Hay fever (allergic rhinitis)
Also known as: allergic rhinitis, seasonal allergic rhinitis, pollen allergy, hayfever
Hay fever is an allergic reaction to pollen, also called seasonal allergic rhinitis.
When to seek care
A pharmacist can give advice and suggest treatments for hay fever. A GP appointment is the route if symptoms get worse or do not improve with pharmacy medicines, or if they last more than two weeks and affect everyday tasks. If hay fever affects breathing or means a reliever inhaler is needed more than usual, NHS Wales advises speaking to a pharmacist, GP practice or asthma nurse. Call 999 if struggling to breathe, unable to speak in full sentences, or if a reliever inhaler is not helping.
Overview
Hay fever is a common allergy that causes sneezing, coughing and itchy eyes. It is an allergic reaction to pollen from plants. Unlike a cold, its symptoms can last for weeks or months. Asthma + Lung UK says symptoms are usually worse between March and September. The NHS says there is no cure, but symptoms can be eased.
Causes
- An allergic reaction to pollen from plants.
- Pollen from trees, grasses and weeds is the usual trigger.
Risk factors
- A family history of allergic disease is a recognised risk factor for allergic rhinitis.
- Early childhood exposure to cigarette smoke has also been reported as a risk factor.
Symptoms
Complications
- Sinusitis and middle ear infection have been reported as complications of allergic rhinitis.
- Allergic rhinitis is a recognised risk factor for developing asthma.
- Hay fever can trigger asthma symptoms, and an NHS source says leaving it untreated raises the risk of a sudden asthma attack in people with asthma.
Diagnosis
Hay fever is usually recognised from typical seasonal symptoms, and formal allergy testing is not usually needed. If there is doubt, a doctor may suggest blood tests or skin prick testing to confirm a pollen allergy.
Treatment
A pharmacist can recommend antihistamine tablets, drops or nasal sprays, and steroid nasal sprays. If these do not help, a GP may refer the person for immunotherapy, which gradually builds tolerance to pollen.
Prevention
The NHS says hay fever cannot be prevented, but symptoms can be eased. Allergy UK suggests checking pollen forecasts and showering and changing clothes after being outdoors.
Key facts
| Fact | Detail |
|---|---|
| Also called | Allergic rhinitis |
| Cause | An allergic reaction to pollen from plants |
| Main symptoms | Sneezing, a runny or blocked nose, itchy or watery eyes |
| Usual season | Tree pollen from late March to mid-May, then grass and weed pollen |
| Where to get advice | A pharmacist can advise on treatments |
| Outlook | No cure, but symptoms can be eased |
What are the symptoms of hay fever?
The NHS lists sneezing and coughing, a runny or blocked nose, itchy, red or watery eyes and loss of smell as common symptoms of hay fever. Allergy UK also lists an itchy throat or ears. MedlinePlus, a United States source, says a stuffy nose, coughing and headache can develop later.
Hay fever can look like a cold, but a cold usually clears within one to two weeks. Hay fever symptoms can last for weeks or months. Asthma + Lung UK says symptoms are usually worse between March and September, when pollen counts are highest.
Hay fever can trigger asthma symptoms such as coughing, wheezing, chest tightness and shortness of breath. NHS Wales advises speaking to a pharmacist, GP practice or asthma nurse if hay fever affects breathing or means the reliever inhaler is needed more than usual.
What causes hay fever, and when is it worst?
Hay fever is an allergic reaction to pollen from plants. Allergy UK says tree pollen in spring, grass pollen in summer or weed pollen in autumn may cause symptoms, and that grass pollen is the main trigger in the UK. MedlinePlus, a United States source, names pollen from trees, weeds and grasses, and says the plants responsible vary from person to person and from area to area.
Allergy UK says warm, dry and windy days can lead to higher pollen counts, while rain helps wash pollen out of the air.
How is hay fever diagnosed?
The NHS in Devon says hay fever is usually recognised from typical seasonal symptoms. It says formal allergy testing is not usually needed unless symptoms are unusual or interfere with daily activities despite regular over-the-counter medicine, and that a symptom diary can help. One NHS-affiliated information sheet says that if there is doubt, a doctor may suggest blood tests or skin prick testing to confirm a pollen allergy.
