Hay Fever

What is hay fever?

Hay fever is an allergic reaction. Usually it is a reaction to pollens of trees, grasses, and weeds. Sometimes it is an allergy to mold spores.

Hay fever may happen any time of the year, but it generally happens in the spring, summer, or fall. It is also called seasonal allergic rhinitis.

How does it occur?

Allergic symptoms result from your body’s reactions to substances that your body sees as foreign. Substances that cause an allergic reaction are called allergens.

The allergens that usually cause hay fever are pollen and mold. They float in the air and are spread by the wind. The type of pollen in the air depends on the growing season and where you live. Tree pollens cause most hay fever in the spring. Grass and some weed pollens are usually the cause in the summer. From late summer to the first frost, other weed pollens, like ragweed, cause hay fever.

The parts of the body that are most often affected by hay fever are the eyes, nose, sinuses, and the tube that connects the middle ear with the back of the throat. Less often, the lungs are affected. If you are allergic to pollen or molds, these substances cause cells in these parts of your body to release a chemical called histamine. Histamine causes the tissues to itch, swell, and produce more mucus or tears than normal.

As many as 1 in 10 people suffer from hay fever at some time in their lives. Hay fever is more common in people with other allergic conditions such as asthma or eczema. Hay fever tends to run in families.

What are the symptoms?

Common symptoms of hay fever are:

  • sneezing  

  • stuffy or runny nose  

  • itchy nose, throat, or ear canals  

  • ear congestion  

  • itchy, watery eyes  

  • postnasal drainage (mucus draining down the back of your throat).  

Other symptoms include:

  • headache  

  • shortness of breath, especially with exercise or exertion  

  • coughing  

  • wheezing.  

How is it diagnosed?

Your Reddy Urgent Care healthcare provider will ask about your history of symptoms. If your symptoms happen just in certain seasons, your healthcare provider will suspect that you have hay fever. A check of your ears, nose, throat, and lungs may confirm the diagnosis.

Because the treatment for most cases of hay fever is the same, no matter what you are allergic to, allergy testing is usually not necessary. Your provider may suggest testing if your hay fever symptoms are severe and you need allergy shots to help them.

How is it treated?

If you know what you are allergic to–pollens, for example–you can try to avoid it. You can do this, for example, by using an air conditioner rather than an attic or window fan. The air conditioner doesn’t let as much pollen get into your home.

Many hay fever symptoms are so mild that they don’t need treatment. Or you may just need to take a nonprescription medicine once in a while. Many nonprescription medicines are available, such as decongestants and antihistamines.

If nonprescription medicines do not control your symptoms, your Reddy Urgent Care healthcare provider may prescribe an antihistamine, steroid nasal spray, or eyedrops.

Decongestants shrink the swollen lining tissues of the ear, nose, and sinuses. Possible side effects of the medicine are trouble sleeping, fast heart rate, and higher blood pressure. They should be used with great caution in older adults.

Antihistamines fight the effects of histamine on your tissues. You may need to take these medicines only when your symptoms are bothering you. Or you might take them daily during your allergy season(s) to prevent symptoms.

There are different types of antihistamines. Drowsiness is a common side effect of many antihistamines. This may not be a problem if a dose at bedtime is all you need. Or you might try the medicine for several days even though it is making you drowsy. Often the drowsiness goes away after you have taken the drug for 3 to 5 days. Some antihistamines usually don’t cause drowsiness. They work well for most people, and some can be bought without a prescription.

Antihistamines can have other side effects as well. Many nonprescription antihistamines, such as diphenhydramine (Benadryl) and chlorpheniramine (Chlor-Trimeton), are more likely to cause side effects in older adults, such as drowsiness, confusion, dizziness, dry mouth and eyes, constipation, trouble urinating, and worsening of glaucoma. Newer antihistamines, such as azelastine (Astelin), cetirizine (Zyrtec), fexofenadine (Allegra), loratadine (Claritin), and desloratadine (Clarinex), are safer but may cause confusion.

Ask your healthcare provider to recommend an antihistamine.

