How to manage hay fever

Written by Dr Deborah Lee, Dr Fox Online Pharmacy

16 million Brits currently suffer from hay fever. Are you one of them?

We all know hay fever is a miserable condition. Itchy, runny, eyes, a runny nose, sneezing, and coughing make you feel wretched. Plus disturbed sleep causes you to feel tired and groggy.

Hay fever can have serious medical consequences. It can worsen asthma, leading to an acute asthma attack, which could be fatal. In addition, 68% of hay fever sufferers say that hay fever symptoms impair their driving ability. Fatigue, which can be linked to taking antihistamines, accounts for 10%-20% of road traffic accidents.

The Met Office are predicting this year could be a particularly bad year for hay fever sufferers. Warmer temperatures mean the trees are starting to make pollen earlier in the year, plus due to climate change, pollen may be becoming more potent.

• What steps could you take to manage your hay fever better?

Read on and find out.

Avoid exposure to pollen

Hay fever is caused by an allergy to pollen. Start by doing all you can to avoid exposure to pollen.

What’s the pollen count today? – Follow the Met Office forecast and stay indoors when the pollen count is high. You might like to download the Met Office Weather app. The pollen count tends to be higher in the early mornings, the evenings 5-8 pm, or when it is windy.

The pollen count is the level recorded in the previous 24 hours. A normal pollen count is 50 grains per cubic meter or less. A high pollen count is 80-200 grains per meter. Very high levels such as 800 grains per cubic meter have been recorded. The Met Office gives a 5-day pollen forecast, and grades this as low, medium-high or very high.

The pollen count includes grass and tree pollen. The count rises in April, May and June. However, tree pollen starts to be produced in March. Your hay fever symptoms will start, depending on which type of pollen you are allergic to.

Keep pollen out of the house  – Shower and change your clothes when you come in from outside. Keep doors and windows closed especially when the pollen count is high. Pets are bad news for hay fever sufferers as they carry pollen on their hairy coats and paws. Eliminate mould and dampness as this can worsen allergy symptoms. Don’t have house plants as the soil can harbour mould. Don’t have fresh flowers in your home.

Clean your home  – Vacuum and damp dust your home at least two to three times a week. Use a vacuum cleaner with a High Efficiency Particulate Air (HEPA) filter. These suck in air and filter out tiny particles including dust, pollen, pet dander, and atmospheric pollutants. They are recommended for allergy sufferers by the American College of Allergy, Asthma and Immunology (AACI).

Don’t dry clothes outside – They can become covered with pollen.

Keep pollen out of your car  – Keep your car windows and doors closed. For best results, have a HEPA filter fitted in your car for the same reasons as above. The filter needs to be cleaned regularly.

Protect your eyes  – Wear wraparound sunglasses when outside. Keeping bright sunlight out of your eyes also helps protect against sneezing. Wearing sunglasses can help prevent eye infections such as conjunctivitis.

Wear a face mask  – You might like to use an anti-allergy face mask – these filter out tiny air particles such as pollen and air pollution. They have specific design features to make them comfortable to wear. Anti-allergy face masks can be purchased online. You might like to apply a small rim of Vaseline to your nostrils before going out as this helps prevent pollen from entering the airways.

Avoid the grass  – Don’t walk in grassy or wooded areas. Keep your lawn short or have the garden paved. Choose plants that are insect rather than wind pollinated.

Hay fever treatments

Hay fever treatments are safe, effective and can be used by those of all ages. Most people need a combination of treatments. Start hay fever treatments 2-4 weeks before the onset of the pollen season. Discuss your symptoms with your pharmacist or GP.

Antihistamines – It is the release of histamine that causes the allergy symptoms. Hence, antihistamines which block histamine receptors, are the mainstay of hay fever treatment. These need to be taken daily throughout the hay fever season.

In general, the newer second-generation antihistamines such as fexofenadine (Allegra), cetirizine (Zyrtec) and loratadine (Claritin) are preferable as they are non-drowsy. Note that you don’t need to buy brand-name products. Generic products work just the same and this can save you a lot of money.

You must take your antihistamines exactly as directed at the same time every day and not miss a dose.

Nasal sprays  – Steroid nasal sprays work well to reduce nasal inflammation. However, you do need to use the correct technique to inhale them. Make sure you read the patient information leaflet and follow the instructions.

Eye drops  – These can also help hay fever sufferers. Sodium cromoglycate eye drops can be bought in the pharmacy without a prescription. Apply one to two drops to each eye, four times a day.

Immunotherapy – This is a process of desensitization. The allergen is presented in increasing doses over a prolonged period to dampen down the immune reaction to it. This is only undertaken in specialist centres and requires a referral to an Immunologist.

Danger signs – Please note that hay fever is an allergic reaction that can be dangerous. If your symptoms are not responding to treatment, and in particular, if you feel short of breath, start wheezing and feel your asthma is worsening, seek help immediately. Acute asthma in the hay fever season can be life-threatening. If you have any concerns, phone 999 without delay.

Final thoughts

Don’t let hay fever get you down this year. Using a combination of treatments including taking a regular antihistamine, plus following the above advice on how to avoid pollen, is likely to make a great improvement to your symptoms.

• What could you do today to get better control of your hay fever?

For more information

• NHS – Hay fever

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Refs:

https://news.sky.com/story/why-hay-fever-is-worse-this-year-and-what-you-can-do-about-it-13326241
https://www.allergyuk.org/types-of-allergies/hayfever
https://www.allergyuk.org/news/face-masks/
https://www.allergyuk.org/our-services/allergyuk-products/respro-allergy-mask
https://weather.metoffice.gov.uk/warnings-and-advice/seasonal-advice/pollen-forecast
https://acaai.org/allergies/management-treatment/living-with-allergies/air-filters
https://www.allergyuk.org/resources/immunotherapy-factsheet/
https://pubmed.ncbi.nlm.nih.gov/10730552/