Hay Fever: A Guide To Symptoms, Triggers & Treatments 

What is hay fever?

Hay fever is a seasonal allergic reaction to pollen. It occurs when fine powder from plants comes into contact with your mouth, nose, eyes, and throat. According to the NHS, it is one of the most common allergies in the UK.

Immune system reaction to pollen

When you have hay fever, your immune system mistakenly identifies harmless pollen as a threat. To protect your body, your immune system produces antibodies, which when you come into contact with pollen again, signals your cells to release chemicals, including histamine. This release of these chemicals, including histamine, is what directly causes the inflammation, swelling, and irritation in your nasal passages and eyes.

Seasonal vs. perennial allergic rhinitis

Medical professionals divide allergic rhinitis into two main categories based on timing and triggers, although the underlying allergic response is identical.

Hay fever vs. the common cold

Because they both cause a runny nose and sneezing, it is easy to confuse hay fever with a common cold. However, they require different treatments. The easiest way to tell them apart is to look at the timeline and the presence of itchiness. Colds develop gradually and pass within a week or two, whereas hay fever starts suddenly when pollen counts are high and lasts for weeks or months.

Main hay fever triggers in the UK

The main hay fever triggers in the UK are tree, grass, and weed pollens, which are released at different times throughout the year. Understanding which season affects you most can help you start your preventative treatments at the right time.

UK pollen seasons

In the UK, the pollen calendar is split into three main, overlapping seasons. Because these three seasons overlap, you might experience a peak in symptoms at a very specific time of year, or you may find your symptoms linger from March right through to September if you are allergic to multiple types of pollen.

According to the Met Office, most people with hay fever are allergic to grass pollen, while tree pollen affects around 25% of people with hay fever.

How to treat hay fever

There is no cure for hay fever, but most people can control their symptoms by reducing their exposure to pollen where possible and using the right treatment. The right treatment depends on what sympsomt bother you most and how severe they are. Many people start with pharmacy treatments and move to prescription options if their symptoms are not controlled. In our virtual GP consultations, we often support patients to optimise their hayfever treatment in a way that will achieve the best relief according to their symptoms.

Step 1: Minimise pollen exposure

Where possible, try to reduce the amount of pollen you’re exposed to. Practical self-help measures and environmental considerations can make a noticeable difference to your daily comfort.

• Monitor daily pollen forecasts and stay indoors when the pollen count is high. Rain washes pollen from the air so counts should be lower on cooler, wet days.
• Keep your doors and windows closed at home and when driving.
• Wear wraparound sunglasses to stop pollen from blowing into your eyes.
• Shower and change your clothes after you have been outdoors to remove trapped pollen.
• Avoid drying your washing outside, as pollen can cling to towels and clothing.
• Vacuum regularly and dust with a damp cloth.
• Consider a pollen filter in the air vents of your car, if you have one, and a HEPA filter in your vacuum cleaner.
• Apply an allergen barrier balm, such as petroleum jelly (vaseline), around the edge of each nostril to trap or block pollens and other allergens and help prevent a reaction.

Step 2: Try over-the-counter pharmacy treatments

If avoiding pollen is not enough, the next step is to speak to a pharmacist. The first line of medical treatment is usually a non-drowsy antihistamine tablet or syrup. This aligns with the NHS approach to managing common, mild conditions through pharmacy care first. A pharmacist can recommend the most appropriate antihistamine to block the allergic reaction before it takes hold.

Step 3: Consider a steroid nasal spray

If your main symptom is a blocked nose, or if antihistamine tablets alone are not providing enough relief, a corticosteroid nasal spray may be the best first choice or the next logical step. Low-dose steroid sprays reduce inflammation inside the nasal passages. They are highly effective, but they do not work straight away, it may take a few days, and sometimes up to 2 weeks of regular use to feel the full benefit.

Step 4: When to see a GP

You should book an appointment with a GP if yoursymptoms are getting worse, are affecting your sleep or daily routine, or have not improved after a couple of weeks of using pharmacy treatments regularly. You should also speak to a GP or pharmacist if you experience side effects from OTC medicines.. Always speak to a GP or pharmacist before taking hay fever medicines if you are pregnant or breastfeeding, the medicine is for a child, or you have other health conditions or take other medicines. Our online cliniciansregularly help patients evaluate their current treatments and adjust their care plans.

You may need to see a GP or your asthma nurse in person if pollen is making your asthma worse. You should also speak to a GP if you have symptoms that aren't typical of hay fever, such as a blocked nose on one side only, nosebleeds, or severe or one-sided facial pain.

Key differences

Common mistakes when managing hay fever

The most common mistakes when managing hay fever are starting treatment too late in the season, using nasal sprays incorrectly, and stopping treatment as soon as symptoms ease. Even with the right medication, it is easy to make simple errors that reduce the effectiveness of your treatment.

Starting treatment too late

Many people wait until they are actively sneezing before they buy their medication. Starting treatment before your pollen season begins and using it regularly can help keep symptoms under control. This is especially important for steroid nasal sprays and sodium cromoglicate eye drops, which do not work straight away and can take days to weeks to reach their full effect. The NHS advises starting a steroid nasal spray at least 2 weeks before your hay fever season usually begins. .

Using nasal sprays incorrectly

Incorrect technique is a major reason why nasal sprays fail to work. Many people tilt their head back and sniff the spray forcefully up the centre of their nose. This causes the medicine to run down the back of the throat, instead of staying in your nose. Instead:

1. Blow your nose gently.
2. Bend your head forward slightly and keep the bottle upright.
3. Close one nostril with your finger and put the nozzle into the other nostril, aiming it slightly away from the centre of your nose (the septum).
4. Breathe in slowly through your nose as you press the spray.
5. Breathe out through your mouth, then repeat in the other nostril if needed.

Stopping treatment too soon

It is tempting to stop taking your medication on a rainy day when the pollen count drops, or as soon as you feel better. Hay fever medication should ideally be taken continuously throughout the pollen season. Stopping and starting allows the symptoms to return, making it harder to get your symptoms back under control. You can learn more about taking your medicines correctly to ensure you get the maximum benefit from your treatment.