What Is Hay Fever? What Are The 

Symptoms Of Hay Fever?

Hay fever (or hayfever), also known as allergic rhinitis, is a common condition that shows signs and 

symptoms similar to a cold with sneezing, congestion, runny nose and sinus pressures. 

This article is about allergic rhinitis. You can read about non-allergic rhinitis here.Hay fever is caused by an allergic response to airborne substances, such as pollen - unlike a cold which is caused by a virus. The time of year in which you get hay fever depends on what airborne substance you are 

allergic to. Despite its name, hay fever does not mean that the person is allergic to hay and has a fever. Hay is hardly ever an allergen, and hay fever does not cause fever. 

Although hay fever and allergic rhinitis have the same meaning, most lay people refer to hay fever only 

when talking about an allergic reaction to pollen or airborne allergens from plants or fungi, and understand allergic rhinitis as an allergy to airborne particles, such as pollen, dust mites or pet dander which affect the nose, and maybe the eyes and sinuses as well. 

The rest of this article focuses on hay fever caused by pollen and other airborne allergens that come fromplants or fungi. Hay fever caused by pollen is also known as pollinosis.

Some people are only mildly affected by hay fever and rarely reach a point where they decide to seek medical advice. However, for many, symptoms may be so severe and persistent that they are unable to carry out their daily tasks at home, work or at school properly - these people will require treatment. Treatments may not get rid of the symptoms altogether, but they usually lessen them and make it easier to cope. 

As with other allergies, the symptoms 

are a result of your immune system 

mistaking a harmless substance as a 

harmful one, and releasing chemicals 

that cause the symptoms. 

It is estimated that about 20% of 

people in Western Europe and North 

America suffer from some degree of 

hay fever. Although hay fever can 

start affecting people at any age, it 

generally develops during childhood 

or perhaps early adulthood. The 

majority of hay fever sufferers find 

their symptoms become less severe as 

they get older.

What are the symptoms of hay fever?

Symptoms of hay fever may start at 

different times of year, it depends 

on what substance the patient is 

allergic to. If a person is allergic 

to a common pollen, then when the 

pollen count is higher his symptoms 

will be more severe. 

Common symptoms include:

Sneezing

Watery eyes

Itchy throat

Itchy nose

Blocked/runny nose

Severe symptoms may include:

Sweats

Headaches

Loss of smell and taste

Facial pain caused by blocked sinuses

Itchiness spreads from the throat, to 

the nose and ears

Sometimes hay fever symptoms can lead 

to:

Tiredness (fatigue)

Irritability

Insomnia

People with asthma may find that when 

hay fever symptoms emerge their 

wheezing and episodes of 

breathlessness become more severe. A 

significant number of people only 

have asthma symptoms when they have 

hay fever.

What are the causes of hay fever?

Hay fever occurs when the immune 

system mistakes a harmless airborne 

substance as a threat. As your body 

thinks the substance is harmful it 

produces an antibody called 

immunoglobulin E to attack it. It 

then releases the chemical histamine 

which causes the symptoms. 

There are seasonal hay fever triggers 

which include pollen and spores that 

will only cause symptoms during 

certain months of the year. 

The following are some examples of 

hay fever triggers:

Tree pollen - these tend to affect 

people in the spring.

Grass pollen - these tend to affect 

people later on in the spring and 

also in the summer.

Weed pollen - these are more common 

during autumn (fall).

Fungi and mold spores - these are 

more common when the weather is warm.

What are the risk factors for hay 

fever?

A risk factor is something that 

increases a person's chances of 

developing a disease or condition. 

Below are some risk factors for hay 

fever:

Family history (inheritance, 

genetics) - if you have a close 

family member who has/had hay fever, 

your risk of developing it yourself 

is higher. There is also a slightly 

higher risk if a close family member 

has any type of allergy.

Other allergies - people with other 

allergies are more likely to suffer 

from hay fever as well.

Asthma - a significant number of 

people with asthma also have hay 

fever.

Gender and age - hay fever affects 

more young males than young females. 

Before adolescence, twice as many 

boys as girls have hay fever. 

