Hay fever

Symptoms of hay fever 

You'll experience hay fever symptoms if you have an allergic reaction to pollen. Pollen is a fine powder released by plants as part of their reproductive cycle. 

You can have an allergy to:

• tree pollen, released during spring
• grass pollen, released during the end of spring and beginning of summer
• weed pollen, released late autumn

Hay fever symptoms vary in severity and may be worse some years. This will depend on the weather conditions and pollen count. The time of year your symptoms start will depend on the types of pollen you're allergic to.

Many people find their symptoms improve as they get older. The symptoms of hay fever include:

• frequent sneezing
• runny or blocked nose
• itchy, red or watery eyes (allergic conjunctivitis)
• an itchy throat, mouth, nose and ears
• cough, caused by postnasal drip (mucus dripping down the throat from the back of the nose)

Less commonly, you may also experience:

• the loss of your sense of smell (anosmia)
• facial pain (caused by blocked sinuses)
• headaches
• earache
• tiredness and fatigue

Even though your hay fever symptoms may be mild, they can interfere with your sleep and your daily activities at school or work.

Hay fever and asthma 

If you have asthma, your asthma symptoms may get worse when you have hay fever. Sometimes, the symptoms of asthma only occur when you have hay fever.

These symptoms include:

• tight chest
• shortness of breath
• coughing
• wheezing

Pollen count 

Hay fever symptoms are likely to be worse if the pollen count is high. The pollen count is the number of grains of pollen in one cubic metre of air. Air samples are collected to find out how much pollen is in the air.

The pollen forecast is usually given as:

• low – less than 30 grains of pollen in every cubic metre of air
• moderate – 30 to 49 grains of pollen in every cubic metre of air
• high – 50 to 149 grains of pollen in every cubic metre of air
• very high – 150 or more grains of pollen in every cubic metre of air

Hay fever symptoms often begin when the pollen count is over 50. The pollen count is usually given as part of the weather forecast during the spring and summer months.

Treating hay fever 

There's currently no cure for hay fever. However most people are able to relieve symptoms with treatment, at least to a certain extent.

Hay fever can often be controlled using over-the-counter medication from your pharmacist. However, if your symptoms are not improving it’s worth speaking to your GP, as you may require prescription medication.

Treatment options for hay fever include, tablets, nasal sprays and eye drops. The medications include:

• antihistamines
• cromoglycate
• corticosteroids (steroids)

Antihistamines and cromoglycate can help to prevent an allergic reaction from occurring, or reduce the severity of the reaction. Corticosteroids (steroids) help to reduce inflammation and swelling, which result from the allergic reaction.

When to seek medical help 

Most cases of hay fever can be treated using over-the-counter medication. Your local pharmacist can advise you on treatments for you or your children.

You usually only need to see your GP if:

• you can't control your symptoms with over-the-counter medications
• you're experiencing persistent complications of hay fever, such as worsening of asthma or repeated episodes of sinusitis
• the pattern of your symptoms is unusual, such as occurring during the winter or only at your workplace (it's likely that another substance other than pollen is responsible, and further testing may be needed to confirm this)

Causes of hay fever 

Hay fever is an allergic reaction to pollen. When these tiny particles come into contact with the cells that line your mouth, nose, eyes and throat, they irritate them and trigger an allergic reaction.

Allergic reaction 

When you have an allergic reaction, your body overreacts to something it perceives as a threat. In hay fever, the allergen (the substance you're allergic to) is pollen. Your immune system (the body’s natural defence) responds as if it were being attacked by a virus.

Your immune system will release a number of chemicals designed to prevent the spread of what it wrongly perceives as an infection. These chemicals cause the symptoms of the allergic reaction, such as watering eyes and a runny nose.

Risk factors 

It's unclear what causes the immune system to react in this way. However,  there are several factors that can increase your risk of developing hay fever. They include:

• having asthma or another allergic condition, such as eczema
• having a family history of hay fever
• being exposed to tobacco smoke and diesel exhaust particles during early childhood

Most people with hay fever are allergic to grass pollen, but it can also be caused by trees and weeds.

Preventing hay fever 

It's very difficult to completely avoid pollen. However, reducing your exposure to the substances that trigger your hay fever should ease your symptoms.

Rubbing a small amount of petroleum gel inside your lower nostrils can help to prevent pollen from entering your nasal passages.

Staying indoors 

If possible, stay indoors when the pollen count is high (over 50). The tips below may help to reduce your exposure to pollen.

• keep windows and doors shut in your house -  if it gets too warm, draw the curtains to keep out the sun and lower the temperature
• don't keep fresh flowers in the house
• vacuum regularly, ideally using a machine with a high-efficiency particle arresting (HEPA) filter
• damp dust regularly - dusting with a wet cloth, rather than a dry one, will collect the dust and stop any pollen being spread around
• keep pets out of the house during the hay fever season - if your pet does come indoors, wash them regularly to remove any pollen from their fur
• don't smoke or let other people smoke in your house - smoking and breathing in other people's smoke will irritate the lining of your nose, eyes, throat and airways, making your symptoms worse
• if possible, avoid drying clothes outside - this will help to stop pollen being brought into your house

Avoiding pollen outside 

If it is not possible to reduce the amount of time you have to spend outside when the pollen count is high, or you're travelling, the tips below may help to reduce your exposure to pollen.

• avoid cutting grass, playing or walking in grassy areas and camping – particularly in the early morning, evening and at night, when the pollen count is at its highest
• wear wraparound sunglasses to stop pollen getting in your eyes
• take a shower and change your clothes after being outdoors to remove the pollen on your body
• keep car windows closed - you can buy a pollen filter for the air vents in your car, which will need to be changed every time the car is serviced

• Find out more about hay fever on the NHS website

More useful links

• How to use your health services