Hay Fever

Hay fever, also known as seasonal allergic rhinitis, is an allergic reaction to pollen from trees, grasses, or weeds. It can cause a range of symptoms, including sneezing, a runny or blocked nose, itchy or watery eyes, and a sore throat. While there is no cure for hay fever, there are many self-care strategies and treatments that can help manage and reduce the symptoms. Below is some essential guidance for patients suffering from hay fever in the UK, along with information on available treatments and when to seek further medical advice.

Self-Help Tips to Protect Against Pollen Exposure

Wear Protective Clothing:
When spending time outdoors, try to protect yourself from pollen as much as possible:
- Hats and sunglasses: Wearing a hat with a wide brim and sunglasses can help keep pollen out of your eyes.
- Avoid direct contact with pollen: If you're heading out, especially during high pollen seasons, consider wearing long sleeves and trousers to reduce skin exposure.
Keep Your Home and Clothes Clean:
- Change clothes after being outdoors: Pollen can stick to clothing, so change into clean clothes after spending time outside.
- Shower and wash your face: Rinsing pollen off your skin and hair, especially your face, can reduce symptoms. Make sure to wash your hands and face thoroughly, especially after coming indoors. Consider using a flannel or wet wipes to wash your eyelids. Try to avoid rubbing your eyes as this causes the pollens too be forced into the eyes and can worsen the eye irritation suffered.
- Use a saline nasal wash: Saline nasal sprays or washes can help rinse pollen and other allergens out of your nasal passages. This simple self-care can reduce the amount of pollen your nose is exposed to and provide relief from nasal congestion.
- Tie Long hair back or wear a hat to stop pollens brushing into the eyes and nose when caught on hair.
Stay Indoors When Pollen Counts Are High:
Pollen levels are typically highest early in the morning (from dawn to around 10am) and in the evening. If you can, try to limit outdoor activities during these times, particularly on dry, windy days. Keep your windows closed throughout the day until after dark to give time for the pollens to settle.
Keep Windows Closed:
Keep windows closed, especially on high pollen days, to prevent pollen from entering your home. This also includes your car windows, if you’re driving.
Use Air Purifiers:
Consider using an air purifier with a HEPA filter in your bedroom or living spaces to reduce airborne pollen indoors.
Bespreads- Cover bedding and pillows with a sheet and carefully remove when going to bed to avoid pollens collecting on bedsheets.

Over-the-Counter Treatments for Hay Fever

A range of over-the-counter treatments are available at pharmacies to help manage hay fever symptoms. These treatments include antihistamines, nasal sprays, and eye drops. Below are some common medications used to treat hay fever, along with their benefits and potential risks:

Antihistamines:
Antihistamines are one of the most commonly used medications for hay fever. They work by blocking histamine, a substance in the body that causes allergy symptoms like sneezing, itching, and runny nose.
- Types:
  - Oral antihistamines (e.g., cetirizine, loratadine, and fexofenadine) are taken in tablet form.
  - Antihistamine nasal sprays (e.g., azelastine) can help to target nasal symptoms directly.
- Benefits:
  - Oral antihistamines are generally effective at reducing sneezing, itching, and runny noses.
  - They are non-drowsy (for most people), especially the second-generation antihistamines, allowing you to go about your daily activities.
- Risks/Side Effects:
  - Some people may experience drowsiness, especially with older antihistamines (e.g., diphenhydramine). Always check the label.
  - Rarely, side effects such as headaches or a dry mouth may occur.
Nasal Sprays:
- Steroid nasal sprays (e.g., fluticasone, beclometasone) are effective for managing inflammation in the nasal passages caused by hay fever.
- Benefits:
  - These sprays work directly at the source of the problem, reducing swelling in the nasal passages and relieving congestion, sneezing, and runny nose.
  - They are very effective for long-term management of symptoms and can be used daily during pollen season.
- Risks/Side Effects:
  - Side effects can include nasal dryness, nosebleeds, or an unpleasant taste. These are usually mild and go away after a short time.
  - Overuse of nasal sprays may lead to irritation of the nasal lining or other complications, so always follow the dosing instructions.
Eye Drops:
- Antihistamine eye drops (e.g., ketotifen, olopatadine) help relieve itchy, watery eyes, which are a common symptom of hay fever.
- Benefits:
  - These drops provide fast relief for eye irritation and reduce redness and swelling.
- Risks/Side Effects:
  - Some people may experience mild stinging or irritation upon applying the drops.
  - Prolonged use of some eye drops can lead to further irritation, so they should be used according to the instructions.
Decongestants:
- Oral decongestants (e.g., pseudoephedrine) or nasal decongestant sprays (e.g., oxymetazoline) can help reduce nasal congestion associated with hay fever.
- Benefits:
  - These are effective at relieving a blocked nose, helping you breathe more easily.
- Risks/Side Effects:
  - Decongestants should be used with caution, particularly for people with high blood pressure, heart problems, or certain other conditions. Prolonged use of nasal sprays can lead to rebound congestion, where symptoms worsen once the medication is stopped.
  - Decongestants can also cause restlessness, sleep disturbances, or a dry mouth.

Why a Blocked Nose Can Cause Sore Eyes

A blocked nose is one of the hallmark symptoms of hay fever. But did you know that nasal congestion can contribute to the soreness in your eyes as well?

The link between your nose and eyes:
The nose and eyes are connected through the nasolacrimal duct, which is responsible for draining tears from the eyes into the nose. When your nose becomes congested due to hay fever, this drainage system is blocked, and your eyes can become watery and irritated.
- Why does this happen? When the nasal passages are swollen and inflamed, the tear drainage system cannot function properly, leading to tears building up in the eyes. This can cause them to feel sore, itchy, and sensitive to light.
- Blocked nasal passages also contribute to post-nasal drip (mucus dripping down the back of the throat), which can exacerbate irritation in the eyes and nose.

When to Seek Medical Advice

While over-the-counter treatments and self-care measures can effectively manage hay fever for most people, there are certain situations where you may need to see a doctor:

Persistent or severe symptoms: If your symptoms are not improving despite using treatments, or if they are interfering significantly with your daily life.
Asthma-related complications: If you have asthma and your symptoms worsen or become harder to control during hay fever season, seek medical advice.
Infection: If you develop symptoms such as a thick green nasal discharge, fever, or facial pain, this could indicate a secondary infection like sinusitis.

Conclusion

Hay fever can be a frustrating condition, but with the right strategies and treatments, you can manage your symptoms effectively. Start by following the self-care tips to limit your exposure to pollen, and consider using over-the-counter treatments like antihistamines, nasal sprays, and eye drops. If your symptoms persist or become more severe, don’t hesitate to seek advice from your GP or pharmacist.

For more information about hay fever and treatment options, visit the NHS hay fever page.