Hayfever is thought to affect 20 percent of the population in the UK, with 80 percent of people diagnosed before they're 20. There's lots you can do to manage your hayfever and you can also use medicines to help you control your symptoms.

What is hayfever?

Hayfever is an allergic reaction to pollen produced by trees and grasses, causing inflammation of the lining of the nose. The allergic reaction is driven by histamine, a chemical produced by the body.

Pollen is a fine dust that disperses effortlessly in the wind to reach other plants for pollination and start new plants. It tends to be more prevalent in certain months of the year. Tree pollen counts are highest between late March and mid-May, while grass and weed pollen counts are highest between mid-May and September. You're most likely to get symptoms when the pollen count is high.

Why should I treat hayfever?

Typical symptoms of hayfever include sneezing, a blocked or runny nose, and itching of the nose, eyes, throat and ears. You may also get a dry irritating cough. 

Although symptoms are usually not serious, untreated or uncontrolled hayfever can disrupt your sleep and concentration.

Hayfever is sometimes found alongside asthma, which is a long-term condition affecting the airways of the lungs. If you have hayfever, you're more likely to have other conditions in the same group, which consists of eczema and asthma. If you do happen to have asthma, uncontrolled hayfever will often worsen asthma symptoms. 

Treatment is based on two principles:

• Avoiding exposure to pollen

• Decreasing histamine levels in the body by using medicines

What can I do to manage my symptoms?

Even when pollen counts are high, there are many ways you can limit your exposure to pollen, such as:  

• Check the pollen counts

• Avoid going outside and keep windows shut

• Don't keep fresh flowers in the house

• Vacuum and dust with a damp cloth regularly

• If possible, delegate mowing lawns and raking leaves to others who don't suffer from hayfever

• Consider buying an air filter for pollen. Some filters can be used in the car

• Wipe any pets that have been outdoors with a damp microfibre cloth before allowing them in, as pets often carry pollen grains on their coats

• Don't dry clothes outside

If you must go outside when counts are high, you can do the following things:

• Apply a barrier balm, like Vaseline, around your nose to trap pollen

• Wear wraparound sunglasses to avoid pollen getting into your eyes

• Change your clothes as soon as you come indoors. It's best to take a shower and wash your hair too, as pollen is difficult to remove unless it's wet

Pollen counts tend to be lower on rainy days, although not if there's thunder.

Which medicines can I use?

If you're still getting symptoms after taking steps to reduce your exposure to pollen, speak to your pharmacist who'll be able to advise you on suitable over-the-counter medicines. There are different categories of medicines that can be used in hayfever.

Antihistamines

Antihistamines often manage mild hayfever symptoms well by blocking the allergic response. These are available over-the-counter as tablets and liquids. Nasal sprays are only available on prescription. Antihistamines can be taken when needed to manage mild symptoms, or regularly if symptoms are present every day. Antihistamines include cetirizine, loratadine and acrivastine. These shouldn't cause drowsiness, although this can occasionally happen to some people. Older antihistamines, such as chlorphenamine, can make some people drowsy, so you may prefer to take them in the evening, especially if your allergy symptoms are worst at night or interrupt your sleep. Ask your pharmacist if you're unsure which ones to take or when to take them. If you become drowsy after taking antihistamines, you should avoid driving or using machines.

Steroid nasal sprays

Steroids, also known as corticosteroids, nasal sprays, help with nasal symptoms of hayfever, such as sneezing and a blocked, stuffy or runny nose. They work by helping to reduce inflammation. They need to be taken regularly and may take three to four days to notice an improvement. Some steroid nasal sprays are available over-the-counter from your pharmacist. If you find that you're still getting symptoms, see your GP as you may need prescription medication.

Decongestants

If you have a blocked nose, then a decongestant nasal spray can help. It usually works quite quickly and should only be used for the short term. In fact, decongestants shouldn’t be used for longer than seven days, as they can cause rebound congestion. Decongestants aren't suitable for everyone. Ask your pharmacist if you're unsure whether you should take them. For example, you should avoid using decongestants if you suffer from high blood pressure or if you're pregnant.

Treating eye symptoms

Steroid and antihistamine nasal sprays usually manage eye symptoms quite well, but you can also consider using eye drops. Cromoglicate eye drops are available over-the-counter and can be effective in managing hayfever eye symptoms. Avoid wearing contact lenses when using these eye drops.

How can I manage my hayfever if I'm pregnant?

Most hayfever medicines aren't suitable to use when you're pregnant, so it's particularly important to carry out lifestyle measures. 

If you find that you're still getting symptoms, speak to your midwife or GP for more help.

When should I see my GP?

If your symptoms are getting worse, or are poorly controlled after carrying out lifestyle changes and taking over-the-counter medicines, make an appointment with your GP.

What is immunotherapy?

Sometimes, in spite of using medicines and doing your best to avoid exposure to pollen, hayfever symptoms remain severe. At this point, your GP may send you for further tests and review by an immunologist or allergy specialist who may consider giving you immunotherapy.

Before you start immunotherapy, you'll need to undergo blood tests or a skin prick test to identify which type of pollen is causing your symptoms. You'll then be exposed to small amounts of this pollen either as a daily tablet that's placed under the tongue, or as injections at regular intervals.

This treatment is quite expensive and needs to be carried out for at least three years. However, it is usually successful for severe allergies. 

Next steps

• Actively manage any hayfever symptoms you may be having as this will help you achieve a better quality of life

• Avoid exposure to pollen by staying inside if possible and check pollen counts regularly

• Ask your pharmacist for medicines that help manage hayfever if your symptoms are still bothersome