People who suffer from hay fever (seasonal allergies) know that the coming of spring may not be as exciting as it is for those who are allergy-free. While friends and family enjoy the warmer weather, increased sunshine, and blooming of flowers, people with allergies get hit with a stuffy nose, itchy eyes, and uncontrollable sneezing. 

Some individuals — due to a combination of genetic and environmental factors — have an immune response to tree pollen, grass pollen, and even dust mites, all of which increase in the spring. As a result, they experience an allergic reaction that can seriously interfere with their daily lives.

Thankfully, there are many options for kicking stubborn allergy symptoms. This guide from HealthTap will go over what they are, in addition to much else worth knowing about hay fever. 

What Is Hay Fever?

Hay fever is an allergic reaction to pollen and other allergens in the air. Doctors also refer to it as “seasonal allergic rhinitis.” 

Many people are affected by hay fever in the spring, which is when plants begin to bloom and pollen count can skyrocket. Hay fever affects about one in four people in the developed world. It is common to first experience symptoms as a child or teenager. 

Hay fever mainly affects the upper airways, which includes the nose and throat. However, it is possible for the condition to include allergic asthma affecting the lungs and allergic conjunctivitis affecting the eyes. What’s more, hay fever can sometimes cause allergies to certain foods — which is known as “cross-reactivity.” 

If hay fever is especially severe, it can increase the chances of developing another medical condition, such as sinusitis (inflammation of the natural airspaces in the facial bones). In addition, severe hay fever can increase the chances of sensitivity to environmental factors, such as cigarette smoke.

What Are the Symptoms of Hay Fever? 

If someone has hay fever, they may experience a stuffy or runny nose, sore throat, itchy or watery eyes, and frequent sneezing. It may also be harder to smell or to taste food. 

Because the nose is linked to the ears, ear clogging is not uncommon alongside the  nasal congestion caused by hay fever. This can be very uncomfortable and even make it difficult to hear. 

If hay fever is especially severe, it can cause full-body symptoms, such as weakness and fatigue. Other symptoms can include coughing, shortness of breath, and pressure headache. 

Because hay fever is an allergy to pollen, these symptoms usually occur during pollen season — which usually coincides with spring. However, if symptoms last year-round, then it can be explained by another type of allergen (i.e. the particle that causes the allergy), such as house dust or pet dander.

What Causes Hay Fever? 

Just like with any allergy, symptoms of hay fever are caused by the body’s immune response. Although the immune system is meant to fight off invaders like bacteria and viruses, sometimes it reacts to substances that are usually harmless, such as pollen. 

When the body perceives these substances to be a threat, it sets off an allergic reaction. First, it creates antibodies to the substance, which bind to specific cells in the body. Then, if these cells come into contact with the substance again, the cells will release histamine. 

Histamine plays a major role in the body’s allergic inflammatory response, and it’s what causes symptoms such as sneezing and hives.

However, not everyone has hay fever symptoms. So, what gives? Well, it can be that some people are just genetically predisposed to allergies — i.e., they were just born that way because it runs in their family. If someone has a family member who has hay fever, then their chances of getting hay fever more than doubles.[1] 

The environment can also play a role in how likely someone is to develop hay fever. For instance, being exposed to secondhand cigarette smoke as a child can increase the chances of having hay fever symptoms in adulthood.[2] 

The modern environment makes it all the more easy to develop hay fever. With an improvement in overall hygiene, humans are less exposed to bacteria, viruses, and other pathogens in the environment. While this is mostly a good thing, it does have its downside: living in an overly-sterilized environment can make the immune system weaker, which can increase the chances of developing allergies. 

Which Medications Can Treat Hay Fever? 

As uncomfortable as hay fever symptoms may be, those with this allergy don’t have to suffer without relief. There are plenty of hay fever treatments that can help bring relief. 

Antihistamines

When something triggers an allergic reaction, the immune system releases histamine. This chemical substance causes common allergy symptoms such as sneezing, coughing, or itching — basically everything that makes having hay fever so uncomfortable.

Antihistamines work by blocking histamine from binding to cells. As a result, it can suppress the symptoms caused by histamine. 

Antihistamines can be taken in a few different ways, including antihistamine tablets or pills, antihistamine eye drops, or even antihistamine nasal sprays. Nasal sprays begin working within 15 minutes, eye drops tend to bring relief within just a minute or two, while pills generally take less than an hour to work. 

Despite their different time of onset, all forms are effective in treating hay allergy symptoms, though eye drops generally won’t help relieve nasal symptoms to a point of real relief. 

Because antihistamines have very few side effects other than sedation, they are usually the first line of approach for doctors. In addition, they’re available over-the-counter, which means a prescription isn’t needed to get it. 

