and preventing nasal symptoms. For the best results it is advised to start using them a couple of weeks before your symptoms usually begin and work best when used regularly.
Steroid nasal sprays are often associated with side effects and bad headlines in the minds of many people, however they are an extremely important part of hay fever treatment for many sufferers. The small amounts of steroid contained in them are excellent at reducing the swelling and inflammation in the membranes of the nose. The dose is small enough to act at the site where it is most needed without entering into your bloodstream and causing side effects.
Nasal Sprays such as Beconase and Pirinase are the most common steroid nasal sprays that are used daily to relieve hay fever symptoms. Prevalin nasal spray is a drug-free alternative that contains a gel that prevents pollen from coming into contact with the nasal membranes and keeps you allergy free. It is particularly useful for patients who cannot or are unwilling to take steroids, or for those under 18 years of age.
Hay Fever Eye Drops:
If your hay fever mainly affects your eyes then drops are most likely the sensible choice. They can treat redness, itchiness and watering (allergic conjunctivitis). These drops contain antihistamines to reduce inflammation in your eyes and relieve the symptoms associated with allergic conjunctivitis.
Most eye drops for hay fever contain sodium cromoglycate, an antihistamine, to help reduce your response to the allergy. It is contained in well-known brands such as Opticrom Allergy eye drops, and Optrex Allergy eye drops. They can be used up to four times daily to relieve the ocular symptoms of hay fever.
Identify the allergen
Hay fever is typically caused by airborne allergens that enter the body through the air we breathe and trigger a severe response from the immune system. If it is highly seasonal, pollen grains and mould spores are the likeliest culprits. By careful observation, or by taking patch tests with the help of a doctor, it is possible to pinpoint the allergen. It will help you take precautions to prevent future attacks.
If you know the specific allergen, it is easier to reduce exposure. Otherwise, noticing whether you are getting it when certain flowers are in bloom or when grass has been freshly cut, if it is getting worse at a particular time of the day or during a specific activity, can help you avoid those situations.
Stay indoors when pollen counts are high
There is daily as well as seasonal fluctuation in pollen and mould counts in the air. Most weather shows broadcast the counts. Make it a point to listen to these reports, and avoid outings on particularly bad days. As a rule, pollen counts are high during the mornings and subside by afternoon. Plan your day accordingly. If you need to go outside when there is a high pollen count, ensure you take medication to help your allergies and wear sunglasses to prevent pollen getting in your eyes. Remember, a pollen count of over 50 may worsen hay fever symptoms.
Change and shower when you come inside
Avoid bringing outside allergens into the house as much as possible. Our clothes and hair are good carriers of these particles. Change outdoor clothes immediately on reaching the home, and take shower to wash off any pollen grains sticking to the body.
Change bed covers frequently
Since we spend a lot of time sleeping, pillow covers and bed covers should be kept as free of allergens as possible. Doctors advise those with severe allergies to cover the bedding with a hypoallergenic, non-permeable barrier and change the bedcovers every day.
Avoid other irritants
Common airway irritants like dust and smoke, especially tobacco smoke, may put your body in high alert towards allergens and make a hay fever attack more likely. Avoid exposure to these where possible.
Get efficient air purifiers
Install a high-efficiency particulate arresting filter (HEPA) into your air-purifier for better protection. The filter device itself can become a breeding ground for mould spores that can undermine the very purpose. Keep it in prime condition with regular servicing.
Delegate cleaning jobs to others
Indoor and outdoor cleaning jobs that typically throw allergens into the air should not be attempted by a person prone to hay fever. Cleaning the carpets, dusting the furniture, raking leaves, turning compost etc. should be delegated to other members of family or to outside help.
Dry clothes inside with the windows closed
As previously stated, pollen sticks to clothes so do not hang your laundry up to dry outside. Instead, keep it indoors at all times and ensure the windows are closed to prevent pollen coming into the house.
Keep allergy medication handy
Anyone with a history of hay fever should carry either over-the-counter anti-allergy medications or those prescribed by the doctor at all times. Regular once daily antihistamines, such as cetirizine or loratidine, should be taken daily throughout the pollen season to prevent hay fever symptoms – they are less effective if used as-and-when.
Depending on your symptoms, antihistamine tablets can be supplemented safely with a nasal spray and/or eye drops to keep your condition under control and allow you to enjoy the warmer weather.
Sunglasses help to prevent pollen getting in the eyes and causing symptoms such as itching, swelling, red and runny eyes.
Do generic antihistamines work?
If you are buying your treatment from a reputable pharmacy, generic treatments will be made to the same high standards as branded treatments. This is a requirement set out by the UK Government & EU to obtain a Product License for a medicine.
Should I be worried about steroids in a nasal spray?
