What is
Hayfever?
Hayfever is an allergy, which results in irritation/inflammation of the
delicate linings of
- The nose (allergic rhinitis)
- The eyes (allergic conjunctivitis, "hayfever eyes").
If you suffer from hayfever, you probably react to one (or more) of the
following airborne allergens:
- Grass pollens from rye grass, timothy grass and others
- Tree pollens from oak, elm, ash, birch or hazel
- Certain mould spores
Hayfever is known as seasonal allergic rhinitis, because the symptoms
are typically seasonal, recurring annually when the atmospheric levels of
pollen or spores are highest.
In some people, hayfever-like symptoms occur throughout the year in the
condition of perennial allergic rhinitis. This condition results from an
allergy to substances, which are continuously present such as house dust
mites, animal fur, certain chemicals, medicines or foods.
Hayfever and perennial allergic rhinitis are more likely to occur in
conjunction with other allergic conditions, such as asthma or eczema.
Certainly, anyone with a family history of allergic problems has an
increased chance of developing hayfever.
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Symptoms
Typically, in hayfever, there are:
Nasal symptoms
-
Sneezing (frequently and in rapid succession)
-
Runny, itchy nose
-
Stuffy, blocked nose (not eased by blowing)
Eye symptoms
-
red, watery, itchy eyes (both eyes equally affected)
Other associated symptoms
-
Dry, itchy throat and tongue
-
Itchy ears
-
Headache
Additional features
-
Disturbed sleep
-
Inability to concentrate
-
Listlessness
-
Depression
Hayfever can really reduce "quality of life"; the combination
of unpleasant symptoms can interfere significantly with work, study and
leisure activities.
Hayfever symptoms are often worse in teenagers and young adults,
peaking between the ages of 20 and 30, then becoming less severe with age.
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Hayfever
Patterns
In Britain,
- Mould spores are present in the air between May and October, peaking
in late summer (August/September)
- The tree pollen season extends from February to late-May
- The grass pollen season runs from May to September, with a peak in
midsummer (June/July)
- Pollen seasons are subject to geographical variation; pollen usually
peaks later in the North than in the South
During the summer months, grass pollen counts (the number of pollen
grains in a cubic metre of air) are reported daily by national and local
media. Grass pollen hayfever symptoms are closely correlated with local
pollen levels, usually beginning when the count exceeds 50.
The amount of pollen in the air can vary widely, dependent on when
different grasses shed their pollen and the prevailing weather conditions;
for example
- On a sunny day, pollen counts will be high, rising throughout the
afternoon and peaking in the early evening (5-Gpm in rural areas,
later in towns/cities).
- On a rainy day, the air will be cleared and pollen counts will be
lower than normal.
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Self–Help
Tips
Symptoms of grass pollen hayfever can be reduced to some extent by
avoiding or reducing your exposure to pollens; e.g.
- Check the pollen count (local newspaper, radio, TV etc) - stay
indoors when it is high
- Avoid being outdoors in the early evening when pollen counts peak
- Sleep with windows closed
- Keep car windows and doors closed (some cars are fitted with pollen
filters)
- Ask someone else to mow the lawn
- Wear sunglasses to stop pollen entering the eyes
- Escape to the seaside where pollen counts are lower
- Seek treatment from your pharmacist or doctor
Several of these self-help measures can also be applied if you suffer
from hayfever due to tree pollens or mould spores. It makes sense to
minimise exposure to the cause of your problem.
However, allergen avoidance may not always be practical, particularly
for sufferers of perennial allergic rhinitis who may not know the cause of
their problem or may simply be unable to avoid it!
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Conventional
treatment
There are a number of effective remedies available for hayfever and
perennial rhinitis. Your doctor can prescribe one for you, or,
alternatively some products are available over-the-counter from
pharmacies.
The most widely used hayfever treatments include:
- "systemic" antihistamine tablets. taken by mouth
- "topical" anti-allergy agents e.g. corticosteroids,
non-steroidals and antihistamines, available as spray or drops for
local application to the nose and/or eyes.
Antihistamines
- A wide variety of antihistamines are available for use in hayfever
and allergic rhinitis/conjunctivitis; several are available directly
from pharmacies
- They act to block the actions of histamine, a natural body chemical
produced during the allergic reaction and involved in generating
inflammation
- In hayfever. antihistamines provide relief from the symptoms of
sneezing, itchy, runny nose and eye irritation; they have little
effect on the symptom of blocked nose
- Older antihistamines e.g. chlorpheniramine (Piriton), may cause
drowsiness as a side effect; this is less of a problem with newer
"non-sedating" antihistamines e.g. terfenadine
(Triludan/Seldane), astemizole (HismanaI /Pollon-eze), loratidine
(Clarityn), cetirizine (Zirtek)
- Taken by mouth into the body, antihistamines have the potential to
- Interact with some other medicines
- Interact with alcohol
- Cause a number of unwanted side effects
Topical Treatments: -
Treatments
applied locally to the nose or eyes are called topical treatments. For
hayfever and perennial allergic rhinitis / conjunctivitis there are a
number of effective topical treatments available:
- Topical anti-inflammatory corticosteroids, available as nasal
aerosols or sprays for application directly into the nose
- Topical anti-allergy agents, e.g. non-steroidals and antihistamines,
available as both nasal sprays and eye drops for use against the nasal
and/or eye symptoms
Anti-inflammatory corticosteroids
- Several are available on prescription e.g. beclomethasone
dipropionate (Beconase), fluticasone propionate (Flixonase);
budesonide (Rhinocort) and the newer once-daily triamcinolone
acetonide (Nasacort); beclomethasone dipropionate (Beconase Hayfever)
and flunisolide (Syntaris Hayfever) are available directly from
pharmacies
- When sprayed into the nose, these agents act to suppress the
allergic reaction locally, so reducing inflammation in the nasal
lining
- Used correctly, topical corticosteroids can prevent hayfever
symptoms such as sneezing, runny nose, itching and nasal blockage; to
be effective, they should be used regularly throughout the season,
from the first sign of symptoms
- Nasal corticosteroids have no direct effect on associated eye
symptoms, but watering of the eyes may improve, since this arises
partly due to nasal irritation
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Anti-allergy
agents
-
Anti-allergy agents are available as both nasal sprays and eye drops
for use against nasal and/or eye symptoms
-
Sodium cromoglycate is available as a nasal spray on prescription
(Rynacrom) or from pharmacies (Resiston 1); sodium cromoglycate is
also available from pharmacies as eye drops (Opticrom, Clariteyes,
Hay-crom) for use in hayfever eyes
-
Sodium cromoglycate is relatively short-acting, so frequent
(four-times daily) applications are required
-
A newer anti-allergy agent, nedocromil sodium (Rapitil), is
available on prescription as an opthalmic solution for twice daily
application in hayfever eyes or perennial allergic conjunctivitis
-
These agents act locally in the nasal or conjunctival lining to
prevent the allergen (pollen) from triggering an allergic reaction
-
They are beneficial in preventing allergic symptoms; to be most
effective they should be used early, before symptoms develop
-
Anti-allergy agents are very well tolerated with few side effects
-
Anti-allergy eye drops are useful in treating troublesome eye
symptoms in combination with other treatments e.g. topical nasal
sprays, to provide complete relief from hayfever and perennial
allergic conditions
Source: -
The British Allergy Foundation
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