Dealing with hay fever
SYMPTOMS: RUNNY NOSE, ITCHY EYES, CONGESTION, SNEEZING, HEADACHE AND SINUS PRESSURE
It can affect your performance at work and school and interfere with your life.
Hay fever is an illness that causes cold-like signs and symptoms, such as a runny nose, itchy eyes, congestion, sneezing and headache and sinus pressure. But unlike a cold, hay fever is not caused by a virus.
Hay fever is caused by an allergic response to outdoor or indoor allergens, such as pollen, dust mites or tiny flecks of skin and saliva shed by cats, dogs and other animals with fur or feathers.
It can affect your performance at work or school and generally interfere with your life.
To manage it one has to learn to avoid triggers and find the right treatment. The best thing to do is lessen your exposure to allergens that cause your symptoms.
Take allergy medications before you’re exposed to allergens, as directed by your doctor.
SYMPTOMS Hay fever signs and symptoms can include:
Runny nose and nasal congestion. Watery, itchy, red eyes. Sneezing. Cough. Itchy nose, roof of mouth or throat. Swollen, blue-coloured skin under the eyes. Postnasal drip. Fatigue.
Signs and symptoms may start or worsen at a particular time of year. Triggers include:
Tree pollen, which is common in early spring.
Grass pollen, which is common in late spring and summer.
Ragweed pollen, which is common in fall.
Dust mites, cockroaches and dander from pets can occur yearround (perennial). Symptoms to indoor allergens might worsen in winter, when houses are closed up.
Spoors from indoor and outdoor fungi and moulds are considered both seasonal and perennial.
It may be difficult to tell whether you have common cold or hay fever since the signs and symptoms can be similar.
Hay fever normally presents with runny nose with thin, watery discharge and no fever. It begins immediately after exposure to allergens and lasts for as long as you are exposed to allergens.
Common cold on the other hand presents with a runny nose with watery or thick yellow discharge; body aches; low-grade fever, it starts one to three days after exposure to a cold virus and lasts three to seven days.
CAUSES
When you have hay fever, your immune system identifies a harmless airborne substance as harmful. Your immune system then produces antibodies to this harmless substance.
The next time you come in contact with the substance, these antibodies signal your immune system to release chemicals such as histamine into your bloodstream, which cause a reaction that leads to the signs and symptoms of hay fever.
RISK FACTORS The following factors can increase your risk of developing hay fever:
Exposure to secondary cigarette smoke in first year of life. Having other allergies or asthma. Having atopic dermatitis (eczema). Having a blood relative (such as a parent or sibling) with allergies or asthma. Living or working in an environment that constantly exposes you to allergens.
COMPLICATIONS Hay fever and the symptoms can lead to the following complications:
Reduced quality of life. Hay fever can interfere with your enjoyment of activities and cause you to be less productive.
Poor sleep/insomnia. The symptoms can keep you awake or make it hard to stay asleep, which can lead to fatigue and a general feeling of being unwell.
Worsening asthma. Hay fever can worsen signs and symptoms of asthma, such as coughing and wheezing.
Sinusitis. Prolonged sinus congestion due to hay fever may increase your susceptibility to sinusitis – an infection or inflammation of the membrane that lines the sinuses.
Ear infection. In children, hay fever often is a factor in middle ear infection (otitis media).
Unlike a cold, hay fever is not caused by a virus
DIAGNOSIS Consult your doctor who will then take a full medical and exposure history, perform a physical examination, and possibly recommend one or both of the following tests:
Skin prick test. You’re watched for an allergic reaction after small amounts of material that can trigger allergies are pricked into the skin of your arm or upper back.
If you’re allergic, you develop a raised bump (hive).
Allergy blood test. A blood sample is sent to a lab to measure your immune system’s response to a specific allergen. This test measures the amount of allergy-causing antibodies in your bloodstream.
TREATMENT
It’s best to limit your exposure to substances that cause your hay fever as much as possible.
If your hay fever isn’t too severe, over-the-counter medications may be enough to relieve symptoms.
For worse symptoms, you may need prescription medications.
Many people get the best relief from a combination of allergy medications. You might need to try a few before you find what works best.
Medications for hay fever include:
Nasal corticosteroid sprays. These require a prescription by the medical doctor and they help prevent and treat the nasal inflammation, nasal itching and runny nose caused by hay fever.
Examples include fluticasone propionate (Flixonase), Mometasone (Nasonex) and budesonide (Rhinocort Aqua). Nasal corticosteroids are a safe, long-term treatment for most people.
Side effects can include an unpleasant smell or taste and nose irritation.
Antihistamines. These preparations are usually given as pills.
However, there are also anti- histamine nasal sprays and eye drops. Antihistamines can help with itching, sneezing and a runny nose but have less effect on congestion.
They work by blocking histamine, a symptom-causing chemical released by your immune system during an allergic reaction.
Examples include allergex, loratadine (Claritin, Alavert), cetirizine (Zyrtec Allergy) and fexofenadine (Allegra Allergy).
Decongestants. These medications are available over-the-counter as liquids, tablets and nasal sprays.
Over-the-counter oral decongestants include pseudoephedrine (Sudafed, Afrinol).
Nasal sprays include phenylephrine and oxymetazoline.
Oral decongestants can cause a number of side effects, including increased blood pressure, insomnia, irritability and headache. It is therefore important that they are used with doctor supervision.
Don’t use a decongestant nasal spray for more than two or three days at a time because it can actually worsen symptoms when used continuously (rebound congestion).
Leukotriene modifier. Montelukast (Singulair) is a prescription tablet taken to block the action of leukotrienes – immune system chemicals that cause allergy symptoms such as excess mucus production.
It’s especially effective in treating allergy-induced asthma. It’s often used when nasal sprays can’t be tolerated or when you have mild asthma.
Montelukast can cause headaches. In rare cases, it has been linked to psychological reactions such as agitation, aggression, hallucinations, depression and suicidal thinking.
Seek medical advice right away for any unusual psychological reaction.
Nasal ipratropium. Available in a prescription nasal spray, ipratropium (Atrovent) helps relieve severe runny nose by preventing the glands in your nose from producing excess fluid. It’s not effective for treating congestion, sneezing or postnasal drip.
Mild side effects include nasal dryness, nosebleeds and sore throat. Rarely, it can cause more-severe side effects, such as blurred vision, dizziness and difficult urination.
The drug is not recommended for people with glaucoma or men with an enlarged prostate.
Oral corticosteroids. Corticosteroid pills such as prednisone sometimes are used to relieve severe allergy symptoms.
Because the long-term use of corticosteroids can cause serious side effects such as cataracts, osteoporosis and muscle weakness, they’re usually prescribed for only short periods of time.
Other treatments for hay fever include: Immunotherapy or desensitization therapy, sublingual allergy tablets and rinsing your sinuses with distilled sterile saline water.
What you can do to minimise exposure to allergens
It’s not possible to completely avoid allergens, but you can reduce your symptoms by limiting your exposure to them.
If you know what you’re allergic to, you can avoid your triggers.
To avoid pollen or moulds
Close doors and windows during pollen season. Don’t hang laundry outside – pollen can stick to sheets and towels. Avoid outdoor activity in the early morning, when pollen counts are highest. Use air conditioning in your house and car. Use an allergy-grade filter in your home ventilation system and change it regularly. Stay indoors on dry, windy days. Use a dehumidifier to reduce indoor humidity.