Hay fever

Spring is here but for many this is a miserable time of year as their hay fever strikes.

Hay fever, or seasonal allergic rhinitis, causes sneezing, runny and/or blocked nose, often with itching of the eyes and nose. A postnasal drip, cough, fatigue and irritability are also common symptoms.

Unlike other allergies, it is difficult to avoid the allergens (pollen typically from trees, bushes and grasses) though some sufferers with mild symptoms will get adequate relief from a simple saline nose wash designed to wash away the pollen.

Most will however need medication to control the symptoms. First line therapy is normally a steroid nose spray (available over the counter from pharmacies) to which can be added, as needed, antihistamine nose sprays, antihistamine eye drops and antihistamine tablets. These are all available over the counter and are all safe used in conjunction with each other. Other prescription medication from the doctor may be appropriate if these strategies are not working.

The only potential cure we have is immunotherapy, or desensitization, therapy. This involves the subcutaneous injection of increasing amounts of allergen to induce protective immunologic responses (sublingual drops/tablets are also available but less effective and usually reserved for children). Treatment is usually continued for 2-5 years and if it doesn't fully cure the hay fever will usually reduce its severity often to the same level that would be achieved using a daily steroid nose spray.