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There has been a staggering 615% increase in hospital admissions related to allergic disease over the last 20 years. Allergy and related conditions are estimated to cost the UK NHS about £1 billion a year. Allergic rhinitis, which is a seasonal allergy, affects 10–15% of children and 26% of adults in the UK, and 44% of the adult population, approximately 21 million people, and 50% of children have one or more allergic disorders, according to statistics reported by Allergy UK.
A 2020 study by Allergy UK and Kleenex® suggests a surge in UK hay fever sufferers over the last few years. Up to 37% of people have developed symptoms for the first time in the last five years and up to 56% of people are anxious that others may mistake their symptoms for signs of Covid-19.
What are seasonal allergies?
Allergens are found in dust mites, pets, pollen, insects, ticks, moulds, foods and some medications. An allergy (allergic rhinitis) that occurs in a particular season is more commonly known as hay fever.
Hay fever comes by its name from the hay-cutting season. Historically, this activity occurred in the summer months, around the same time many people experienced symptoms. However, because it is possible to experience allergic rhinitis almost year-round, it is now better known as a seasonal allergy.
Seasonal allergies are immune system responses triggered by exposure to pollen allergens; allergies to such things as pets, dust mites, foods etc. are constant, and are categorised as perennial allergies. Pollen is discharged from the male part of a flower or from a male cone. Each grain contains a male gamete that can fertilise the female ovule, to which pollen is transported by the wind, insects, or other animals.
It is a fine powder made up of microscopic pollen grains. Its dispersion and movement in the atmosphere occur at various times during the year, predominately between spring and autumn.
Hay fever, or seasonal allergy, occurs when the body makes allergic antibodies to certain substances such as pollen and your immune system overreacts to this outdoor allergen. The body releases compounds to combat what it perceives as a harmful substance. One of these compounds is histamine.
This compound helps protect the body and fight the invader, but histamine causes many common allergy symptoms. In other words, the immune system releases antibodies to fight something that is not actually harmful.
Allergies are often genetic, i.e. passed down through families. You are more likely to have hay fever if you have a parent or family member with allergies. People who have asthma or eczema are also more likely to develop hay fever.
Whether you are likely to suffer seasonal allergies can also be dependent upon where you live in the UK. The hay fever season will start at different times in different areas; for example, there is a later start and shorter season in the north of the UK, where generally there is less pollen. Urban areas have lower counts than the countryside, and places inland have higher counts than those around the coast.
What are the types of seasonal allergies?
Seasonal allergic rhinitis, commonly known as hay fever, is caused by exposure to grass pollen, tree pollen and other plant pollen often known as weed pollen, which is released into the air at different times of the year. Most people are allergic to grass pollen.
In the UK, pollen exposure is most common in the spring and summer months, but different species of plant pollinate at different times of year, so some individuals may experience symptoms at specific times and none at others. There are also lots of factors that change the start date of the pollen season. Low temperatures in winter will keep plants and trees dormant for longer into the new year.
Essentially, the lower the temperature the less pollen is produced; however, this can change if soil and air temperatures in spring are higher than normal. Spring rainfall is also key, as a dry spring season reduces the amount of pollen production.
Tree pollen occurs first, typically from late March to mid-May. Grass pollen, which actually has two peaks, lasts from mid-May until July, and weed pollen covers the end of June to September. These peaks may be masked by how wet, dry, warm or cold it is, and the timing of the peaks very much depends on the weather during spring and early summer.
Most people in the UK are unlikely to suffer from hay fever in January as there isn’t much tree pollen around, and no grass pollen; however, from mid-late January, tree pollen season begins for Hazel, Alder and Yew and the pollen season for Willow and Elm trees starts in February.
At the start of spring, it is the peak time for tree pollen from Willow, Elm, Birch, Poplar and Alder, with Birch, Plane, Ash and Oak at their peak in terms of pollen release by mid-spring. Silver Birch pollen is highly allergenic and is a significant cause of asthma and rhino-conjunctivitis.