NHS 111 Wales advises seeing a GP when it is unclear whether symptoms are hay fever or something else. One GP practice leaflet adds children under 2, pregnancy or breastfeeding, and symptoms in unusual patterns such as winter, when something other than pollen may be responsible.
The NHS suggests seeing a GP if symptoms are getting worse or do not improve after taking medicines from the pharmacy.
How is hay fever treated?
The NHS says there is no cure for hay fever and it cannot be prevented, but symptoms can be eased. A pharmacist can give advice and suggest the best treatments, such as antihistamine drops, tablets or nasal sprays, and steroid nasal sprays. The NHS describes cetirizine as a non-drowsy antihistamine used for allergy symptoms such as hay fever, and chlorphenamine as a drowsy antihistamine. Allergy UK says most people with hay fever can manage their symptoms with a daily non-sedating antihistamine.
MedlinePlus, a United States source, says nasal corticosteroid sprays are the most effective treatment for allergic rhinitis. The NHS says a GP might prescribe a steroid treatment, and may refer the person for immunotherapy if other treatments fail. Immunotherapy gives small amounts of pollen as an injection or tablet to build up immunity. It usually starts a few months before the hay fever season and may not be available everywhere.
Some local NHS areas in England, such as Frimley, say GPs no longer prescribe antihistamine tablets, steroid nasal sprays or sodium cromoglicate eye drops for hay fever. Policies vary by area.
Living with hay fever and getting help
The NHS suggests putting petroleum jelly around the nostrils, wearing wraparound sunglasses, showering after going outside and keeping windows shut when pollen counts are high. Allergy UK advises checking pollen forecasts daily and staying indoors where possible when the count is high. It also advises showering, washing hair and changing outer clothing after coming home, and not drying clothes outside when counts are high.
NHS inform and the Patient information site both say hay fever treatment works best when started early.
Allergy UK advises seeing a GP or practice nurse if symptoms persist despite antihistamines or other medicines, or if they last more than two weeks and affect everyday tasks. If hay fever affects breathing, NHS Wales advises speaking to a pharmacist, GP practice or asthma nurse. It says to call 999 if struggling to breathe, unable to speak in full sentences, or if a reliever inhaler is not helping.
Frequently asked questions
Can hay fever be cured?
The NHS says there is no cure for hay fever and it cannot be prevented, but symptoms can be eased. A pharmacist can recommend antihistamines and steroid nasal sprays. If these do not work, a GP may refer the person for immunotherapy, which gradually builds tolerance to pollen. Allergy UK says a daily non-sedating antihistamine works for most people.
How can hay fever be told apart from a cold?
Hay fever and a cold can look similar. A cold usually clears within one to two weeks, while hay fever symptoms can last for weeks or months. Hay fever commonly brings itchy or watery eyes and an itchy throat. Allergy UK advises seeing a GP or practice nurse if symptoms last more than two weeks and affect everyday tasks.
Can hay fever affect asthma?
Hay fever can trigger asthma symptoms such as coughing, wheezing, chest tightness and shortness of breath. An NHS source says leaving hay fever untreated raises the risk of a sudden asthma attack in people with asthma. NHS Wales advises speaking to a pharmacist, GP practice or asthma nurse if hay fever affects breathing, and calling 999 if struggling to breathe or a reliever inhaler is not helping.
When is the hay fever season?
Asthma + Lung UK says symptoms are usually worse between March and September.
Does hay fever run in families?
A family history of allergic disease is one of the strongest documented risk factors for allergic rhinitis, according to published reviews. Early childhood exposure to cigarette smoke has also been reported as a risk factor. Hay fever itself is an allergic reaction to pollen from plants.
Connected pages in detail
What each linked page on Anatomy Nexus covers, in a line, for Hay fever (allergic rhinitis).
Conditions
- Asthma A chronic inflammatory disease of the airways causing reversible narrowing, with episodes of wheeze, breathlessness, chest tightness and cough.
Symptoms
- Headache Pain felt anywhere in the head.
Medications
- Cetirizine and antihistamines A second-generation (less sedating) antihistamine that blocks histamine H1 receptors to relieve hay fever, hives and other allergic symptoms.