Hay fever, also known as allergic rhinitis, is a common condition that shows signs and symptoms similar to a cold with sneezing, congestion, runny nose and sinus pressures.
Hay fever is caused by an allergic response to airborne substances, such as pollen – unlike a cold which is caused by a virus. The time of year in which you get hay fever depends on what airborne substance you are allergic to.
The substance that causes an allergic reaction in hay fever is called an “allergen”. For the majority of people, those who do not get hay fever, these substances are not allergens, because their immune system does not react to them.
Despite its name, hay fever does not mean that the person is allergic to hay and has a fever. Hay is hardly ever an allergen, and hay fever does not cause fever.
Although hay fever and allergic rhinitis have the same meaning, most lay people refer to hay fever only when talking about an allergic reaction to pollen or airborne allergens from plants or fungi, and understand allergic rhinitis as an allergy to airborne particles, such as pollen, dust mites or pet dander which affect the nose, and maybe the eyes and sinuses as well.
The rest of this article focuses on hay fever caused by pollen and other airborne allergens that come from plants or fungi. Hay fever caused by pollen is also known as pollinosis.
Some people are only mildly affected by hay fever and rarely reach a point where they decide to seek medical advice. However, for many, symptoms may be so severe and persistent that they are unable to carry out their daily tasks at home, work or at school properly – these people will require treatment. Treatments may not get rid of the symptoms altogether, but they usually help to lessen their impact, making them easier to live with.
As with other allergies, hay fever symptoms are a result of your immune system mistaking a harmless substance as a harmful one, and releasing chemicals that cause the symptoms.
It is estimated that about 20% of people in Western Europe and North America suffer from some degree of hay fever. Although hay fever can start affecting people at any age, it generally develops during childhood or early adulthood. It is said that the majority of hay fever sufferers find their symptoms become less severe as they get older.
Hay fever facts
- Hay fever (allergic rhinitis) is a common allergic condition.
- Symptoms of hay fever mimic those of chronic colds.
- The best way to treat an allergy condition is to identify the allergic trigger and avoid it.
- Histamine is a key chemical cause of allergic rhinitis and other allergic reactions.
- Effective treatment is available in many forms, including medications and desensitization therapy (immunotherapy).
- Antihistamines are the drugs most commonly used to treat allergic rhinitis.
Hay Fever Symptoms
- Runny nose
- Itchy eyes, mouth or skin
- Stuffy nose due to blockage or congestion
- Fatigue (often reported due to poor quality sleep as a result of nasal obstruction)
Hay Fever Triggers
- Outdoor allergens, such as pollens from grass, trees and weeds
- Indoor allergens, such as pet hair or dander, dust mites and mold
- Irritants, such as cigarette smoke, perfume and diesel exhaust
Hay Fever Causes
Hay fever occurs when the immune system mistakes a harmless airborne substance as a threat. As your body thinks the substance is harmful it produces an antibody called immunoglobulin E to attack it. It then releases the chemical histamine which causes the symptoms.
There are seasonal hay fever triggers which include pollen and spores that will only cause symptoms during certain months of the year.
The following are some examples of hay fever triggers:
- Tree pollen – these tend to affect people in the spring.
- Grass pollen – these tend to affect people later on in the spring and also in the summer.
- Weed pollen – these are more common during autumn (fall).
- Fungi and mold spores – these are more common when the weather is warm.
Hay Fever Treatments
There is a vast array of OTC (over-the-counter) and prescription medications for treating hay fever symptoms. Some patients may find that a combination of two or three medications works much better than just one.
It is important for parents to remember that some hay fever medications are just for adults. If you are not sure, talk to a qualified pharmacist, or ask your doctor.
Antihistamine sprays or tablets
These are commonly available over the counter. The medication stops the release of the chemical histamine. They usually effectively relieve symptoms of runny nose, itching and sneezing. However, if your nose is blocked they don’t work.
Newer antihistamines are less likely to cause drowsiness than older ones – but older ones are just as effective. Examples of OTC antihistamines include loratadine (Claritin, Alavert) and cetirizine (Zyrtec). Examples of prescription antihistamines include Fexofenadine (Allegra) and the nasal spray azelastine (Astelin). Azelastine starts working very rapidly and can be used up to 8 times a day – however, it can cause drowsiness and leave a bad taste in the mouth after use.
These reduce itching and swelling in the eyes and are usually used alongside other medications. Eye drops containing cromoglycate are commonly used.
These sprays treat the inflammation caused by hay fever, and are a safe and very effective long-term treatment. Examples include fluticasone (Flonase), fluticasone (Veramyst), mometasone (Nasonex) and beclomethasone (Beconase). Most patients may have to wait about a week before experiencing any significant benefits. Some patients may notice an unpleasant smell or taste, and have nose irritation.
For very severe hay fever symptoms the doctor may prescribe prednisone in pill form. They should be prescribed only for short-term use, because of their long-term link to cataracts, muscle weakness and osteoporosis.
Immunotherapy (allergy shots) is a proven treatment approach providing long-term relief for many people suffering from allergic rhinitis. It works by gradually desensitizing the patient’s immune system to the allergens that trigger their symptoms.
Immunotherapy can potentially lead to lasting remission of allergy symptoms, and it may play a preventive role in the development of asthma and new allergies.
The Food and Drug Administration (FDA) approved another form of allergy immunotherapy in April 2014 called sublingual immunotherapy.