Hay fever is an allergy response that includes watery eyes, itchy skin, and sneezing that have little to do with hay and a lot to do with a variety of allergens. Otherwise known as allergic rhinitis, hay fever is primarily an allergic reaction to the pollen from certain types of grass, trees, and weeds. It can create unpleasant allergy symptoms any time of year, but symptoms are typically worse during the spring, summer, and fall seasons when pollen counts are highest.
To further complicate how hay fever is treated, dust mites and pet dander can also trigger similar symptoms.
Hay Fever Symptoms
Allergic rhinitis symptoms can be mild, moderate, or severe. You may experience only a few allergy symptoms or a range of them. They may come and go, or they may be constant, especially during certain seasons or in triggering environments.
The most common hay fever symptoms include:
- Coughing and post-nasal drip from excess mucus
- Sneezing and a runny nose
- Stuffy nasal passages, similar to a cold
- Itchy eyes, nose, or throat
These allergy symptoms are similar to those of the common cold, but there are a few key differences. With allergic rhinitis, sneezing and other symptoms likely happen more often, and they're tied to specific allergens, like pollen from trees or grasses. If you have a cold, sneezing and other symptoms are most likely caused by a virus and disappear after a week or two.
Hay fever symptoms can also cause:
- Dark circles under your eyes (allergic shiners)
- Fatigue and lack of energy
- Sinus pressure in your nose or cheeks
- Shortness of breath
- Popping in your ears
You may notice symptoms worsen on certain days or times of the year. For example, if you're allergic to tree pollen, you may experience more allergies in the spring when trees are blooming. If you're allergic to grass pollen, you could experience symptoms in the summer when grasses release more pollen.
But remember: hay fever, unlike a cold or the flu, is not caused by a virus and seldom causes a fever. If you experience yellow nasal discharge and thick phlegm instead of watery, thin mucus, it's best to see a doctor to have them check for an infection.
What Causes Hay Fever?
There are two types of hay fever: seasonal allergic rhinitis and perennial allergic rhinitis.
Seasonal Allergic Rhinitis
Seasonal allergic rhinitis is most often caused by pollen from trees, grasses, or weeds. Outdoor allergens cause hay fever symptoms primarily during certain seasons or months of the year. The pollen count, which is the number of grains of pollen in the air at a given time, is usually highest between early morning and late afternoon on hot, dry days with little wind.
For some people, the mere presence of pollen in the air is enough to trigger hay fever symptoms. For others, it may take more exposure before they notice any effects. Also, on damp or stormy days, many people with hay fever discover they are less likely to experience symptoms. Rainfall washes away extra pollen, lowering your exposure to airborne particles.
Typically, hay fever is worse during the following times of the year:
- Spring, from late April through May. Spring allergies are primarily triggered by pollen from trees.
- Summer, from late May through July. Summer allergies are triggered by pollen from grasses and/or weeds.
- Fall, from late August through November. Fall allergies result from pollen from weeds like ragweed.
Your risk for seasonal allergic rhinitis increases if you have a family history of allergies or other conditions like asthma or eczema. You're also more likely to experience allergy symptoms if you live in an urban area with high levels of pollution, which can irritate your respiratory system and make you more sensitive to allergens.
Perennial Allergic Rhinitis
Indoor allergens—like dust mites, pet dander, or certain types of mold—cause perennial allergic rhinitis. These allergens can trigger allergic reactions year round.
Symptoms of indoor allergies often get worse at night when you spend the most time in your home environment (if you work from home, you might have symptoms 24/7). Allergies can also interrupt sleep, making you tired and groggy the next day.
Why Does the Body React to Allergens?
An allergen is a benign substance, like pollen or pet dander, that is harmless, but that your immune system mistakenly identifies as a threat. When it enters your body, the body either ignores the allergen or mounts a defense. If your body perceives the allergen as a threat, your immune system produces a protein called immunoglobulin E (IgE) to neutralize the foreign particles.
The next time you come in contact with that same allergen, your body releases histamines and other chemicals as part of its defense mechanism. These chemicals cause hay fever symptoms like watery eyes, runny nose, and sneezing to get the allergen out of your body.
How Is Hay Fever Diagnosed?
If you're experiencing hay fever symptoms and think you might be allergic to something in your environment, it's best to see an allergist or immunologist. These specialists are trained to diagnose and treat hay fever and other allergies.
During your appointment, the doctor asks about your medical history and completes a physical exam. They may also recommend one or more of the following tests:
- Skin prick test: For this test, the doctor or nurse places a drop of a suspected allergen on your skin. They then make a small prick on the surface of your skin. If you're allergic to the allergen, you develop a raised, itchy bump called a wheal within 15 minutes. Skin prick tests can be uncomfortable and can take more time than other tests.
- Blood test: A blood test measures your level of IgE antibodies. This test can help determine if you're allergic to a specific allergen. It is a simple blood draw that can be done the same day as your appointment.
- At-home test: Another option is an at-home test kit provided by an allergy doctor. This convenient test checks for allergies to both indoor and outdoor triggers (pollen, dust mites, etc.). This test also measures your level of IgE antibodies. After providing a few drops of blood from a finger prick and returning the kit, you meet with an allergy doctor to go over your results and get a personalized treatment plan.
Home Remedies for Hay Fever
Medication and consulting an allergy specialist are frequently the best ways to treat hay fever, but there are a few home remedies that can reduce symptoms.