Many varieties of flowers also start to bloom in early spring, making hay fever in April very common. Early morning and early evening are peak pollen times.
Towards the end of spring is typically the beginning of grass pollen season, with Pine and Oil Seed Rape tree pollen also peaking. Oil Seed Rape is a common food crop in the UK, grown principally for oil production. Oil Seed Rape fields are easily recognisable by the bright yellow flowers which are characteristic of this species.
At the start of summer when temperatures are high and rainfall is low, pollen production is high, bringing the first peak of grass pollen. It is also the peak time for Dock, Nettle and Lime trees. As summer progresses, grass pollen takes over from tree pollen as the prime allergen and other plants are also still a bother. Activities such as lawn mowing and baling of hay may increase the levels of pollen.
As summer moves into autumn, the grass pollen season and weed pollen season both come to an end. The weather becomes cooler, and crucially damper, which can increase airborne mould spores. Most of the autumn allergies people experience in the UK are down to mould spores, as the damp weather increases the number of airborne mould spores.
Winter hay fever is not very common, as pollen should not be too much of an issue at this time of year. You are unlikely to experience hay fever during the winter months; however, you may experience symptoms of the common cold which have many similarities. These are highlighted later in this article.
The UK is facing a threat from changes in the geographical distribution of allergenic plants, due to climate change, with invasive species such as Ambrosia, also known as the common ragweed, being on the watch list. A single ragweed plant can produce a billion grains of pollen per season and its pollen causes strong allergic reactions.
What are the signs and symptoms of seasonal allergies?
An allergy can have respiratory symptoms similar to the common cold, such as coughing, sneezing, or a runny nose. However, there are also differences in symptoms. Allergy symptoms tend to hit all at once when you come into contact with an allergen.
If you have allergies, your immune system mistakes a substance that is ordinarily harmless to most people as a threat and goes into defence mode. Histamine is a substance produced by the body as part of its defence mechanisms. It is stored in cells called mast cells, in almost all tissues of the body.
When the body reacts to a foreign substance, known as an allergen such as flower pollen, that enters the nose, the mast cells that line the nasal passage are stimulated by the allergen and release their stores of histamine. At this early stage, there may be no symptoms.
The released histamine then binds to its receptors (H1 receptors), causing a chain reaction that results in allergic symptoms. It causes an increase in blood flow to the area of the allergy, and the release of other chemicals that add to the allergic response. This results in the symptoms of an allergic reaction. In allergic rhinitis, histamine causes white blood cells to flood into the affected area, causing the irritation and inflammation of the nose and eyes.
And results in some, or all, of the following symptoms:
- Itchy, watery eyes.
- A runny nose.
- Nasal congestion.
- Clear, thin, watery mucus.
- Sore throat.
- Feeling tired.
- Headaches, sinus pain and dark circles under the eyes.
Over the course of the next 6–12 hours, inflammation leads to the release of more histamine, and worsening symptoms. Whilst the symptoms are very unpleasant and can be debilitating, allergies are not contagious. Many people with seasonal allergies may also have asthma. If you have both hay fever and asthma, your seasonal allergens may trigger an asthma attack.
How are seasonal allergies different from a cold?
You catch a cold when a virus makes its way into your body. Your immune system responds to this foreign invader by attacking the virus. A cold is contagious and you can catch it when someone with a cold sneezes, coughs or touches you.
Cold and allergy symptoms can be similar; however, they have different causes and vary in type and duration. The common cold is a transmissible, viral illness, most commonly a rhinovirus or a coronavirus (not the same type of coronavirus that causes Covid-19).
A cold only affects your upper respiratory tract, your nose and throat, not your lungs. Because of this a cold is often referred to as a “head cold”. Colds usually aren’t serious.
