Hay fever

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Overview

Hay fever (allergic rhinitis) is one of the most common chronic conditions in the United States, affecting about 10 percent of the population. The condition may cause you to sniffle, drip and itch your way through the pollen-filled blooming months or while exposed to other allergic triggers.

Symptoms can make life so miserable that many people with allergies dream of finding relief by moving to a different part of the country. Unfortunately, allergies aren’t that easy to escape. 

Allergy Relief

Some of the medications used to treat respiratory allergy symptoms include antihistamines, decongestants, nasal sprays and eyedrops. What do medications do? Allegra D Allegra Claritin-D Flonase Nasacort Nasacort AQ Nasonex Patanol Zyrtec

Many hay fever culprits — or their close relatives — are common across the United States. If you’re prone to allergies, you may begin reacting to new allergens within a year or two.

Fortunately, there are many effective ways to treat hay fever. Medical advances during the past few years have brought new and improved drugs, and allergy shots and lifestyle modifications also can help keep your symptoms under control.

Signs and symptoms

Signs and symptoms of hay fever may include:

• Congestion
  
• Runny nose
  
• Frequent sneezing
  
• Watery eyes
  
• Itchy eyes, nose, roof of mouth or throat
  
• Cough

It may be difficult to distinguish hay fever from a cold. If you’re not sure what is causing your symptoms, look for these clues:

• A cold tends to last a week or less, while allergy symptoms can persist throughout one or more seasons.
  
• Fever, body aches, and sore throat are more likely to be caused by a cold.
  
• Nasal secretions caused by a cold tend to be thicker than those caused by hay fever.

Hay fever reactions are mild in many people. If you’re not so lucky, your signs and symptoms can be severe enough to disturb your sleep and trigger asthma attacks.

In asthma, airways in your lungs are inflamed and swollen. Muscles surrounding your airways, irritated by inflammation, tighten and constrict spontaneously. Membranes in airway linings secrete excess ...

Causes

Although no one knows why, you may be more susceptible than other people are to allergies. Researchers suspect that allergic tendencies are inherited. If your parents have allergies, you may too, although not necessarily to the same things. Hay fever can develop anytime during your life. The good news is that symptoms often fade as you get older.

People with hay fever react to one or more specific allergy-causing substances (allergens), such as pollen, mold, dust mites and pet dander. When you inhale the offending allergen, your immune system reacts to the allergen by releasing histamine, leukotrienes and other chemical substances. These substances work to inflame the linings of your nose, sinuses, eyelids and eyes — causing itching, sneezing, runny nose and watery eyes.

Depending on which substances trigger your allergies and where you live, your symptoms may begin to appear in spring as soon as the ground thaws and plants begin to bloom. Trees are the first to pollinate each spring, beginning as early as January in the southern states and April in the northern states. Grasses begin pollinating in late spring, followed by weeds in the summer and fall. Outdoor mold spores start growing soon after the ground thaws, peaking in midsummer in the warmer states and early fall in the colder states.

Indoor molds, dust mites and pet dander can trigger allergy symptoms throughout the year.

When to seek medical advice

If you experience occasional symptoms of hay fever, try over-the-counter remedies. See your doctor to design a treatment program if there’s no improvement, if symptoms are chronic or if you experience side effects from over-the-counter medicines. An allergy specialist is your best bet for an accurate and complete diagnosis.

Treatment

Your allergist will conduct a thorough history and physical examination and may recommend skin testing. Skin testing helps determine which allergens you’re most sensitive to. Allergy blood tests also may be used. Your doctor then can design a treatment program specifically for you.

Medications to treat hay fever include:

• Antihistamines. These medications counteract histamine, an inflammatory substance released when your immune system encounters an allergen. Over-the-counter (OTC) antihistamines that have been available for many years include diphenhydramine (Benadryl) and chlorpheniramine (Chlor-Trimeton). These drugs may relieve your itching eyes and nose, but they often cause drowsiness and dehydration. Loratadine (Claritin), recently made available over-the-counter, doesn’t cause these side effects. However, it may not be effective for everyone. Ask your doctor about prescription antihistamines, including fexofenadine (Allegra) and cetirizine (Zyrtec), if your symptoms persist. Both drugs are relatively nonsedating, but Zyrtec may cause drowsiness in some people. Although antihistamines usually can keep you from sneezing, they’re not quite as effective for your clogged nose.
  
