About hay fever
Hay fever is one of the most common health conditions in the UK, estimated to affect around 1 in 4 adults, and up to 15% of children. Studies also show that this number is rising. Also known as allergic rhinitis, it’s a type of allergy caused by several different triggers.
Although it’s not often considered to be a serious problem, hay fever can have a significant impact on your quality of life if you are severely affected. Knowing your triggers and using some of the many medications that are widely available can help counteract symptoms and help you to manage.
Causes of hay fever
Hay fever happens when your immune system overreacts to a usually harmless substance. This causes your body to produce chemicals called histamines, and it’s these that cause your allergy symptoms.
Everyone is different, and so what triggers your hay fever may be different to what causes someone else’s. However, there are some hay fever triggers that are more common than others.
Causes of hayfever | |||
|---|---|---|---|
Trigger | When/where triggers occur | Common examples | Things to note |
Tree pollen | Spring | Birch, oak, ash and elm | Often worse on dry, windy days |
Grass pollen | Late spring to summer | Ryegrass and other common grasses | The main cause of hay fever in the UK (affecting approx. 95% of people with the condition) |
Weed pollen | Late summer to autumn | Nettle, dock, mugwort | Keeps symptoms going after other pollen types have passed |
Mould spores | More common in damp, humid weather | Indoor and outdoor damp/mould, outdoor fungi | Can occur anytime in the right conditions |
Dust mites | Microscopic bugs found in carpets and bedding | At least 13 species, but European house dust mite one of the most common | Feed on shed skin cells and are a primary cause of year-round allergies |
Pets | Any contact with pets, but generally worse with animals who shed a lot of hair | Cats cause the most pet allergies, and you’re twice as likely to be allergic to a cat than a dog | Contrary to popular belief, allergies are to proteins found in pet dander (tiny flakes of dead skin), saliva and urine |
You could also be more likely to experience hay fever if:
You have other allergic conditions, such as asthma, eczema or food allergies.
A close blood relative, such as your parents or siblings also have hay fever.
You are going through puberty (thanks to hormonal changes).
You’re in menopause or perimenopause (also due to hormone fluctuations).
Symptoms of hay fever
Hay fever can cause a wide range of symptoms. These can come and go and vary in their severity. Most people also experience a combination of them, rather than just one symptom alone.
Some of the most common hay fever symptoms include:
Frequent sneezing.
Runny or blocked nose.
Itchy, watery eyes.
Eyes that appear red or bloodshot.
Itchy, sore, dry or irritated throat, nose and/or ears.
Coughing.
Sinus pressure, headache and earache.
Feeling tired.
Poor sleep quality that affects daytime concentration.
Depending on your hay fever triggers, you may find that your symptoms are worse at some times of the year, and better at others.
Diagnosis of hay fever
Hay fever is usually diagnosed from your symptoms and what seems to trigger them, such as a pattern of sneezing, a blocked or runny nose, itchy eyes, and symptoms that come and go with pollen seasons. A clinician may also examine your nose and eyes and ask whether the symptoms happen at certain times of year or around specific exposures. If the diagnosis isn’t clear, allergy skin tests or blood tests may be used to help confirm which pollen is causing the reaction.
Complications of hay fever
Although hay fever isn't usually a serious condition, its symptoms can have a significant impact on your day-to-day life. Hay fever can also increase the risk of developing or worsening other health conditions.
Allergic inflammation in the airways may trigger asthma symptoms, including coughing, wheezing and shortness of breath, particularly during periods of high pollen. Ongoing nasal congestion can also contribute to sinus infections (sinusitis), while irritation around the eyes may increase the likelihood of conjunctivitis. In children, untreated hay fever may affect sleep and concentration, which can sometimes impact learning and school performance.
If your symptoms are severe, last for much of the pollen season or aren't well controlled with over-the-counter treatments, it's a good idea to speak to a pharmacist or GP. They can recommend stronger treatments or investigate whether another condition may be causing your symptoms
Self-help for hay fever
There are some things that you can do to help prevent hay fever yourself.
One of the most effective self-help strategies for hay fever is to know your triggers. Understanding your allergies is crucial for helping to prevent them. For example, if you know that you’re allergic to cat dander, you can take steps to avoid being in an environment where cats live or roam.
Other ways to help manage your hay fever without medications include:
Keeping doors and windows closed when pollen counts are high.
Showering and changing your clothes after being outside.
Avoiding cutting grass or spending long periods of time on grass.
Using wraparound or oversized sunglasses to protect your eyes from pollen.
Wearing a hat or head covering to stop pollen getting onto your hair.
Airing rooms where damp and mould are likely to form.
Vacuuming and dusting regularly to remove dust mites from your home.
Washing bedding regularly.
Not drying clothes outside, where they could become coated in pollen.
Applying a barrier in the form of petroleum jelly around your nostrils to limit how much pollen you inhale.
Washing your hands regularly.
Using hay fever wipes to clean surfaces and hands.
Treatment of hay fever
Self-help strategies are rarely effective enough alone to treat hay fever. Instead, they should be combined with one of the many different hay fever medications currently available.
Antihistamine tablets
Antihistamine tablets work by blocking histamine release so that you don’t experience symptoms when you come into contact with one of your usual hay fever triggers. There are lots of branded (and unbranded) antihistamines available, and they are typically divided into those that cause drowsiness and those that don’t. This can be an important consideration if you must take them and drive or operate heavy machinery, or take part in similarly potentially risky activities.