It is safe to take antihistamines and decongestants together unless you have had a bad reaction to either type of medicine.

If antihistamines do not help eye symptoms, your healthcare provider may prescribe allergy eye drops.

Prescription nose sprays containing steroid medicine can prevent or control nasal and sinus congestion, runny nose, and postnasal drainage. They also help eye allergy symptoms. A nonprescription nose spray containing cromolyn is also very effective. These nose sprays work best to relieve symptoms if you use them on a regular basis during the allergy season. Steroid sprays require a few days to build up in the tissues of the nose before they start to work. Using a steroid for a long time can have serious side effects. Take steroid medicine exactly as your healthcare provider prescribes. Don’t take more or less of it than prescribed by your provider and don’t take it longer than prescribed. Don’t stop taking a steroid without your provider’s approval. You may have to lower your dosage slowly before stopping it.

Nonprescription decongestant nose sprays are available for short-term use. Generally you should not use these sprays for more than 3 days. They can make the nose swelling and congestion worse if they are used for more than a few days. Ask your healthcare provider if it is OK for you to use a nasal spray decongestant longer than this.

Symptoms that affect your breathing are treated with medicines used to treat asthma, such as:

  • quick-acting, inhaled bronchodilators to treat symptoms  

  • other types of pills and inhaled medicines to prevent symptoms.  

If these medicines do not control your symptoms, or if you often have complications, such as ear or sinus infections or asthma attacks, your healthcare provider may suggest allergy shots. First you will have tests to find out what you are allergic to. For most people the best tests are skin scratch or prick tests. For these tests tiny amounts of suspected allergens are put under your skin. Your provider then looks for reactions to the allergens.

For your allergy shots, a mixture is prepared that contains the allergens found with your allergy tests. The mixture is injected into your skin in tiny but increasing amounts over the course of many months. Over time, the shots make you less sensitive to the allergens. Usually after 4 to 6 months of allergy shots you will start to have relief from your symptoms. However, you may need to keep getting the shots for at least 2 years and sometimes longer.

How long will the effects last?

Allergies last different amounts of time from person to person. Children with hay fever may keep having seasonal allergies as they grow older, or the allergies may go away over time. If you start having allergies as an adult, you will probably keep having them. However, the allergies may stop if you move to a place with different allergens in the air.

How can I help myself?

Here are some things you can do to help lessen or prevent symptoms caused by hay fever:

  • Follow your healthcare provider’s advice for controlling your symptoms.  

  • If you usually get symptoms when you are housecleaning or doing yard work, wear a mask over your nose and mouth during these chores. (You can buy masks at the drug store.) Don’t stay in the house when someone else is cleaning your house.  

  • Vacuum your carpets, curtains, and soft furniture often. Clean your hard floors with a damp mop or cloth.  

  • Remove any mold you find in your home. Use paint rather than wallpaper on your walls. Don’t put carpet in damp areas.  

  • Stay away from trees and grass as much as you can during pollen season.  

  • Keep doors and windows shut during pollen season. Use an air conditioner, if you have one, in your house and car. Do not use a window or attic fan.  

  • Shower or bathe each evening to remove pollens or other allergens from your hair and skin.  

  • Use artificial-tears eyedrops to help wash out the eyes. Antihistamine eyedrops may help, too. You can get these eyedrops at the store without a prescription.  

Hay fever and allergy problems are a common complaint during pregnancy. Many of the medicines used to relieve the symptoms of allergies, such as antihistamines, decongestants, or even inhaled steroids, are considered safe to use during pregnancy. However, you should use these medicines only after talking with your healthcare provider.

What can be done to help prevent hay fever?

There is no known way to prevent allergies. However, some research has shown that breast-fed babies may be less likely than bottle-fed babies to have allergies or asthma. If your family has a very strong history of allergies, you might try to avoid your family’s most common allergens. For example, you may need to stay away from cats. This might keep you from becoming allergic to cats.

Cigarette smoke can make hay fever and asthma symptoms worse. You can help your symptoms by not smoking. It also helps to avoid being around others who are smoking