Written by Ada’s Medical Knowledge Team
What is hay fever?
People affected by hay fever experience an allergic reaction to pollenfrom plants. The type of allergic reaction involved in hay fever an allergic rhinitis reaction, which may involve a skin rash called hives, as well as coughing, sneezing and itchty, watery eyes. Allergic rhinitis is one of the atopic diseases; a set of genetically inherited conditions including asthma, atopic eczema and atopic dermatitis.
Plants produce more during the early spring and summer months. For this reason,the allergic rhinitis that occurs in hay fever can also be described as seasonal rhinitis.Both adults and children can suffer from hay fever and it is estimated to affect between40 and 60 million people in the United States. 1
Symptoms of Hay Fever
The allergic rhinitis reaction is triggered when certain allergens such as pollen, mold or house dust come into contact with the lining of the eyes, nose and throat. This causes symptoms such as:
- Coughing (as a result of the post nasal drip)
- Hives (a rash on the skin)
- Red, itchy, and watery eyes (allergic conjunctivitis
- Runny or stuffy nose
- Swelling around the eyes
The symptoms of allergic rhinitis can be uncomfortable for the sufferer and may interferewith daily life. As a result of their symptoms, people with hay fever can experience problems including:
- Trouble sleeping
- Problems remembering things
- Decreased concentration
- Increased risk of work-related injuries and vehicle accidents
In addition to the symptoms listed above, people who suffer from both asthma and allergicrhinitis are likely to experience asthmatic symptoms during an attack of hay fever. Mostcommonly these include a tight feeling in the chest, wheezing and shortness of breath. If you think that you or a loved one may be affected by hay fever, you can get a free symptom assessment by downloading the Ada app.
Sufferers of hay fever commonly experience symptoms during the summer months when the pollen count is at its highest. To reduce the negative impact of hay fever, it is necessary to identify the specific allergens which trigger the symptoms.
Particular plants which are known to cause hay fever symptoms on a widespread scale include: 2
- Airborne mold (summer and autumn)
- Grass pollen (spring and summer)
- Pollen from trees (spring and summer)
- Weed pollen (spring, summer and autumn)
To diagnose hay fever, a doctor will assess the symptoms.
Diagnostic tests which may be carried out include an intradermal test and/or a prick and scratch test. These tests involve giving the affected person small amounts of specific allergens to see if an allergic reaction takes place.
An intradermal test is the most accurate way to determine whether a person is sufferingfrom hay fever. Possible allergens (such as grass and weed pollen) are injected under theskin. After 20 minutes, the site is monitored for an allergic reaction, which usuallyinvolves the reddening of the skin and an itching sensation.
Prick or scratch test
The prick or scratch test the most common type of skin test. It involves pricking or scratchingthe skin before exposure to an allergen-containing solution. The results are known within10 to 20 minutes.
In certain cases; for example, if there is a medical reason why intradermal or prick or scrach testing cannot be carried out, a blood test may be used to confirm the diagnosis of hay fever.
A blood test for hay fever is also known as an antibody test. It involves sending a sample of the affected person's blood to a laboratory, where it will be analysed for the presence of antibodies called immunoglobulin E (IgE). These are protiens which are produced by the immune system during an allergic reaction to pollen. In people who are having an allergic response to pollen, levels of IgE in the blood will be significantly higher than in those who are not, leading to a diagnosis of hay fever.
A treatment plan for hay fever typically involves following precautions to avoid hay fevertriggers and taking medication as needed to manage the symptoms. For many people, one ormore short-term medications can be sufficient to manage the symptoms of hay fever. Forothers, immunotherapy is a possible treatment option that can provide long-term relief.
Medications for temporary relief
For many people affected by hay fever, short-term medications effectively treat the symptomsof hay fever on a temporary basis. Alleviating the symptoms when they flare up is usuallysufficient for someone with hay fever to maintain a normal quality of life.
Antihistamines relieve the symptoms of an allergic reaction, such as itching, skinirritation and watery eyes. They can be administered as needed as nasal spray, tablets oreye drops.
Nasal corticosteroid medications are very effective at reducing the symptomscaused by allergies. Used over time, they can help to desensitise the nasal passageway tothe allergens which cause hay fever. 3
Immunotherapy (hyposensitization therapy)
If antihistamines and nasal corticosteroid medications do not enable a person to manage theirhay fever symptoms effectively, the doctor will prescribe a course of immunotherapy.
Immunotherapy is a long-term treatment option which serves to alter the body’s autoimmune response to allergens. When it is used to treat hay fever, a course of immunotherapy typically begins about three months before exposure to hay fever triggers is likely to occur and involves either a series of injections or the administration of sublingual allergy tablets.
Treatment with sublingual immunotherapy involves daily administration of the allergens, ina liquid or tablet which is placed under the tongue. Treatment with injections is dividedinto two stages. In the first stage, a person will be injected at intervals over a period of several weeks with increasingly concentrated doses of the allergen. During the second phase, they will receive monthly top-up injections of the the allergen at a uniform dose.
Whilst it is not always possible to avoid pollen and other allergens completely, it ispossible to take precautions against hay fever. Making changes to one's daily routine andenvironment can reduce a person's exposure to airborne pollen.
To prevent pollen exposure as one goes about one's day is advisable to stay indoors as much as possible. Drinking plenty of fluids throughout the day can help to prevent allergic reactions. It is also advisable to avoid using tobacco products, particularly smoking, which can aggravate the symptoms of hay fever by irritating the airways. Breathing moist air (from hot water) can also help to alleviate the congestion associated with hay fever.
To exclude pollen from the home environment, keeping the windows and doors shut is reccomended. It is also advisible to change into freshly washed clothes when you reenter the house and cleaning any domestic air vents and installing a pollen filter in your car can also help reduce contact with allergens. When one is outside, it is helpful to avoid cut grass and fresh flowers.
Hay fever FAQs
Q: Does antihistamine cause tiredness?
A: Many systemic antihistamines cause drowsiness as a side-effect. Doctors oftenadvise taking varieties of antihistamine which cause tiredness at night time. When sourcingmedication for hay fever, it is important to find out whether tiredness is one of its sideeffects, as this will make it unsafe to drive or operate heavy machinery.
Q: Is there a cure for hay fever?
A: There is no absolute cure for allergic rhinitis, but the right treatment plan canreduce symptoms significantly and enable a normal quality of life. Immunotherapy/hyposensitizationtherapy can achieve long-term pollen desensitization to specific triggers.
Q: Can hay fever be mistaken for other conditions?
A: Hay fever shares many symptoms with the common cold. If you have been sufferingfrom cold-like symptoms including nasal congestion and sneezing for over two weeks, it isadvisable to seek a medical opinion as you may be suffering from hay fever.