There’s no evidence to suggest that one type works better than any other, but most people find that they need to try a few to find the one that provides them with the greatest relief.
Find out more about antihistamines, including how to take them and what side effects to expect.
Corticosteroid nose sprays
Corticosteroid nasal sprays are a highly effective hay fever treatment. Steroids mimic natural hormones in your body, blocking the release of histamines when you come into contact with an allergen. This helps to prevent nasal swelling, irritation that causes sneezing and mucus. They are known as a topical treatment, because they specifically target where the issue is.
Find out more about corticosteroid nose sprays including who they are suitable for and how often you can use them.
Decongestants
As their name suggests, this treatment works by reducing congestion in the nasal cavities caused by allergic rhinitis. They are available in a variety of forms, including nasal sprays, liquids and oral tablets. However, because they only target congestion, it’s always best to combine this medication with antihistamines for optimal symptom improvement.
Learn more about decongestants, including finding advice about which decongestant may be right for you.
Allergy eye drops
You’ve probably guessed that allergy eye drops specifically target hay fever symptoms that affect your eyes, including itching, watering, redness and pain, all caused by pollen. Some types block histamines before they can be released, while others help block histamines that have already been triggered. They can also be combined into a dual-action treatment for optimal symptom improvement.
Find out more about how allergy eye drops work, the different types available and how to tell which variety is right for you.
Immunotherapy treatment
Immunotherapy is a specialist treatment that involves gradual exposure to tiny amounts of allergen to help your immune system become less sensitive. Immunotherapy is usually only considered when other more conservative treatment isn’t helping.
Find out more about what’s involved in immunotherapy for hay fever.
Comparing allergy treatments | |||
|---|---|---|---|
Treatment type | Symptoms targeted | OTC or prescription | Any considerations |
Antihistamine tablets or medicine | Sneezing, itching, runny nose, watery eyes | Both | Often a once-daily treatment, some can cause drowsiness |
Antihistamine nasal spray | Mainly nasal symptoms like sneezing, stuffy or runny nose | Both | Can taste bitter |
Corticosteroid spray | Mainly nasal symptoms like sneezing, stuffy or runny nose | Both | Works best when used regularly |
Decongestants | Blocked nose, headache, sinus pain | Both | Long term use of nasal versions not recommended as can cause rebound congestion while oral decongestants can raise blood pressure |
Eye drops | Itchy, watery, red eyes | Both | Preventative and active treatment options available |
Immunotherapy | All symptoms | Prescription | A long-term treatment that aims to make your immune system less reactive to triggers |
Frequently asked questions
What are the signs of hay fever?
Signs of hay fever can vary by individual but can include a runny nose, sneezing, itching and red, watery eyes.
What is the best way to treat hay fever?
The best way to treat hay fever is to combine preventative strategies such as limiting exposure to triggers with hay fever medication. It can be a case of trial and error to find the best hay fever medication for you.
What is the main cause of hay fever?
Grass pollen is the most common cause of hay fever in the UK.
In what months does hay fever start?
Hay fever can occur all year round, with different pollens becoming prevalent at different times of the year. Pollen timing can also vary depending on the weather and where you live in the UK, so a warm, dry and windy day can make symptoms worse, even if the season is just starting.
We’ve put together a handy pollen calendar to help you prepare:
UK pollen calendar | |||
|---|---|---|---|
Pollen type | Main season in the UK | Typical peak | What to know |
Tree pollen | Late March to mid May | April to early May | Often the first big hay fever trigger of the year |
Grass pollen | Mid May to July | June | The most common hay fever trigger in the UK |
Weed pollen | End of June to September | July to August | Can prolong summer symptoms into the autumn when people think they should have got over their hay fever |
Can hay fever get worse as you get older?
Yes, hay fever can get worse as you age. This is because your immune system naturally weakens as you get older, and this could make allergies more intense, or even cause them to develop for the first time.
What is the difference between hay fever and a cold?
A cold is caused by a contagious virus that can quickly spread from person to person. Hay fever is your body overreacting to a harmless substance.
Can hay fever cause fatigue and affect concentration?
Yes, studies show that hay fever can cause severe sleep disturbances that may result in daytime fatigue and issues with concentration. And it’s not just adults that are affected. Studies show that hay fever has been linked to increased absenteeism and distraction in school aged children.
Does moving to a different area or country help with hay fever?
Moving may help if your specific allergen isn’t in the new location, but equally it could expose you to new ones. Because different areas have different plant types, climates and pollen seasons, you may leave current triggers behind only to develop brand new allergies instead.
Can diet or gut health influence hay fever symptoms?
Yes, diet and gut health can have a direct impact on your hay fever symptoms. Up to 80% of your immune system resides in your gut and a healthy gut microbiome helps regulate your immune system. An anti-inflammatory diet and specific nutrients can help to naturally reduce allergy symptoms by lowering histamine levels.
Is immunotherapy available on the NHS and how do I access it?
Yes, for hay fever, immunotherapy is available on the NHS for some people, but it is usually only considered if other treatments have not worked. Your GP can assess your symptoms and may refer you to an allergy or ENT specialist, who will decide whether you’re suitable for it. Treatment is usually started a few months before the pollen season and may involve injections or tablets.
Sources
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