Hay fever season is kicking off again, and for nearly a quarter of the population, that can mean seasonal misery and debilitating symptoms.
Hay fever is an allergy to airborne particles such as pollen and fungal spores that affects the nasal passages, eyes and lungs, causing sneezing, an itchy, runny or congested nose, watering and sore eyes, aching sinuses and a wheezy cough. The symptoms can interfere with sleep and make it hard to concentrate.
In the UK, trees pollinate from late March to mid May, grasses from mid May to July and weeds from the end of June to September. The pollen “season” is normally March to August, but it can start in January and last until November. When your symptoms start depends on whether you are allergic to tree, grass or weed pollen. Different tree species pollinate at different times and you may be much more allergic to one type of tree pollen than another.
People who are highly allergic will get severe symptoms even if pollen counts are low. And even non-allergic people may experience some sneezing and itchy eyes if they spend a lot of time outdoors when pollen counts are unusually high. The Met Office provides a five-day pollen forecast that can help you take preventive action.
The best approach to hay fever is to avoid the triggers – but pollen gets everywhere and it’s miserable to stay indoors when the sun’s shining. NHS Choices suggests you rub Vaseline just inside your nostrils to keep pollen out, and stay indoors with windows shut when the pollen count is above 50. Pollen counts are highest in early morning, evening and night, so avoid cutting the grass at those times or camping in grassy fields. Shower and change clothes after being outdoors, wear sunglasses, and keep car windows closed. Consider getting a pollen filter for airvents in the car.
Any hay fever sufferer needs a kit of effective treatments. Oral antihistamines work but older ones, such as chlorphenamine (Piriton) make you sleepy. That’s good if you need a comfortable night’s sleep – less so if you have an exam the next day. Newer antihistamines such as cetirizine (Zirtek) are less likely to cause drowsiness. Buy the cheapest – there’s an extraordinary markup for certain brands and smaller pack sizes. I found a supermarket own-brand cetirizine for 9p a pill that was identical to Zirtek sold by an online pharmacy for 41p a pill. An antihistamine nasal spray, azelastine (Rhinolast), is as effective as an oral antihistamine for nasal symptoms, but won’t help your eyes, sinuses or lungs in the same way.
Steroid nasal sprays such as beclometasone (Beconase) are as effective as oral antihistamines. They reduce all hay-fever symptoms if started early enough in the year because they damp down nasal inflammation and stop pollen triggering a widespread allergic response. Dymista is a newish nasal spray that combines a steroid and antihistamine. It is expensive and not approved for NHS prescription in all areas.
Oral decongestants such as pseudoephedrine (Sudafed) can be helpful if you are very bunged up. You can take Sudafed for a few days until a steroid nasal spray starts working. Actifed is a tablet that combines an antihistamine with pseudoephedrine, but the combination may not be much more effective than antihistamines alone and the risk of side effects and interactions with other drugs is much greater. Decongestant nasal sprays such as oxymetazoline (Vicks Sinex) work faster than oral decongestants, but you cannot use them for longer than a week because you get a rebound effect and end up with worse congestion than you started with.
Allergy specialist Dr Glenis Scadding says: “The new thing in hay fever is Serenz.” It’s a carbon dioxide nasal washout that works well as a rescue treatment when symptoms are troublesome.
Holly Shaw, nurse adviser at Allergy UK, says: “Natural remedies such as allergen barrier balms, and nasal saline douching are very effective add-on treatments that can be purchased over the chemist’s counter.”
When all else has failed and you are facing an exam or your wedding day with swollen eyes, streaming nose and a head that feels like bursting, you can get oral steroids from your GP that should work a treat. It is only a short-term fix, and repeated or prolonged courses are harmful, but it will get you through the exam or down the aisle.