Hay fever symptoms and treatment

Itchy eyes. Runny nose. Constant sneezing. Sound familiar? As anyone who suffers from hay fever can attest, this affliction is the pits, and as the weather warms up, allergy sufferers may feel a sense of impending doom. But what is hay fever? And, more importantly, what can we do about it?

Consider nib your health partner when it comes to looking after your body and mind. So, we spoke to nib group medical advisor Dr Hamish Black about this very common condition.

Hay fever is “usually associated with sneezing, itching and congestion”, says Hamish. Known clinically as allergic rhinitis, it is an allergic reaction that occurs when you come into contact with environmental allergens, such as pollens, mould, dust mites and animal dander (tiny flecks of skin shed by animals such as cats and dogs).

Hay fever can be a year-round problem (perennial) if you're allergic to things like dust mites, animal hair, or mould spores. It can also be seasonal, flaring up during certain times of the year like in spring, when pollen is high or after thunderstorms (the timing depends on where you live, as pollen counts vary across different parts of Australia throughout the year). 

For many of us – one in five Australians in fact – when our eyes or nose come into contact with these allergens, our bodies trigger an immune response, releasing a chemical called histamine, which causes swelling and inflammation of the inner lining of the nose.

While many people associate seasonal hay fever with spring – when there’s an abundance of airborne grass pollens – allergic rhinitis can occur at any time of the year and can be incredibly debilitating, interrupting sleep and hindering concentration, learning and daily function.

Despite its name, fever is not a symptom of this condition (nor is it caused by hay). The most common hay fever symptoms include:

• runny or itchy nose

• nasal congestion

• constant throat clearing

• frequent sneezing

• itchy, watery eyes

• snoring

Less-common symptoms may include:

• disturbed sleep

• daytime tiredness

• poor concentration

• frequent headaches

• frequent sore throats and a hoarse voice

• facial pain or pressure

• a reduced sense of smell

• frequent sinus infections (in adults)

• frequent ear infections (in children)

Getting a hay fever diagnosis

If you’re suffering from these symptoms, a trip to your GP can help you find out whether allergic rhinitis is to blame.

“Your doctor may be able to diagnose hay fever based on a description of your symptoms and when they occur,” says Hamish. “It's also helpful to keep a diary of any triggers you've noticed and how hay fever impacts your daily life so your GP can make a full assessment.”

Along with noting your symptoms, your medical professional may examine your nose and eyes, ask to see how you breathe through your nose or examine your nostrils and throat for signs of hay fever.

“Hay fever is normally diagnosable clinically,” explains Hamish, however: “where there is doubt about the diagnosis, blood or skin tests or imaging may be helpful in making the correct diagnosis.”

If this is the case, your GP will refer you to clinical immunologist or allergy clinic for testing to identify the allergen you're allergic to. You may have a skin prick test where a small amount of the suspected allergen will be applied to your skin (usually on your forearm, upper arm, or back) to test if the spot becomes swollen or itchy.

"A positive result doesn’t necessarily mean the allergen is causing your symptoms, just that your body is sensitive to it.” 

Luckily, hay fever is usually fairly simple to treat at home. Identifying which specific allergens are causing a reaction is an important step in managing hay fever so you can minimise your exposure to them where possible. For people whose allergies flare up with the seasons, this could mean checking the day’s pollen count before heading outdoors (and staying inside where possible when the count is high or if it’s particularly windy), wearing sunglasses, showering and rinsing eyes with water after you’ve been outside.

If you can’t avoid your triggers (because who wants to sit inside all spring and summer!?), medication can help. “It is appropriate for older children and adults to try either oral non-sedating antihistamines or intranasal glucocorticoids to see if this settles symptoms,” suggests Hamish.

Antihistamines block the body's response to histamine, which makes our noses run and our eyes and skin itch, swell and go red, and can be used to help reduce symptoms and taken when needed.

Intranasal corticosteroid sprays (INCS) reduce inflammation in the nasal lining and need to be used regularly as directed to be effective. “This type of nasal spray is the most effective treatment and should be used daily for chronic symptoms,” adds Hamish.

Sometimes you can get a combination of both which offers you benefits of both medications. 

“If you are using decongestant nasal sprays, be aware that they may provide quick relief but shouldn’t be used for more than a few days, as long-term use can harm the nose lining,” Hamish advises. “You should avoid these if you're pregnant or have high blood pressure. Always check with your GP or pharmacist first.” 

Hay fever sufferers looking for a long-term solution may be tempted to try Allergen immunotherapy (AIT). “This is also called desensitisation as AIT gradually exposes you to more of an allergen to help reduce symptoms. This should only be done under the care of an allergy specialist,” says Hamish. 

Of course, before you consider medication or for any advice, diagnosis and treatment, it’s important to visit your GP or healthcare professional. nib members get can access exclusive discounts for GP telehealth appointments.

Please note: The tips throughout this article serve as broad information and should not replace any advice you have been given by your medical practitioner.