What you need to know about hay fever

Hay fever causes cold-like symptoms, a runny nose, itchy eyes, congestion, sneezing, headache and sinus pressure.

It is not caused by a virus, but by an allergic response to allergens, such as pollen, dust mites or tiny flecks of skin and saliva shed by pets.

It can affect your performance at work or school and interfere with your life. To manage, one has to learn to avoid triggers and find the right treatment.

Lessen your exposure to the allergens or take medications before you’re exposed to allergens, as directed by your doctor.

It may be difficult to tell whether you have a common cold or hay fever since the symptoms can be similar. Hay fever normally presents with no fever immediately after exposure to allergens, and lasts as long as you are exposed.

Common cold presents with a runny nose with watery or thick yellow discharge; the body aches; there is a low-grade fever, and it starts one to three days after exposure to a cold virus and lasts three to seven days.

Picture: iStock

Causes

With hay fever, your immune system identifies a harmless airborne substance as harmful. It produces antibodies to this harmless substance.

Next time you come in contact with the substance, these antibodies signal your immune system to release chemicals such as histamine into your blood, which cause a reaction that leads to the symptoms of hay fever.

Risk factors

• Exposure to secondary cigarette smoke in first year of life;
• Having other allergies or asthma;
• Having atopic dermatitis (eczema);
• Having a relative (a parent or sibling) with allergies or asthma;
• Living or working in an environment that exposes you to allergens.

Complications

• Reduced quality of life;
• Poor sleep/insomnia, leading to fatigue and a general feeling of being unwell;
• Worsening asthma;
• Sinusitis, an infection or inflammation of the membrane that lines the sinuses;
• Ear infection. In children, hay fever is often a factor in middle ear infection (otitis media).

Asthma. Picture: iStock

Diagnosis

Consult your doctor who will possibly recommend one or both the following tests:

• Skin prick test. You’re watched for an allergic reaction after small amounts of material that can trigger allergies are pricked into the skin of your arm or upper back. If you’re allergic, you develop a raised bump (hive) at the site of that allergen.

• Allergy blood test. A blood sample is sent to a lab to measure your immune system’s response to a specific allergen.

Treatment

Limit your exposure to substances that cause your hay fever.

If your hay fever isn’t too severe, over-the-counter medications may relieve symptoms. Many people get the best relief from a combination of allergy medications. You might need to try a few before you find what works best.

Skin prick allergy test. Picture: iStock

Medications include:

• Nasal corticosteroid sprays. These require a prescription. They are a safe, long-term treatment for most people. Side-effects can include an unpleasant smell or taste and nose irritation.

• Antihistamines. Work by blocking histamine, a chemicalreleased by your immune system during an allergic reaction.

• Decongestants. Available in over-the-counter and prescription liquids, tablets and nasal sprays. Oral decongestants can increase blood pressure, cause insomnia, irritability and headache, so use them with a doctor’s supervision. Don’t use a decongestant nasal spray for more than two or three days at a time because it can worsen symptoms.

• Leukotriene modifier, a prescription tablet taken to block the action of leukotrienes – immune system chemicals that cause allergy symptoms. Effective in treating allergy-induced asthma. Can cause headaches. In rare cases, it has been linked to psychological reactions like agitation, aggression, hallucinations, depression and suicidal thinking.

• Nasal ipratropium helps relieve severe runny nose by preventing the glands in your nose from producing excess fluid. Not recommended for people with glaucoma or men with an enlarged prostate.

• Oral corticosteroids. Corticosteroid pills such as prednisone sometimes are used to relieve severe allergy symptoms. Because the long-term use of corticosteroids can cause serious side effects such as cataracts, osteoporosis and muscle weakness, they’re usually prescribed for only short periods of time.

Other treatments for hay fever include: immunotherapy or desensitisation therapy, sublingual allergy tablets and rinsing your sinuses with distilled sterile saline water.

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