Hay fever | Mate hei

Hay fever is inflammation of the lining of your nose, eyes, throat and sinuses due to an allergy. When cells in these areas come into contact with an allergen, they release histamine, which causes inflammation.

Most often this response is triggered by grass pollen. Other allergens that can cause hay fever, include:

• house dust mites
• mould spores
• hair and skin flakes from animals (also known as ‘dander')
• cockroach droppings.

Hay fever is also known as allergic rhinitis, which has 2 types:

• Seasonal allergic rhinitis – when symptoms happen at certain times of the year, eg, spring. Wind-borne pollens are the cause of seasonal hay fever, which usually occurs in spring and summer. The length of the pollen season depends on where you live and the plant species you are allergic to.
• Perennial allergic rhinitis – when symptoms occur at any time of the year. Dust mites and domestic pets are the most common causes of perennial rhinitis.

Symptoms of hay fever include:

• sneezing 
• runny nose 
• watery, itchy, red and puffy eyes
• blocked nose
• itchy throat, mouth, nose and ears
• blocked ears
• coughing
• loss of smell
• headache
• earache
• lethargy and fatigue.

These symptoms range from mild to severe, and can affect your daily life.

Image credit: Canva

If hay fever is severe and untreated:

• you may sleep poorly, which can leave you feeling tired during the day
• you may be more prone to sinus infections and eye infections
• you may also have poor concentration during the day
• if you also have asthma, hay fever can make your asthma symptoms more difficult to manage.

Hay fever symptoms can be similar to other conditions that affect your nose, such as the common cold or nasal polyps. See your doctor to get the right diagnosis. Your doctor will ask about your symptoms and when they occur. They will also examine your eyes, nose and throat for signs of irritation and congestion.

If the cause of your symptoms is not clear, your doctor may order blood tests or perform a skin-prick test to find out what you are allergic to. They may also refer you to an allergy specialist for further testing if your symptoms are severe.

Skin prick tests

• This involves placing a drop of the allergen on your skin and then scratching your skin through the drop. This is usually done on the skin of your arm, but can be done on your legs or body.
• If you are allergic to the allergen, your skin will become red and swollen at the site within 15 minutes.
• Skin tests are not a diagnosis by themselves and these results need to be considered with your history and symptoms.
• As many as 30 allergens can be tested at the same time to help identify the particular substances you are allergic to.

The most important part of managing hay fever is to avoid the allergens if possible. Other treatment includes self-care measures, medicines and allergen immunotherapy (AIT).

Self-care measures

Although it is hard to avoid pollens at all, there are things you can do to minimise your exposure when the pollen count is high.

• Stay indoors if possible.
• Keep your windows and doors shut as much as possible.
• Change your clothes and shower after you have been outdoors.
• Vacuum your house and dust with a damp cloth regularly.
• Get someone else to mow your lawn.
• Wear wrap-around sunglasses to avoid pollen getting in your eyes.
• Getting a pollen filter for the air vents in your car and a vacuum cleaner with a HEPA filter.

Medicines

Medicines to treat and help prevent hay fever are available from your doctor or over the counter at your pharmacy. These can be very effective in reducing your symptoms. Keep avoiding your allergen whenever possible, even when taking medicines.

Medicines include:

• antihistamines – tablets such as loratadine or cetirizine, or antihistamine nasal sprays
• corticosteroid nasal sprays
• decongestants (for short-term use)
• medicated or non-medicated eye drops
• combination products that combine these medicines, eg, an antihistamine and a decongestant.

If you also have asthma, see your GP (doctor) a few weeks before the hay fever season starts. Hay fever can make asthma worse and difficult to control. It may be important to review or make an asthma action plan. 

Allergen immunotherapy (AIT)

Immunotherapy may also be an option if your symptoms are severe and the allergen is difficult to avoid. Immunotherapy works by changing the way your immune system reacts to allergens. Your doctor gives you a very small amount of an allergen you are allergic to over a period of 3–5 years. Immunotherapy can be given under your tongue, into your nose or by an injection.

The aim of immunotherapy is to make your body develop tolerance to a particular allergen. Immunotherapy does not work for everyone and you must consult your doctor or allergen specialist about whether it is right for you.

The best way to avoid an allergic reaction is to avoid the allergens that trigger it. 

Pollens

• Consider staying inside when the pollen count forecast is high, on windy days or after thunderstorms.
• Choose plants for your garden that are pollinated by birds or insects, rather than plants that release their seeds into the air.
• Avoid mowing the lawn, raking leaves or having an open compost heap.
• Splash your eyes with cold water or shower after any activities expose you to a lot of pollen.
• Rub petroleum jelly (like Vaseline) inside your nose to stop the pollen from coming into contact with the lining of your nose.

Pet dander

• Ideally, don't have a pet.
• If you do, keep your pet outdoors and out of bedrooms.
• Wash them regularly. 

Dust mites

• Keep your house well ventilated to avoid a build up of moist air inside the house (house dust mites thrive in damp conditions).
• Choose vinyl or leather furnishings rather than soft covers.
• Cover mattresses and pillows with dust mite covers.
• Use a vacuum cleaner with a HEPA air filter or, if possible, get someone else to do the vacuuming.
• Dust with a damp cloth.
• Wash soft toys regularly in hot water or put in the freezer for 1–2 days.

Allergy NZ(external link) provides information, education and support for people with allergy, parents of children with allergy, teachers and healthcare providers. Find out more on their website(external link).