Itchy eyes, blocked nose, sneezing, itchy throat – doesn’t take a doctor to diagnose a case of hay fever or “seasonal allergic rhinitis”. It is common and it can really make people’s lives a misery, just when you should be outside enjoying the good weather (what good weather I hear you ask?)
So what is it? Hay fever is an allergy to pollens, and how you are affected depends on which pollens you are allergic to. Here in Luxembourg, surrounded by beautiful forest, we have a lot of tree pollens so many people’s allergies start early in the year, around March. The tree pollens are followed by grass pollens in May to august, then later on, in the autumn, the pollens from weeds such as nettles and fungal spores make an appearance. If you are really unlucky, and allergic to several different types of pollen, you may be symptom free for only a few months of the year.
The symptoms I described above are the commonest, along with red, watery and possibly swollen eyes, a nose that is constantly streaming, and for some sufferers, a flare up in symptoms of asthma. Hay fever often becomes apparent for the first time in children or teenagers, but you can develop it at any age.
How is it diagnosed? Normally it is fairly obvious and no special testing is needed. However if you have a background of nasal problems it may be less clear. Some people like to know exactly which pollens they are allergic to, and often you can tell this by looking at the months when your symptoms are strongest. However, it is also possible to do allergy testing, either by blood tests looking for specific antibodies to the pollens, or by skin prick testing.
You might imagine that hay fever would always be worse in the country, but actually people often suffer equally or sometimes more in the city. Pollution from buses, cars and lorries means that the diesel particles carry the pollen deeper in to the airways causing worse symptoms.
There are lots of practical measures you can take to minimize your hay fever symptoms. On hot sunny days the pollen count is higher than cold wet days. There are certain times of the day when pollen counts are higher too; first thing in the morning and early evening. So if you are a sufferer, try to avoid being outside at the times of highest pollen count. If you do venture out, wear wrap around sunglasses, and put a little Vaseline just inside your nostrils to trap the pollen particles before they go right inside your nose.
If you have been outside, have a shower and wash your hair before you go to bed, thereby avoiding leaving pollen all over your pillow. Try to avoid hanging your washing outside to dry, and if you have a furry pet, try to keep them inside when pollen counts are highest or give them a regular shower as well! Hoover regularly and use a wet cloth to clean surfaces rather than a duster.
Keep your bedroom windows closed as much as you can, and use the air conditioning in your car rather than opening a window, as most cars have filters that will stop the pollen particles coming inside the car.
It may sound obvious, but if you are allergic to grass pollens, get somebody else to mow your lawn for you (surprising the number of people who don’t think of that) and avoid sitting around on the grass.
At the pharmacy
But if all that fails and you continue to suffer, do not despair as your pharmacy or doctor will have plenty to offer you. For the mildest of symptoms, a simple non-sedating anti-histamine tablet taken as needed will usually suffice. If symptoms are more troublesome, you should take the antihistamine every day, ideally starting 1-2 weeks before the pollen levels rise.
That would also be the time to start your steroid nasal spray; these need to be taken every day, symptoms or not, in order to be effective. The steroid nasal sprays are also safe in pregnancy and so can be a life saver when you are not allowed to take your normal antihistamine tablet. They work by calming down the inflammation inside your nose and are often more effective for really blocked noses. Finally antihistamine eye drops taken as needed can also be useful.
For those with really bad hay fever or some important event coming up like exams or a wedding, we will sometimes use steroid tablets or even a steroid injection; this is a last resort though because of the systemic side effects of higher dose steroid therapy.
More recently, immunotherapy is becoming more popular. This involves the introduction of tiny amounts of the allergen (pollen) either by injection or by drops or a small tablet which you place under your tongue. This is always started in an environment with resuscitation equipment on hand incase you have a major allergic reaction, and the injections are always done in a medical centre or hospital, but the tablets or drops can be continued at home. The treatment does need to continue for many months or years, requiring regular doctors visits, so is not for everyone.
For an interesting insight into pollen counts in Luxembourg, check out the pollen.lu website. It lists the pollen levels for all the different trees and common allergens and could easily help you work out exactly what is making you sneeze.
By Susie Tunstall-Pedoe, May 2013