More than 200 viruses can cause a cold, and adults can expect to have two to three colds a year. Children are likely to have even more colds every year. Most adults recover from a cold in around 7–10 days, but symptoms can persist for up to three weeks.
Usual cold symptoms include:
- Muscle aches.
- A blocked or runny nose.
- A sore throat.
Sometimes cold symptoms include:
- A raised temperature.
- Pressure in your ears and face.
- A loss of taste and smell.
Not typically symptoms of a cold:
- Diarrhoea or vomiting.
- Itchy, watery eyes.
In addition to the basic common cold symptoms, a person can develop complications from a cold virus.
- Prolonged, post-infectious phlegm and cough.
- Bronchitis or inflammation of the bronchial tubes.
- Ear infections.
- Worsened asthma or chronic obstructive pulmonary disorder (COPD).
Since colds and allergies share many of the same symptoms, it can be hard to tell if you are coming down with something or suffering from allergies. Symptoms of a cold usually appear one at a time and develop slowly over a few days, whereas allergy symptoms tend to hit all at once when you come into contact with an allergen. Colds may come with slight body aches and pains. Allergies are not usually associated with body aches and pains.
Colds are more common during the winter months but could also occur at any time of the year, whereas seasonal allergies are more common from spring to autumn when the pollen counts are high.
Colds typically run their course within 7–10 days. It’s important to get plenty of rest and keep yourself hydrated if you have a cold and it would be considerate to avoid contact with other people, to avoid spreading viruses, especially to older or vulnerable people who might become seriously unwell as a result.
If your cold symptoms last longer than 10 days, talk to your doctor. Allergy symptoms can last weeks or months, and will be present as long as you are exposed to the allergen.
How are seasonal allergies diagnosed?
Hay fever is usually easier to diagnose than other allergies. If you have allergic symptoms that only occur at certain times of the year, it is a sign that you have seasonal allergic rhinitis. Your doctor may also check your ears, nose and throat to make a diagnosis. Allergy testing usually isn’t necessary.
There is currently no cure for hay fever; however, there are many ways to alleviate and minimise the symptoms.
How are seasonal allergies treated?
Several allergy medications can improve symptoms and help you live with hay fever.
These treatments come in many forms, including:
- Eye drops.
- Nasal sprays.
While there are many different kinds of over-the-counter and prescription hay fever treatments, they essentially fall into two main categories: defence and relief.
Preventative treatments are designed to work in the early stages of hay fever, and at the first sign of your symptoms. Antihistamine tablets are a common example of preventative treatments.
As the name suggests, these work by blocking the action of histamines, which can cause your hay fever symptoms to flare up. However, it is worth remembering that some older antihistamines may cause drowsiness, so try to look out for the non-drowsy versions.
Tablets can take up to an hour to be effective; however, allergen barrier nasal sprays and nasal gels act directly in the nose and get to work within a few minutes. These treatments help to prevent the allergens from entering the nasal passage, and effectively defend the main gateway to the body – the nose.
The longer the exposure to the allergen, the more severe the symptoms become, so in the later stages of hay fever, the key is often to manage and minimise the symptoms with relief medication, enabling you to get back to normal life.
While antihistamines may be helpful in reducing a runny nose, or sneezing, they are less effective in combatting congestion. However, corticosteroid nasal sprays can help to control a number of different symptoms, from inflammation of the nasal lining and itchy red eyes, to a runny nose, swollen sinuses and sneezing.
Salt is a natural decongestant, so you can also use natural remedies such as a saline nasal spray to try to relieve allergic symptoms, including a runny nose or congestion.
Many hay fever sufferers find it useful to choose a combination of treatments that cover different stages of their symptoms.
If your symptoms do not improve after taking medicines from the pharmacy, or your symptoms are getting worse, speak to your GP. Your GP might prescribe a steroid treatment, such as a steroid nasal spray.
If steroids and other hay fever treatments do not work, your GP may, in some circumstances, refer you for immunotherapy.