No, the amount of steroid contained in a nasal spray is not enough to cause any side effects. As it is being delivered directly to the area of action very small doses can be given to produce the same effect as a much larger dose of tablets.
When is pollen season?
There are three types of pollen that commonly cause hay fever; grass pollen, tree pollen and weed pollen. The majority of people with hay fever (90%) suffer with an allergy to grass pollen whereas only 25% suffer an allergy to tree pollen and an even smaller minority to weed pollen.
Depending on which pollen you are allergic to, the pollen season, and subsequently when you experience the most severe symptoms, will change. From late March to mid-May the majority of pollen is tree pollen, followed by grass pollen from mid-May through to July. Weed pollen normally occurs the latest in the year from the end of June to September. If you know which pollens you are most allergic to, you can plan your treatment to suit your needs throughout the pollen season.
The dates provided for pollen season are a rough guide, they can change from year to year depending on the weather and other factors.
How do I know what treatment is right for me?
For most people it is sensible to start with a once daily antihistamine such as cetirizine or loratidine, taken each morning during pollen season, even if pollen counts are low. You can then adapt your treatment depending on your response, if a once-daily antihistamine is not enough to keep symptoms under control then a different antihistamine can be tried or a nasal spray or eye drops can be added.
Can I treat my children for hay fever?
Hay fever is common in children, especially those that also suffer with asthma or eczema. There are multiple treatments available for children in liquid form including Piriton Liquid, Benadryl Allergy 6+ Oral Solution, Cetirizine Oral Solution, and Zirtek Allergy Relief For Children. They are suitable from 1 year and over (check the individual treatments for their specific age range).
Do you get hay fever on holiday?
You can still experience hay fever on holiday and hay fever sufferers should take preventative medication with them to ensure they can keep their symptoms at bay abroad. It is worth noting that as the trees, plants and grasses can vary abroad, depending on how far you have travelled, the symptoms you experience can be different (more or less severe) to those at home. It is worth taking treatment with you so you are prepared.
Does the weather affect the pollen count?
Yes, the daily pollen count can fluctuate greatly depending on the weather. In general, rainy days will clear pollen from the air and mean symptoms will be decreased. Both wind and humidity can cause pollen to spread more easily meaning that symptoms will be worse, as they will be on sunny days where more flowers open. Pollen counts tend to be lowest in the early morning and rise throughout the day to a peak at early evening.
Can I use a nasal spray, eye drops and tablets to treat hay fever together?
Yes, as long as each item is individually appropriate for you to take, there is no problem combining an antihistamine tablet, steroid nasal spray and allergy eye drops to keep hay fever symptoms under control.
Information About Hay Fever
Hay fever is an extremely common long-term condition that is thought to affect up to 1 in 5 people in the UK. People who suffer with hay fever can often find that it has a significant impact on their lifestyle unless it is well controlled as symptoms such as sneezing, runny nose; congestion and irritated eyes disrupt daily life and leave them feeling miserable. Hay fever is not normally serious and for some people it can be controlled using medicines from a pharmacy. However, for those who cannot control their hay fever with pharmacy medicines our Online Doctor is able to provide a consultation to see if prescription-strength medicines are safe and suitable for use.
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If you do not require prescription strength treatments, please see our range of hay fever treatments in our Hay Fever section in the pharmacy for effective treatments at discounted prices.
What Causes It?
Hay fever is a common allergic reaction of the lining of the eyes, nose and throat to pollen. In those suffering from hay fever, pollens is an allergen, triggering the release of chemicals that cause inflammation when it comes into contact with sensitive areas. The resultant inflammation is the cause of the symptoms such as coughing and sneezing as well as irritated eyes and a runny nose.
Some people are more likely to develop hay fever than others. If you have a history of, or a family history of, asthma or eczema you are more likely to develop hay fever. Also, if you were exposed to tobacco smoke as a child it is thought to make you more likely to develop hay fever.
It is thought that up to 90% of people that suffer with hay fever are allergic to grass pollens that occur from around May to August. Around 25% of sufferers are allergic to tree pollens that are most likely to occur January to April.
What Treatments Are Available?
Antihistamines are the main treatment for most people with hay fever. They help to block the release of histamine, an inflammatory chemical that is responsible for most of the symptoms of hay fever. Some antihistamines can cause drowsiness, however this is less likely to occur in once-daily formulations.
For some people, treatment with pharmacy products such as simple antihistamines, nasal sprays and eye drops are sufficient to keep their hay fever well controlled. Please see our range of hay fever treatments in our Hay Feversection in the pharmacy for effective hay fever treatments at discounted prices.
For those who suffer with more severe symptoms, pharmacy medicines may not be sufficient to control their symptoms. Our Online Doctor service offers prescription strength treatments to help effectively control your hay fever with a quick and easy consultation and take back your summer months!