However, after adolescence many boys 

outgrow it and slightly more girls 

than boys are affected.

Birth date - people born during the 

high pollen season have a slightly 

higher risk of developing hay fever 

than other people.

Second-hand smoke - infants and babies who are regularly exposed to cigarette smoke during their first years of life are more likely to develop hay fever than babies who 

aren't.Being the first child - a higher percentage of firstborn children eventually develop hay fever, compared to other people.

Babies from smaller families - a higher proportion of babies with no siblings, or just one sibling develop hay fever later on compared to babies to larger families.

Babies born to high income families - babies born to families with a high standard of living have a higher risk of developing hay fever later on, compared to other babies Experts believe that the last three isk factors are linked to childhood infections. If a baby and/or small child has had fewer infections, there is a greater risk of autoimmune problems.

How is hay fever diagnosed?Generally, doctors can make a diagnosis based on the symptoms, which are usually fairly obvious. The doctor will also ask questions about the patient's personal and family medical history, and how signs and symptoms have been dealt with so far. 

A blood or skin test can be followed up to identify which substance(s) the patient is allergic to.

Skin test - the skin is pricked with a minute amount of a known allergen (substance that some people are allergic to). The amount of IgE antibodies (immunoglobulin E) is measured. IgE antibodies are produced in high amounts if a person has an allergy to something.

Blood test - the test simply measures the level of IgE antibody in the blood. If it is zero there is no sensitivity, whereas 6 indicates very high sensitivity.

What are the treatment options for hay feverThere is a vast array of OTC (over-the-counter) and prescription medications for treating hay fever symptoms. Some patients may find that a combination of two or three medications works much better than just one. It is important for parents to remember that some hay fever medications are just for adults. If you are not sure, talk to a qualified pharmacist, or ask your doctor. 

Medications include:

Antihistamine sprays or tablets - these are commonly available over the counter. The medication stops the release of the chemical histamine. 

They usually effectively relieve symptoms of runny nose, itching and sneezing. However, if your nose is blocked they don't work. 

Newer antihistamines are less likely to cause drowsiness than older ones - but older ones are just as effective. 

Examples of OTC antihistamines include loratadine (Claritin, Alavert) and cetirizine (Zyrtec). 

Examples of prescription antihistamines include Fexofenadine (Allegra) and the nasal spray azelastine (Astelin). Azelastine starts working very rapidly and can be used up to 8 times a day - however, it can cause drowsiness and leave a bad taste in the mouth after 

use.

Eye Drops - these reduce itching and swelling in the eyes and are usually used alongside other medications. Eye drops containing cromoglycate are commonly used.

Nasal Corticosteroids - These sprays treat the inflammation caused by hay fever, and are a safe and very effective long-term treatment. 

Examples include fluticasone (Flonase), fluticasone (Veramyst), mometasone (Nasonex) and beclomethasone (Beconase). Most patients may have to wait about a week before experiencing any significant benefits. Some patients may notice an unpleasant smell or taste, and have nose irritation.

Oral corticosteroids - for very severe hay fever symptoms the doctormay prescribe prednisone in pill form. They should be prescribed only for short-term use, because of their long-term link to cataracts, muscle weakness and osteoporosis.

Desensitization treatment (immunotherapy) - this treatment used to be more common in the UK, but is now very rarely used and is not used at all in the USA, because it can cause some very strong reactions. 

Increasing amounts of the allergen are introduced into the patient. This treatment is only done in very specialized centers for patients with severe symptoms.

Alternative therapies - some alternative therapies claim to treat hay fever effectively. A study published in The Medical Journal of Australia carried out by researchers at the University of Melbourne, suggested that acupuncture is effective in the symptomatic treatment of persistent allergic rhinitis. (MJA 2007; 187 (6): 337-341).

It is important to remember that although some patients do report benefits from alternative therapies, a lot of information one reads in books and on the internet is anecdotal. For therapy to be convincing, it should undergo proper clinical tests which are either compared to a placebo (dummy treatment) or some treatment known to be effective. Before undergoing any complementary/alternative therapy, check it out carefully.