Try a sinus rinse: A rinse can help clear out nasal passages. All you need is warm, distilled water (plain tap water is not recommended), a saline solution, and a neti pot or squeeze bottle. You can buy saline solution packets if you don't want to make your own. To rinse your sinuses, follow these steps:
- Mix the saline solution with lukewarm distilled water
- Tilt your head to the side and pour a small amount of the solution into one nostril
- Allow the solution to drain out through your other nostril, and repeat on the other side
- Do this once or twice a day, or as needed
- Use a humidifier: Dry air can worsen hay fever symptoms, especially congestion and a sore throat. A humidifier adds moisture into the air, which can make breathing easier. Be sure to clean your humidifier frequently to prevent mold growth.
- Minimize ceiling fan usage: Many hay fever sufferers are also allergic to dust mites. When you use a ceiling fan, it can circulate these tiny creatures throughout the room, exacerbating hay fever symptoms. If you need to use a fan, try an oscillating one that circulates the air without stirring up too much dust.
How to Prevent Allergy Symptoms with Lifestyle Changes
Though it isn't possible to prevent all allergies, there are several lifestyle changes you can make to reduce symptoms, especially while at home.
- Set outdoor limits during allergy seasons: If you suffer from hay fever, pay attention to pollen counts and stay indoors as much as possible when they're high.
- Filter your indoor air: Use an air conditioner or air purifier with a HEPA filter to help remove allergens from the air in your home.
- Keep your windows shut: This practice keeps outdoor allergens, like pollen, out of your home.
- Wear a mask while doing yard work: If you can't avoid being outdoors during hay fever season, take precautions while doing activities that will stir up pollen and other allergens. To reduce the allergens you breathe in, wear an N95-filtering mask while mowing the lawn or working in the garden.
- Wash up after being outdoors: Pollen can stick to your skin and clothing, so take a shower and change clothes as soon as you come inside. This habit prevents you from tracking pollen through your house and coming into contact with it later.
- Launder bedding in hot water weekly: Dust mites thrive in warm, humid environments. By washing sheets and other bedding in hot water (at least 130 degrees Fahrenheit), you can kill dust mites and help reduce hay fever symptoms.
- Vacuum regularly: Regular vacuuming with a HEPA-filtered vacuum helps remove pollen, pet dander, and dust mites from your floors and furniture. Be sure to vacuum carpets, rugs, and upholstered furniture often during hay fever season.
- Watch indoor humidity levels: Humidity can help mold and pests, like cockroaches or dust mites, grow. To prevent allergies, keep your home's humidity level under control. It is recommended that the indoor relative humidity in your house be between 30% and 50%.
- Keep pets out of the bedroom: If you're allergic to pet dander, it's best to keep your furry friends out of your bedroom and off the furniture. This way, you can create a space in your home where you can escape pet allergens.
What Medicines Treat Hay Fever?
Thankfully, there are a variety of medications available to treat allergic rhinitis. Which one is right for you depends on the severity of your symptoms, how often they occur, and your overall health. Antihistamines, decongestants, and nasal steroids are the most frequent medications used to temporarily treat hay fever.
Your doctor may advise you to take your allergy medication before the start of allergy season. This practice has been shown to help prevent allergy attacks and manage allergy symptoms more effectively.
Sudafed (pseudoephedrine) is one of the most popular decongestants. This type of allergy medication clears your nose of congestion if pollen, pet hair, or other allergens trigger excess mucus production.
Decongestants can cause undesirable side effects, some of which are common with other medications. When used too frequently, they can lose their effectiveness and exacerbate hay fever symptoms. Please follow directions carefully when using decongestants to minimize unwanted side effects.
Antihistamines block histamine from being released. By blocking histamine, hay fever symptoms like watery eyes and runny nose can be reduced or eliminated for short-term symptom relief.
Like decongestants, antihistamines can cause side effects like drowsiness. It's best not to operate heavy machinery or drive a car until you know how the medication affects you.
Types of antihistamines include:
- Azelastine (a nasal spray sold as Astelin) or olopatadine (Patanase). Both of these are prescription only.
- Loratadine (Claritin), fexofenadine (Allegra), and cetirizine (Zyrtec). All three are over-the-counter allergy medications.
- Ketotifen (Alaway, Zaditor). This is an allergy eye-drop your doctor can prescribe.
Nasal corticosteroids reduce inflammation in your nasal passages. They come as a nasal spray and can be used once or twice a day, depending on the severity of your symptoms. Because they work by reducing inflammation, they may take several days to reach full effectiveness.
Nasal corticosteroids, like other medicines, can have adverse side effects. Before you use nasal corticosteroids, talk to your doctor about any concerns.
Some common brands of nasal corticosteroids include:
- Fluticasone (Flonase) and triamcinolone (Nasacort). Both are over-the-counter allergy medications.
- Budesonide (Rhinocort) and mometasone (Nasonex). These two are prescription-only medications.
In certain circumstances, your doctor may recommend a nasal spray that includes a corticosteroid and an antihistamine like Dymista, which has azelastine and fluticasone.
If hay fever symptoms are not responding to the above medications, or if you're looking for long-term relief instead of something that only masks your symptoms, immunotherapy might be right for you. This type of allergy treatment trains your immune system to build a tolerance to your trigger allergens, eventually leading to lifelong symptom relief.
Sublingual immunotherapy (under-the-tongue tablets or drops) is a popular allergy treatment because after consistent usage it can provide an allergy-free life with no more daily pills or weekly injections. It can also be taken from the comfort of your home!
Discover an Allergy-Free Life With Wyndly
Sublingual immunotherapy is a simple and effective allergy treatment. By gradually exposing you to increasing doses of allergens, sublingual immunotherapy can help your body build immunity and eliminate your allergy symptoms.
At Wyndly our doctors assess your allergies and create a personalized treatment plan for you to start your journey toward an allergy-free life. To get started, schedule a consultation with a Wyndly allergy doctor today!