You may think it’s too early for an article about hay fever, but many of its 18 million UK sufferers would disagree. The main pollen season runs from March to September and if you’re sensitive to tree pollen, your symptoms could start as early as January.
2018’s high pollen counts caused misery for many. If you were one of them, here are ways to be proactive this year, combining prevention and treatment to reduce your symptoms.
Prevention can be easier if you know your triggers and the pollen forecast. Your GP can refer you for a skin prick test for the most common allergens or a blood test for the Immunoglobulin E (IgE) antibody, which is produced when you come into contact with pollen. For pollen count information, you can check the Met Office pollen forecast at www.metoffice.gov.uk/health/public/pollen-forecast.
You can reduce pollen contact by:
- Avoiding drying washing outside and cutting grass
- Showering before bed and wearing fresh clothes every day
- Closing windows
- Putting Vaseline around your nostrils
- Wearing wraparound sunglasses
- Vacuuming (preferably with a HEPA filter vacuum cleaner) and damp-dusting regularly
- Getting a pollen filter for the air vents in your car and air purifier units for indoors
Controlling your symptoms
Both cigarette smoke and drinking alcohol can make your symptoms worse, so avoid them.
Research by Allergy UK in 2014 showed that 62% of hay fever sufferers found their medication ineffective – yet they either failed to change it or didn’t use it properly. So remember:
- Hay fever treatments aren’t effective unless used as directed (and regular use is essential to prevent symptoms).
- Combining treatments can help you better control your symptoms, but always seek the advice of a GP or pharmacist first.
- If your current treatments aren’t working, don’t ignore it—ask your GP or pharmacist for alternatives.
Oral Medications (Tablets and Liquids)
Antihistamines work by blocking the action of histamine, a chemical produced when your body is exposed to an allergen and the culprit responsible for your allergic reaction. They may not relieve a blocked nose, but they’re effective against other nose and eye symptoms. As a preventative, they work best if taken regularly and are best started before high pollen count periods or the months your hay fever usually occurs. However, they can also be taken as required when your symptoms begin.
Some antihistamines (e.g. chlorpheniramine, known as Piriton) make you drowsy, potentially affecting your ability to work or drive, but non-sedating antihistamines such as Loratadine or Cetirizine are available. If one type doesn’t work for you, ask your pharmacist or your GP about alternatives before you give up on antihistamines altogether.
Decongestant nasal sprays help to unblock your nose by reducing swelling in the blood vessels. Ideally, they should only be used for occasional relief or as a short-term additional treatment when your symptoms are severe, as they can cause rebound congestion.
Steroid nasal sprays or drops contain a small amount of steroid that helps reduce inflammation in the nasal lining. They can also help itchy eyes, and are usually used when other treatments haven’t worked.
Antihistamine nasal sprays help relieve an itchy nose and reduce sneezing.
Antihistamine eyedrops help to reduce itchiness and relieve watering eyes.
Treating Severe Hay Fever
If your symptoms are so severe that it seriously affects your quality of life and ability to work, or causes or exacerbates asthma, other treatments or therapies are required.
Steroid tablets are only usually used for a short course of treatment, and only given if other medications aren’t working. They reduce inflammation caused by your allergic reaction, which reduces the severity of your symptoms.
You may be offered a steroid inhaler, which will reduce inflammation in your airways, and/or a ‘reliever’, such as salbutamol (‘Ventolin’), which opens up the airways and makes breathing easier.
These may be recommended too if steroids aren’t adequate. Monoclonal antibody treatments (‘mabs’) such as Xolair block a substance involved in the body’s allergic reaction. Xolair injections are usually given every two or four weeks.
Immunotherapy (building resistance)
Immunotherapy progressively builds up your allergen immunity and it’s only available in specialist hospital centres, so that your reaction can be closely monitored and any adverse effects treated. Treatment should ideally be started three months before your trigger pollen season.
A specialist will gradually introduce your body to small amounts of allergen, either by injection into the skin or via a sublingual tablet (which dissolves under the tongue). You may be able to continue the sublingual tablets (‘SLIT therapy’) at home.
The dose of allergen is gradually increased until you can tolerate exposure without developing major symptoms. Immunotherapy is given over three consecutive years and it’s important that the course is completed for the best results.
Being trapped indoors by hay fever is miserable. If you’re desperate for a day out but can’t face the pollen potential of the countryside, head for the seaside. The pollen count is lower nearer the coast.
AllergyUK: www.allergyuk.org; Helpline 01322 619 898, 9am-5pm Mon-Fri