This means you will be given small amounts of pollen as an injection or tablet to slowly build up your immunity to pollen. This kind of treatment usually starts in the winter about 3 months before the hay fever season begins.
How to manage seasonal allergies
The exact timing, peak and severity of pollen release will vary from year to year according to the specific weather conditions, with wind, temperature and rainfall all having some effect. A changing climate will mean that changes in temperature and rainfall may lengthen the UK pollen season and potentially make pollen concentrations higher.
The pollen count monitoring network combines Met Office weather data with expertise from organisations such as the National Pollen and Aerobiological Unit, who have been producing pollen forecasts at the University of Worcester since 1995, to produce pollen forecasts for 5 days ahead across the whole of the UK.
These begin in March each year and identify which pollen and fungal spore types are airborne at any one time. If you suffer from seasonal allergies then knowing the pollen count can help in planning your day.
Use the postcode of where you will be that day when you check to get an accurate forecast, and try to avoid going outdoors when the pollen count is Medium or High.
Allergens such as those from pollen can stick to your body, clothes and hair. To help reduce your exposure, make it a habit to remove your shoes, change your clothes and wash your hands and face when you come inside, and if your children have allergies, make sure they do the same.
Showering at night before bed can help make sure that allergens stuck on your hair and skin don’t end up in bed with you. If your child has allergies, giving them a bath or shower at bedtime can also help.
Other practical steps you can take to minimise your exposure include, but are not limited to:
- Be sure to always have your allergy medication at hand.
- Close windows at night.
- Vacuum regularly, preferably with a high-efficiency particle arresting (HEPA) filter in place.
- Avoid keeping flowers in the house.
- Avoid walking in grassy, open spaces, particularly during the early morning and early evening.
- Install pollen filters in your car.
- Drive with windows closed.
- Avoid drying washing outdoors when the pollen count is high or when cutting the grass, as this can bring pollen into the house.
- Consider wearing wrap-around sunglasses to stop pollen from getting in your eyes when outdoors.
- Consider wearing PPE masks when outdoors.
- Put Vaseline around your nostrils to trap pollen.
Pets can also suffer from seasonal pollen allergies just like humans. While the cause of the allergies is the same in pets as it is in humans, the signs can be a little different.
Here are some of the signs they might show if your pet is allergic to pollen:
- Licking or biting their paws.
- Excessive scratching.
- Redness of the skin, especially around the eyes and ears and in between the paws.
- Shaking their head.
- Rubbing their ears or muzzle.
- Tired or lethargic, particularly on days when the pollen count is high.
If you notice your pet showing any of these signs, particularly if it is seasonal, i.e. that it is worse in summer and better in winter, then that may mean it is possibly due to pollen, so take them to your vet so it can be diagnosed and treated.
It is important not to try home remedies on your pet before checking with your vet, or to give any medication to your pet without a prescription, as many can be dangerous in the wrong doses, or for certain species. Never give human medication to a pet.
Try to identify what times of year your pet is most affected. This means you can plan ahead and take precautions for locations you might want to avoid.
Other practical things you can do include:
- Try to avoid walking your dog in early morning and early evening as this is usually when the pollen count is highest. The best time to take dogs out is when the pollen is low, such as before dawn, and late evening, though these times vary depending on the weather.
- Keep dogs on a lead near grass; a quick roll in the grass can leave their fur covered in pollen, causing hours or even days of misery.
- Wipe their paws and muzzle after every walk. Sensitive baby wipes are ideal for this, or you can use special wipes designed for pets. If your dog is particularly sensitive your vet may advise rinsing them with water, or even shampoo, after walks to reduce their symptoms.
- Wash them weekly with a specialist hypo-allergenic pet shampoo.
- Wash their bedding weekly.
With some advice from your vet and by taking precautions, you can help to alleviate much of the suffering your pet might be experiencing due to seasonal pollen allergies. These actions can also help you if you also suffer from seasonal allergies.