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Hay Fever

What is hay fever?

Hay fever (also known as allergic rhinitis) is an allergic reaction of the nose, throat and eyes to irritating particles in the air. It is similar to asthma, except that the oversensitive (allergic) reaction occurs in the upper respiratory tract instead of the lungs.

There are two types of allergic rhinitis:

• seasonal rhinitis, which occurs only during certain seasons, usually spring
• perennial rhinitis, which is present throughout the year

What are the symptoms?

Symptoms are sneezing, running and itching nose, itching dry throat and itching eyes.

What is the cause?

The airborne irritants, also known as allergens, enter the nose, throat and eyes and cause sensitive cells (mast cells) to become active (rather like a dormant volcano erupting). These cells release a substance called histamine, which causes the symptoms.

What are the allergens?

The allergens are either foreign proteins (tiny invisible particles from plants and animals) or chemicals. They include:

• pollens from trees (in spring) and grass (in summer)
• house dust mites (cause perennial rhinitis)
• mould
• hair, fur or feathers (from cats, dogs, horses or birds)
• some foods (such as milk, eggs, peanuts and peanut butter)

Many people do not know what they are allergic to.

Do any other things aggravate hay fever?

• Chemicals such as smoke, paints and sprays, cosmetics and aspirin can make hay fever worse.
• Emotional upset, fatigue, alcohol, chilly damp weather and air-conditioning can aggravate it also.

Is it inherited?

• It does tend to be hereditary.
• Children whose parents are allergic have an increased chance of getting hay fever.
• It is a common disorder, and people can grow into it and out of it at any age.

What are the risks?

Hay fever is not a serious disease but, if not treated, it can lead to asthma, nasal polyps and hearing problems.

Can hay fever be cured?

No, but modern treatment can control the problems and relieve the symptoms. People do not have to suffer with it and should contact their doctor if it is troublesome. Hay fever can be so mild that some people do not realise they have it; and some people seem to grow out of it.

What is the treatment?

Self-help

1. Keep healthy, eat a well-balanced diet, avoid 'junk food' and live sensibly with balanced exercise, rest and recreation. If your eyes give you problems, try not to rub them, avoid contact lenses and wear sunglasses.
2. Avoid using decongestant nose drops and sprays: although they soothe at first, a worse effect occurs on the rebound.

Avoidance therapy

• Avoid the allergen, if you know what it is. (Consider pets, feather pillows and eiderdowns.)
• Sources of the house dust mite are bedding, upholstered furniture, fluffy toys and carpets. Seek advice about keeping your bedroom or home dust-free, especially if you have perennial rhinitis.
• Pets, especially cats, should be kept outside.
• Avoid chemical irritants such as aspirin, smoke, cosmetics, paints and sprays.

Medical help

Your doctor has many treatments available, ranging from antihistamine pills to desensitisation (after skin testing reveals your allergens). The newer antihistamine pills do not cause as much drowsiness as did the older ones. Sprays for the nose and drops for the eyes, available by prescription, are very effective.

Copyright 1995: John Murtagh, Professor of General Practice
Monash University, Melbourne, Australia