• Decongestants. These medications, often used in combination with antihistamines, are available in liquid, tablet and nasal spray forms both with and without a prescription. Don’t use OTC nasal sprays for more than a few days in a row because continued use can actually cause nasal congestion, referred to as rebound congestion.
  
• Leukotriene modifiers. These medications block the action of leukotrienes, which can cause hay fever symptoms. Montelukast (Singulair) is a tablet taken once a day.
  
• Nasal sprays. Nasalcrom, a nasal spray containing the anti-inflammatory agent cromolyn sodium, is available without a prescription. One advantage of using Nasalcrom is that it has few side effects even for children as young as 6. However, many people find Nasalcrom only modestly effective in controlling symptoms.
  
• Corticosteroids. For more troublesome symptoms, corticosteroid nasal sprays, such as beclomethasone (Beconase), fluticasone (Flonase), triamcinolone (Nasacort), budesonide (Rhinocort), flunisolide (Nasarel, Nasalide) and mometasone (Nasonex), can help you breathe better. These corticosteroid nasal sprays are the most effective treatment for hay fever. An occasional bothersome side effect for some people is irritation of the nasal passages. These nasal sprays can take three to 10 days to provide maximum relief, so start them before the season hits or on the first day of your symptoms. Give them an adequate trial, as you can’t expect results after the first day of use. Corticosteroid nasal sprays can do wonders for your nose, but may not relieve your itchy eyes.
  
• Eyedrops. Drops containing antihistamines or decongestants can help relieve itchy eyes. Both OTC and prescription eyedrops are available.

If you are taking any other medications or have a chronic health condition, talk to your doctor or pharmacist before starting these therapies, to be sure you’re not at risk of a drug interaction or other adverse effect.

If medications don’t relieve your hay fever symptoms or if your symptoms are chronic, allergy shots (immunotherapy) may help you. The solutions given in allergy shots contain a small amount of the substances (allergens) to which you’re allergic. Slowly increasing the dose of the allergy shot over time allows you to become desensitized to the allergy-causing substance. Ask your doctor whether allergy shots are right for you. You generally need to get the shots regularly for one to two years for maximum benefit, although most people begin to experience significant relief and reduced need for medication within one year of beginning the shots.

A small area of swelling with surrounding redness is typical of a positive allergy skin test....

# Video: All about an allergy test

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Self-care

It’s not possible to completely avoid allergens, but you can reduce your symptoms by minimizing exposure. If you’re allergic to pollen or molds, follow these tips:

• Keep your windows and doors closed and air conditioning on at home and in your car during your allergy season.
  
• Use a good air filter at home.
  
• Run a dehumidifier at home to reduce humidity, which may allow mold to grow.
  
• Stay indoors during the pollen season.
  
• Keep your house especially clean during the pollen season to reduce levels of pollen and mold.
  
• Avoid mowing the lawn or raking leaves — which stirs up both pollens and molds — as much as possible.

If you’re allergic to dust mites:

• Use dustproof encasements on your mattress and pillows.
  
• Repair any water or moisture problems in your home.
  
• Run an air conditioner with an allergy-type filter to lower humidity and filter dust particles.
  
• Remove carpeting in your home if you’re highly sensitive to dust mites.

If you’re allergic to pets:

• Remove the animal from the house if possible.
  
• Keep your pet out of the bedroom.

RELATED STORIES:
Epinephrine: Treatment for anaphylaxis   Allergy treatments   Hives and angioedema   Allergy definitions   Anaphylaxis   Antihistamines: One form of allergy relief   Food allergy   Decongestants: One way to relieve allergy symptoms

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