Hay Fever (Allergic Rhinitis)

What Is It?

Hay fever, also known as seasonal allergic rhinitis, is an allergy-related inflammation of the nasal passages, throat and eye membrane (conjunctiva), caused by sensitivity to airborne pollens and molds. These airborne pollens come from various species of trees, grasses, weeds and other plants whose pollens are carried by the wind rather than by insects. Because different types of pollen trigger symptoms in different people, each person's specific hay fever "season" is fairly predictable and is related to times when their allergy-triggering plant is in bloom. For example, for people who are allergic to tree pollens and who live in temperate North America, symptoms usually are worst from March through May, when trees are blossoming. June and July are peak months for people allergic to grasses, while people with ragweed allergies suffer the worst symptoms from mid-August through October. Since molds depend on damp, dark conditions, people who are allergic to molds tend to have the least predictable allergy season. They usually find that their symptoms are more related to warm, rainy weather. In the United States, this means summer and fall are peak times.

Hay fever and its sister ailment, perennial allergic rhinitis (a year-round sensitivity to animal dander, dust mites or cockroaches), are most common in people who have a family history of allergies or a personal history of allergy-related conditions, such as eczema and childhood asthma. Currently, about 20 percent of people in the United States suffer from either seasonal or perennial allergic rhinitis. Although seasonal allergic rhinitis can affect people in all age groups, its symptoms generally peak during childhood and adolescence.

Symptoms

Symptoms of hay fever usually begin before age 30. They typically include some of the following: sneezing, itchy and runny nose; stuffy nose; red, itchy or watery eyes; itchy or sore throat. The congested nose can lead to mouth breathing, and the dripping mucus can cause persistent cough and sore throat. Because hay fever also causes swelling in the sinuses and near the opening of the Eustachian tube (passage that connects the throat to the middle ear), sufferers can develop additional symptoms of secondary sinus infections or ear infections.

Diagnosis

Your doctor will ask you about your symptoms, especially about when and where (outdoors or indoors) they occur. Your doctor also will ask about your family history of allergies and your personal history of allergy-related conditions, including eczema, hives and asthma.

Your doctor will make the diagnosis of hay fever based on your allergy history, the timing and appearance of your symptoms and the results of your physical examination. During your physical examination, your doctor will check for signs of inflammation in your eyes, nose and throat. Typically, the lining of the nose is swollen and pale pink or bluish, though it can be red. The doctor often looks for other signs of allergic rhinitis, such as dark circles under the eyes (called allergic shiners)resulting from chronic sinus congestion, wrinkles under the eyes as a result of chronic puffiness around the eyes, and a crease across the nose from frequently wiping it and pushing it upward.