Hay fever or allergic rhinitis is an allergic condition that affects people across the world. It is estimated that the condition affects around 30% of the global population with the resultant costs in health care and medication running into billions of dollars. Moreover, experts regard most figures on hay fever as being underestimates as in many cases the condition goes undiagnosed with people attributing the symptoms like nasal congestion
and hay fever cough to a chronic cold.
The condition took its name because of the prevalence of symptoms of hay fever like sneezing, nasal congestion and eye irritation during the seasons in which hay was traditionally harvested, but the condition has no connection to hay itself. It is most likely that seasonal changes that ushered in the harvest also increased levels of allergens like pollen, resulting in the symptoms. Allergic rhinitis or hay fever isn’t just caused by pollen present in hay producing regions, however, and the symptoms could occur as a result of exposure to other various allergens. When the condition is represented with seasonal flare-up of symptoms it is called seasonal allergic rhinitis, but it can also affect other individuals throughout the year. In the case of year round symptoms it is called perennial allergic rhinitis.
Hay fever can affect individuals of any age group but it tends to be more prevalent among children. The condition is more likely to develop after years of sustained exposure to the allergens. The incidence of hay fever was rather low in India in the past, but has begun to see a dramatic increase. In the past the condition, like most allergies, was most prevalent in the developed world where cases of hay fever also continue to rise.
What Causes Hay Fever?
Hay fever is an allergic condition, which means that it occurs as a result of exposure to an allergen. In any allergic condition the body perceives certain nonthreatening substances as a threat and it reacts accordingly, or rather overreacts. An allergen, for example pollen, is any substance that causes the immune system to mount an inappropriate inflammatory response. If you suffer from hay fever it means that your body’s immune system reacts to pollen the way it would if it were faced with a viral or other infection. The immune system triggers the production of certain chemicals and antibodies to fight the perceived threat and this results in the symptoms of hay fever.
Although the exact causes of this immune response are not clearly understood there are certain conditions that could increase your risk of hay fever:
- The presence of other allergic conditions like eczema or the presence of asthma.
- Genetic predisposition with a family history of the condition.
- Exposure to tobacco smoke early in childhood.
What are the Symptoms and Signs of Hay Fever?
Symptoms can vary significantly among different individuals, with some experiencing mild symptoms that are sporadic while others may have severe symptoms that are persistent. Common symptoms include:
- Running nose and nasal congestion
- Sneezing and blocked nose
- Itching and watering of the eyes
- Soreness of the throat
- Sinus problems with facial pain
Symptoms like the loss of smell are less common and there are also instances where only the eyes are affected. In patients who suffer from asthma, symptoms like wheezing and breathlessness can become a lot more severe. Some asthmatics may only suffer from symptoms of asthma during the hay fever season and there is also an increased risk of individuals who suffer from hay fever eventually developing asthma
In severe cases, the symptoms could be so bad as to interfere with regular activities and performance because of the effects on sleep.
How to Diagnose Hay Fever?
A hay fever diagnosis is not complicated and most doctors will be able to make a diagnosis simply based on your symptoms. It is important that you provide your doctor with all information regarding the symptoms and family history of hay fever. If there is any suspicion of hay fever, medications are usually prescribed to treat the symptoms and if there is a favorable response it helps confirm the diagnosis.
In some cases it may be harder to arrive at a diagnosis and under such circumstances doctors may recommend blood or skin tests to confirm or rule out the presence of a pollen allergy
If there is a possibility that some other conditions may be responsible for the symptoms, such as a mechanically restricted or obstructed airway, then further tests and imaging scans may also be needed to check the airflow through the nostrils, mouth and lungs.
What are the Treatments for Hay Fever?
Hay fever can be treated with a wide variety of medications and these could vary greatly depending on the symptoms. Treatments that are commonly used to treat hay fever include the following:Corticosteroid sprays –
Intranasal corticosteroid sprays that contain low-dose steroids are often recommended as a treatment for hay fever and can be extremely effective. These nasal sprays need to be used fairly regularly, so make sure you use these nasal sprays as per the recommendations of your doctor.Antihistamine Medications –
Non-sedative antihistamine medications can be helpful and may provide relief from sneezing and nasal congestion but are not as effective as nasal sprays. Inform your doctor if you are breastfeeding as some of these medications may cause irritability and restlessness in your baby.Eye drops –
Irritation of the eyes or watering can be relieved with certain eye drops. In cases where this is the only symptom you may not even require medical care but can simply ask your pharmacist or doctor for help choosing the appropriate eye drops.Decongestant nasal sprays –
Exercise caution when using decongestant nasal sprays. They can provide quick relief, but prolonged usage can cause damage to the nasal lining. It is also advisable to avoid the use of these nasal sprays during pregnancy or if suffering from hypertension. Allergen immunotherapy
– In immunotherapy
the patient is subjected to controlled exposure to the allergen, in gradually increasing amounts. This has been found to improve tolerance to the allergen and can bring about significant reduction in symptoms. Depending on the severity of your condition this treatment can pose certain risks, which is why it needs to be conducted under strict medical supervision.
What are the Natural Remedies for Hay Fever?
There is little supporting evidence for most alternative treatments and home remedies for hay fever, but some patients claim to get relief from such treatment. Certain herbal remedies like butterbur extract may help to prevent some of the symptoms of hay fever. Some studies suggest that spirulina and Tinospora cordifolia could help in the treatment of hay fever but most findings are inconclusive and there is inadequate data. Probiotics
may also help in the treatment of hay fever with some studies suggesting that probiotic supplementation can help to both prevent and treat hay fever, but this depends on several factors, such as the strain of bacterium and the timing of supplementation among others. A study published in 2004 also found that acupuncture and chinese herbal medicine can serve as an effective and safe therapeutic approach to the treatment of hay fever.
How to Prevent Hay Fever?
The most effective method of prevention is to avoid any exposure to allergens or to at least minimize the exposure to allergens. This easier said than done however. Here are some tips to help prevent hay fever:
- Keep track of the local pollen count and if higher than 50 try to avoid going outdoors.
- As unpleasant as it may seem, try to keep windows and doors shut in your house.
- Avoid keeping fresh flowers in your house.
- Avoid areas with smokers and do not allow anyone to smoke in your house.
- If your pets spend time outdoors, don’t allow them in during hay fever season or make sure that they are bathed as soon as they come indoors to avoid tracking any pollen.
- Vacuum your house regularly, using a HEPA filter device.
- Dust furniture regularly, but stick to damp dusting, using a wet cloth to avoid dispersing dust and pollen around.
When venturing outdoors during hay fever season make sure to take these precautions:
- Avoid mowing your lawn yourself and try to stay away from areas with dense vegetation and grassy patches. This is especially important at times when the pollen count is at its highest such as during the night and early in the morning and early evening.
- To prevent pollen from entering your eyes try to use wraparound sunglasses.
- When travelling, make sure that all windows are sealed and install a pollen filter in your car’s air vents.
- Apply a small amount of vapo-rub along the inside of the nostril as this should help to filter out some of the pollen.