But keep one thing in mind: some antihistamines can cause drowsiness. As such, most antihistamines come with a warning to avoid using before “operative heavy machinery,” i.e. driving a car. It’s also possible to stick to a special class of “non-drowsy” antihistamines, which are known as second-generation, non-sedating antihistamines. 

Common non-sedating antihistamines include Claritin (loratadine), Zyrtec (cetirizine), Patanase/Pataday (olopatadine) and Aller-Ease (fexofenadine).

Nasal Steroid Sprays (corticosteroids)

Corticosteroids are a type of steroid that produce an anti-inflammatory response. For those with hay fever, inflammation may be driving the swelling in the nose, sinuses, eyelids, and conjunctivae. Using corticosteroids can reduce this inflammation. 

Unlike histamines, corticosteroids take a longer time to work. In some cases, it’s possible to experience some relief in about 6-12 hours. However, it is more common for corticosteroids to take several days to gradually reduce inflammation.

This medication is commonly administered as a corticosteroid nasal spray at low doses. For this reason, it is considered fairly safe. That said, patients still need to get a prescription from their doctor for some types of corticosteroid medications. 

Leukotriene Receptor Antagonists

Leukotrienes are chemical messengers that play a role in the inflammatory response. They cause a tightening of airway muscles while producing extra mucus in the sinuses.

Leukotriene receptor antagonists work by blocking the action of leukotrienes. Although they are not as effective as histamines and corticosteroids in relieving hay fever symptoms, they can be especially useful for patients experiencing additional asthma symptoms. A common brand of this is Singulair (montelukast). 

Mast Cell Stabilizers

A mast cell releases histamine during an allergic reaction. Mast cell stabilizers work to prevent this by blocking histamine on mast cells. These are most effective when used before exposure to pollen. However, they can also be used to relieve symptoms after you begin to feel hay fever symptoms. 

Decongestant Nose Drops and Nasal Sprays

Decongestants work by reducing swelling in the nose and sinuses, making it easier to breathe through the nose. They do this by constricting blood vessels in the nose. 

While they are effective in the short term, using decongestant nasal sprays for a long time can result in the opposite effect: the sinuses might swell up even more. This is called “rebound congestion.” For this reason, they are generally used for a maximum of three days, and mainly if the above steroid and antihistamine options are not working. 

Do Some Medications Work Better Than Others? 

Corticosteroids are often recommended as the first line of approach in treating symptoms of hay fever. They have very few side effects and may be more effective than antihistamines in bringing symptom relief.[3] 

However, if symptoms don’t improve with corticosteroids and antihistamines, then doctors will usually try different medications. With the help of their doctor, patients can try different types of medications, different dosages, or even a combination of treatments. 

As a reminder, it’s important to never mix too many medications without a doctor’s approval — doing so can be dangerous. If a medication isn’t working out, then it’s wise to bring this up with a medical doctor before trying a different route. 

How To Prevent Symptoms of Hay Fever

In the first place, it’s best to reduce pollen exposure (we know, easier said than done). If staying indoors on a beautiful spring day is impossible, then there are some things to try to make pollen less bothersome. 

For instance, it might help to wear special types of sunglasses — called wraparound sunglasses — to prevent pollen from getting into the eyes. Also, wearing a mask (such as a COVID-19 mask) outdoors can reduce symptoms.[4] 

Pollen can still make its way indoors, too. To keep this from happening, it’s best to keep doors and windows shut as much as possible during peak pollen counts. If you want to let fresh air in, then it might help to invest in a filter dense enough to trap pollen (called a HEPA filter). 

Next, it’s important to examine diet, which can play a role in allergy symptoms. And no, we’re not talking about avoiding shellfish or peanuts.

Research shows that the gut microbiome — the billions of bacteria that live in the GI tract — can play a role in the allergy response. Although the gut microbiome mostly plays a role in food allergies, it’s possible that it’s involved in hay fever, as well. 

To optimize gut health, it’s best to talk to a doctor about starting probiotic supplements — not all supplements are made the same. In addition, it helps to eat a colorful diet full of produce, which will feed “good” gut bacteria while also increasing their diversity. 

Aside from improving gut health, it’s best to avoid foods and beverages that contain histamine. Many fermented foods, such as sauerkraut, contain high amounts of histamine, which can exacerbate hay fever symptoms. Alcohol is another major culprit, with wine — both red and white — being by far the worst offender. 

Finding Allergy Relief With HealthTap 

Experiencing hay fever? HealthTap has affordable primary care providers who can help you prevent or treat symptoms — from the comfort of your own home. 

HealthTap provides virtual doctor visits to help you manage your symptoms. Over our secure platform, you’ll be able to discuss your concerns, get tests done, receive medication prescriptions, and be guided in every step of your healing journey. 

Get started on your health and wellness journey today.