With longer days and the arrival warmer weather, many of us will be heading outside to make the most of the sunshine.
However, the increase in temperatures also means the pollen count will be higher – causing problems for those of us who suffer from hay fever.
Often those affected will experience sneezing, itchy eyes and a runny nose.
But you don’t have to wait to see your GP to get relief right away.
Independent prescribing clinical pharmacist Farzana Haq, who works in Fife, has shared her top tips on the best ways to manage flare-ups with the early onset of hay fever season.
What is hay fever?
Hay fever is a common allergic condition that affects up to one in five people at some point in their life.
People tend to suffer at different times of the year, depending on which pollen they’re allergic to.
According to the Met Office, pollen season can start as early as January and end as late as November.
In the UK, tree pollen occurs typically from February to mid-May. Meanwhile, grass can lasts from mid-May until August, and weed pollen usually covers August to October.
Ms Haq explains what hay fever sufferers can expect as the days get warmer.
“As temperatures rise, pollen levels, particularly tree and early grass pollen, are expected to increase and this can significantly worsen hay fever symptoms,” she says.
“Tree pollen levels remain high until mid-May, so those sensitive to birch, ash, and oak pollen are particularly at risk currently.
“However, as grass pollen season begins soon, individuals with general hay fever symptoms may also notice an early worsening.
“Sufferers may experience heightened sneezing, nasal congestion, and eye irritation, particularly on warm, dry, and windy days when pollen is at its highest.”
Hay fever symptoms include:
- frequent sneezing
- runny or blocked nose
- itchy, red or watery
- an itchy throat, mouth, nose and ears
How can you treat hay fever?
For most patients the most common treatment is antihistamine tablets.
Ms Haq, who has been a registered pharmacist for 20 years, says people with hay fever should start taking antihistamines now.
“They should start antihistamines early, before symptoms become severe, as this can help reduce the allergic response and prevent worsening symptoms.
“Daily, regular use is advised rather than waiting for symptoms to flare up.
“The oral tablets are all antihistamines that can be split into older or newer ones.
“The older ones are effective but cause drowsiness. The newer ones are non-drowsy.
“Nearly all of these are available over the counter, but this depends on the active drug and its strength as well as the age of the patient.
“In some cases, they will need to be prescribed,” she adds.
What antihistamines are the most effective for symptoms?
Hay fever treatments include antihistamines, steroid nasal sprays, mast-cell stabiliser eyedrops and allergy barrier sprays/balms.
Ms Haq explains which antihistamines are the most effective.
“Piriton is an older antihistamine and while it’s effective, it needs to be taken regularly throughout the day and can cause drowsiness.
“Whereas cetirizine, loratadine and fexofenadine are non-drowsy and are taken once a day so they are long-acting.
“Acrivastine, loratadine and cetirizine are all equally effective. In some patients, Acrivastine results in better symptom control due to three times a day dosing.”
How good is Fexofenadine as a hay fever treatment?
In recent years some hay fever sufferers have hailed Fexofenadine Hydrochloride as a ‘wonder drug‘ in relieving symptoms.
It is now available over-the-counter, after previously only being available to sufferers through prescription from a healthcare professional.
Ms Haq says: “Fexofenadine Hydrochloride is a highly effective non-drowsy antihistamine now available over the counter at 120 mg strength for individuals aged 12 and over.
“It is particularly beneficial for those whose symptoms are not well controlled with other second-generation antihistamines such as loratadine or cetirizine.”
But Ms Haq warns that while it is effective, it can cause a side-effect in some people.
She continues: ” Fexofenadine isn’t brand new but, until late 2020 was only available on prescription.
“It is newer than the 2nd generation antihistamine (loratadine, cetirizine), and It is available in three strengths (30mg, 120mg, 180mg).
“It can, however, cause drowsiness in some people.”
Finding suitable tablets is crucial in controlling symptoms because how a person responds is variable among the differing antihistamines.
And more than one type may have to be tried to provide symptom control.
What products work alongside antihistamines?
Sometimes oral antihistamines are not enough to control all the hay fever symptoms, and other products can be added to take alongside them.
Ms Haq says: “Antihistamines remain a cornerstone of hay fever management.
“But for more persistent nasal symptoms, steroid nasal sprays such as beclometasone or fluticasone are recommended.
“Newer combination therapies, such as sprays combining an antihistamine with a corticosteroid, for example Dymista®, can offer enhanced relief, although these will require a prescription.”
Ms Haq says if nasal symptoms are of particular concern, then steroid nasal sprays can be bought over the counter for those over 18 years of age.
“These contain anti-inflammatory drugs that can help with several nasal symptoms. Regular usage is essential for a full therapeutic effect which can take several days to achieve.
“For eye symptoms eye drops can be bought over the counter. They can stop allergic symptoms such as itchy, red and watery eyes from occurring.”
What can children take to combat hay fever symptoms?
Ms Haq often consults with parents whose children are exhibiting hay fever symptoms for the first time.
Hay fever commonly affects school-aged children, with the average age of onset being 10.
She said: “Piriton liquid can be bought over the counter for children over one.
“Loratadine and cetirizine liquid for over two-year-olds.
“Eye drops are generally recommended for those over six.
“Steroid sprays will have to be prescribed by a clinician if the child is under 18.”
Why do some people get hay fever while others don’t?
Ms Haq explains: “The exact reason why some people get hay fever is unknown but there does appear to be hereditary factors involved.
“So if a parent has it, their child may be more likely to get it. Hay fever is also a recognised risk factor for the development of asthma.”
She adds: “The best way to deal with hay fever symptoms is to avoid pollen where possible.
“The weather can affect the amount of pollen in the air (higher on warm, sunny days and often rises in the evening) so it’s useful to be aware of high the pollen count is.”
Self-care tips for hay fever symptoms
Ms Haq says people can also take other measures to avoid pollen.
“During high pollen periods, people should keep windows and car vents closed, especially during peak times like early morning and evening.
“Using air purifiers indoors and showering and changing clothes after being outdoors, can help reduce pollen exposure.
“Checking daily pollen forecasts can also help people plan activities.”
Ms Haq says drug-free options such as nasal barrier sprays (e.g., containing cellulose powder) can help trap pollen before it enters.
She continues: “Saline nasal sprays can also rinse pollen out of the nose.
“Pollen filters fitted to cars and using HEPA air filters indoors have become increasingly recommended.”
She adds: “And face masks have also shown to reduce taking in airborne pollen, particularly during high pollen days.”
Other measures include:
- Stay inside when pollen count is particularly high
- Avoid cutting grass if affected by grass pollen or walking in areas with high pollen exposure
- Wear wraparound sunglasses
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