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Treating hay fever

Before visiting your GP, you could first visit your pharmacist and try treating your symptoms with over-the-counter medications, such as antihistamines.
If these fail to improve your symptoms then you make an appointment to see your GP as you may require treatment with prescription medications such as steroid medication (corticosteroids).
Treatment options are discussed below.
Antihistamines treat hay fever by blocking the action of the chemical histamine, which the body releases when it thinks it is under attack from an allergen. This prevents the symptoms of the allergic reaction from occurring.
Antihistamines are usually effective at treating itching, sneezing and watery eyes, but they may not help with clearing a blocked nose.
They are available in tablet form and also as nasal sprays.
You can use antihistamines:
as an “as-required” treatment – where you take them when you first notice that you are developing the symptoms of hay fever
as a preventative treatment – for example, if you know there is going to be a high pollen count, you can take them before leaving the house in the morning
Different antihistamine tablets for hay fever include cetirizine, fexofenadine and loratadine. A common antihistamine spray is azelastine.
Unlike older antihistamines, these newer types shouldn’t cause drowsiness, although this can occasionally occur in some people.
If this does occur to you then avoid driving or using tools or machinery. Also contact your pharmacist or GP as there may be an alternative antihistamine you cant take.
Corticosteroid nasal sprays and drops
Corticosteroids (steroids) are used to treat hay fever because they have an anti-inflammatory effect.
When the pollen triggers your allergic reaction, the inside of your nose becomes inflamed.
Corticosteroids can reduce this inflammation and prevent the symptoms of hay fever.
Your GP may prescribe corticosteroid nasal sprays or drops instead of antihistamines if:
You have persistent hay fever that does not respond to antihistamines.
Your main symptom is a blocked nose.
You are pregnant or breastfeeding.
Corticosteroids are more effective than antihistamine tablets at preventing and relieving nasal symptoms, including sneezing and congestion. They can also relieve itchy, watery eyes. They are most effective if you start using them a couple of weeks before your symptoms usually begin, and work best when used regularly.
It’s important that you carefully read the instructions that come with your medication as applying the drops or the spray incorrectly can increase your risk of side effects, such as:
irritation and dryness of your nose
nose bleed
unpleasant taste in your mouth
itchy skin rash around the nose
Corticosteroids tablets
If you require rapid short-term relief from severe symptoms (for example if you had an exam or driving test coming up), your GP may prescribe a course of corticosteroids tablets.
The use of corticosteroids for longer than 10 days is not recommended, as the longer you take steroid tablets the more likely it is that you will begin to experience unpleasant side effects, such as:
weight gain
changes in mood, such as feeling irritable
Nasal decongestants
Hay fever can cause a blocked nose. A decongestant, in the form of a nasal spray, can relieve this. Decongestants reduce the swelling of the blood vessels in your nose, which opens your nasal passage and makes breathing easier.
Your GP can prescribe a nasal decongestant, but there are many available from your pharmacist. Check the ingredients as some decongestants also contain antihistamine. If they do, they may relieve other symptoms as well.
If not, the decongestant will only relieve your blocked nose.
Nasal decongestants shouldn’t be used for longer than seven days. They may cause dryness and irritation in your nasal passage, and can make the symptoms of congestion worse (this is known as rebound congestion).
Eye drops
Eye drops are available from your pharmacist to treat the hay fever symptoms that affect your eyes, such as redness, itchiness and watering (allergic conjunctivitis). These drops contain antihistamine to reduce the inflammation in your eyes, which will relieve the symptoms.
Eye drops containing the active ingredient sodium cromoglicate are the most widely used. Check the patient information leaflet for the correct way to use them. Some may cause side effects, such as a stinging or burning feeling in your eyes.
If you have persistent hay fever symptoms which are not relieved by the above treatments, your GP may refer you for immunotherapy treatment. This involves gradually introducing you to small amounts of the allergen (the substance that you are allergic to), such as pollen, and monitoring your allergic reaction.
However, this treatment is only carried out in specialist medical centres in case a serious allergic reaction (anaphylaxis) occurs.
The allergen can be given to you as :
an injection into your skin – this is known as systemic injection immunotherapy (SIT)
a tablet that dissolves under your tongue – this is known as sublingual immunotherapy (SLIT)
You will then be monitored for up to an hour.
Further doses of sublingual immunotherapy can safely be administered at home after an initial dose has been given under medical supervision.
As you get used to the allergen, the amount used is slowly increased and your allergic reaction to it should get less severe and you should slowly build up an immunity to it.
This can improve people’s tolerance of the allergen, improve their quality of life and has long-term results.
However, immunotherapy may take months or even years to be effective.

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