Green Light Pharmacy Blog

May 2007: Hayfever

Hayfever, or seasonal allergic rhinitis, is an over reaction to external stimuli or allergens which are normally harmless - the most common being pollen (hence it's prevalence in spring) from plants and trees like Silver Birch, Ash, Oak and London Plane, or more commonly in the UK - grass (around mid-summer), weeds like nettles, dock and wild flowers (Late Summer and Autumn) and even mould spores (more so in winter) - The Pollen Calendar.

Therefore it is much like asthma and eczema, and indeed they all run in families and members may have one or more of the three. In hayfever the reaction that results is an irritation and inflammation of things like the nose, throat, lungs and eyes due to the release of histamine by the body.

When the pollen or allergen hits the eyes/nose it over-reacts, setting off a series of reactions that release histamine, leading to symptoms such as sneezing, runny nose of thin watery mucus, red and itchy eyes, and maybe an itchy throat. There may also be a wheezy chest. The symptoms do vary from person to person - one person may just sneeze a lot and not have their eyes affected, while in another person the reverse is true.

It affects about 20 % of the population in Britain or 12 million people, mainly being caused by grasses in the UK from May to August, later in the north.

It's unusual for kids under 2 years to get it, more commonly 11 to 12 years are the likely age group and a quarter of 13 to 21 year old's suffer. Symptoms usually peak at between 20 and 40 years of age and then decrease as one gets older. It has been reported that children who are born around a hayfever season are more likely to get hayfever in later life. The National Pollen Research Unit advises parents to keep newborns away from high pollen concentrations in the first year of a baby's life to reduce the chances of developing hayfever in later life.

Treatment

The most common treatment is anti-histamines tablets/syrup, which as the name suggests counteracts the histamine released by the body in response to the allergic trigger.
There are two sorts of anti-histamines, the older generation which cause drowsiness and hence not suitable if driving or operating machinery, or need concentration at work or school. The newer generation are less likely to cause drowsiness and normally only need to be taken once a day, like loratadine and cetirizine.
Antihistamines will usually help runny nose, itchy or watery eyes but not a blocked up nose.

Next there are steroid nasal sprays which reduce or dampen-down the local inflammatory response building up in the nose. They need to be used regularly (during the hayfever season) for maximum effect, and may take a few days to start working initially (so preferably start a few days or a week before the expected season). They are very safe.
Also there are Antihistamine sprays which usually provide fast effective 'when required' relief, but should only be used short term.

Finally there are also eye drops which also reduce the local inflammatory response in the eyes, if only they are affected.

Some people can be effectively treated with just one of the above product types, while other may need a combination eg an anti-histamine tablet and a nasal spray.

Prevention

Is the best cure .... so avoid allergens by:

  • Staying inside and keep windows and doors closed between 5pm and 7pm and mid-morning, when pollen counts are usually high in summer.
  • Apply a thin layer of Vaseline just inside the nostrils to trap pollen before it gets inhaled.
  • Wear sunglasses or glasses to reduce the frequency of pollen hitting the eyes.
  • Dry washing outside at night or indoors to avoid bringing pollen stuck to clothing indoors.
  • Wash hands and hair more frequently to carry less of the offending pollen around with you.
  • Use an air/dust/allergen filter if possible (especially office air-conditioning, car and bedroom) to remove allergens from the air.
  • Dust with a damp cloth to trap dust, and vacuum (with filters attached to prevent allergens being recirculated) your home regularly, to reduce pollen and dust in the air.
  • Listen out for the pollen count on TV/radio and avoid areas of high pollen concentration, eg long grass, a particular tree and it's pollen, or whatever your allergen is.

Pollen Calendar

  • Feb- March: Willow, Alder, Hazel, Elm.
  • Apr-May: Birch, Chestnut, Rape seed, grasses.
  • June-July: Grasses, Nettles, Dock, Mugwort.
  • Aug-Sept: Grasses, Dock, Nettles, fungal spores and moulds.