Hay fever or seasonal allergic rhinitis afflicts sufferers with a variety of symptoms, such as:

· Itchy, runny & / or blocked nose

· Itchy, watery, red eyes

· Sneezing

· Itchy throat

· Less commonly; headache, face pain, sweats, loss of smell, asthma symptoms (breathless, wheezing)

Hay fever is caused by an allergy to pollen, the commonest coming from grasses and weeds which causes symptoms during spring & summer. Tree pollens can also affect many people, but tend to do so earlier in the year, generally from March till May. If symptoms persist in the winter months then other causes of allergy maybe to blame, such as fungal spores, house dust mites and animal & pet dander from fur.

Symptoms are caused by the body’s immune system reacting to pollen, cells in the lining of the nose & on the surface of the eyes release histamine when exposed to an allergen which causes inflammation & irritation. Hay fever affects about 20% of the population and often starts in childhood and re-occurs each year for several years before improving or disappearing completely. People that suffer from hay fever are also often prone to asthma & eczema; these so called “atopic” conditions also tend to run in families.

Simple measures to reduce exposure to pollen can help ease symptoms, but avoiding pollen completely is virtually impossible. The following actions may help when the pollen count is high (50+):

· Stay indoors as much as possible with the doors & windows closed

· Keep car windows & air vents closed, consider fitting pollen filters.

· Wear wrap around sunglasses

· Avoid cutting grass & large grassy areas as much as possible

· Shower & wash your hair often to remove pollen


Hay fever is treated mainly with anti-histamine tablets, nasal sprays (anti-histamine or steroid) & eye drops. For optimal control, treatment should begin BEFORE the hay fever season starts and continue until the pollen season ends.

Anti-histamine tablets are classified into 1st generation (e.g. Chlorpheniramine – PIRITON?) which commonly cause drowsiness & also need to be taken several times a day.

2nd generation anti-histamines (e.g. Loratidine – CLARITYN? & Cetirizine – ZIRTEK?) generally do not cause drowsiness and are only taken once per day. Loratidine is considered the least likely to make you feel sleepy or to interact with alcohol. Both these drugs can occasionally cause dizziness and should be avoided during pregnancy & breastfeeding. These drugs can ease all symptoms of hay fever with the exception of a blocked nose, if this symptom is troublesome the use of a decongestant, such as pseudoephedrine can be tried or alternative anti-histamines prescribed; Fexofenadine or Desloratidine. Anti-histamines taken orally tend to act in about 30 minutes, but for faster relief Acrivastine – BENEDRYL? can be used which offers relief within 15 minutes, but requires frequent doses every 8 hours.

Steroid nasal sprays (Beclometasone – BECONASE? & Fluticasone – FLIXONASE?) are very effective at relieving nasal & eye symptoms. They are used once or twice daily in each nostril and can take between 5 & 20 days to provide a full effect. Anti-histamine nasal sprays (e.g. Azelastine – RHINOLAST?) offer fast relief of nasal symptoms, but do not help affected eyes and are generally less effective than steroids. Cromoglycate nasal sprays (RYNACROM?) offer another alternative, but these also need to be used regularly and can take up to 2 weeks to reach full effect. They are more often used in children. Ipratropium bromide nasal sprays (ATROVENT?) are particularly effective in stopping very watery nasal discharges, but have no effect on other nasal or eye symptoms.

Eye symptoms can be rapidly relieved by anti-histamine eye drops (e.g. Antazoline – OTRIVINE ANTISTIN?) or alternatively use drops with the anti-allergy ingredient Sodium Cromoglycate (CLARITYN? or OPTREX? allergy drops) however these need to be used regularly and can take several days to reach full effectiveness.

Successful relief of hay fever is often only achieved with the use of several products and may require treatment with anti-histamine tablets, a nasal spray & eye drops combined, starting a few weeks before the season begins.

Michael Lord BPharm(hons)

Pharmacist for 25 years & health journalist