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A quarter of all people in the UK currently have hay fever – equating to a huge 16 million people. Hay fever is responsible for millions of sick days every year and is said to cost the economy in the UK more than £300 million in lost productivity every year.
As well as the symptoms people with hay fever experience, the Natasha Allergy Research Foundation (NARF) states that people with hay fever are four times more likely to suffer from other conditions connected to hay fever, such as eczema, asthma and food allergies.
What is hay fever?
Hay fever, also known as allergic rhinitis, is an allergic reaction to pollen. Pollen is a fine, powdery substance that is produced by plants. Hay fever typically occurs when the pollen comes into contact with your mouth, nose, eyes or throat.
Exposure to pollen can cause cold-like symptoms that can negatively impact a person’s life.
There are approximately 30 different types of pollen that can cause hay fever. As different plants produce pollen at different times of the year, people experience hay fever symptoms at different times. However, hay fever is usually more prevalent in the Spring and Summer months when the weather is warmer, and plants and flowers release more pollen.
People with hay fever usually experience symptoms between the end of March and September when the pollen count is highest. The pollen count is the amount of pollen in the air. The higher the pollen count, the higher the risk of a person experiencing symptoms of hay fever.
The weather can have a significant impact on the amount of pollen in the air and the severity of hay fever symptoms. If there is higher humidity and more wind, this can result in pollen spreading more easily and more occurrences of hay fever. A lack of rain can also increase hay fever as it prevents pollen from being cleared from the air.
You may experience more severe hay fever symptoms at different times of the day. Usually, pollen counts are higher in the early morning and the late evening. This is because pollen rises in the air during the day and then begins to descend in the evening when the air begins to cool.
What causes hay fever?
Hay fever is an allergic reaction to pollen. If you have hay fever, this means your body overreacts because it sees pollen as a threat. Your immune system will release antibodies that are designed to fight the threat.
Next time you come into contact with pollen, the antibodies will send a signal to your immune system. Your immune system will then respond as though it is fighting a virus or infection and release several chemicals, such as histamine, that are designed to prevent the spread of the perceived virus or infection.
These chemicals can then cause a reaction. These are the symptoms of hay fever, including red, swollen eyes and a runny nose.
There is no one known cause of hay fever, and it is still not clear why certain people’s immune systems react to pollen this way.
However, there are several risk factors that could increase the likelihood of a person developing hay fever, including:
- Having asthma.
- Having eczema.
- Having another allergic condition.
- Having a close blood relative who has allergies or asthma.
- Being exposed to tobacco smoke or diesel exhaust particles in early childhood.
- Being exposed to high levels of pollution.
- Living or working in an environment that consistently exposes you to allergens.
What are the different types of hay fever?
There are approximately 30 different types of pollen that can cause hay fever. Some people are allergic to one type of pollen whereas others are allergic to two or more types.
This pollen can come from different plants, including:
This is the most common cause of hay fever. Approximately 90% of those with hay fever in the UK have an allergic reaction to the pollen produced from grass.
You can be allergic to the pollen from one or multiple types of trees. This could include oak, cedar, birch, ash and apple trees. Around 25% of people with hay fever have an allergy to tree pollen. Different types of trees release pollen at different times.
Weeds cause hay fever less frequently than other plants. Hay fever caused by weeds is more prevalent in Autumn than Spring or Summer.
This is another common plant that causes hay fever. Some flowers rely on the wind to disperse their pollen, rather than bees. This results in pollen becoming airborne and can increase the prevalence of hay fever.
Different plants release pollen at different times of the year. This means that depending on the type of hay fever you have, you are likely to experience symptoms at different times.
The exact timing of when the pollen season will begin and when the pollen count will be at its highest can vary from year to year. This is because weather conditions, including temperature, wind and rainfall, can have a significant impact on the amount of pollen that is in the air.
Below is an approximation of when the different types of pollen are released into the air and when your hay fever symptoms are likely to be more severe.
|Type of Hay Fever||Usual Period of Pollen Release||Peak Pollen Release|
Signs and symptoms of hay fever
The signs and symptoms of hay fever can vary from person to person and can change depending on the type of pollen you are allergic to. Symptoms can also vary from month to month and year to year, depending on the pollen count and the weather.
Some common hay fever symptoms include:
- A runny nose or nasal congestion.
- Frequent sneezing.
- Itchy, watery, red or swollen eyes.
- An itchy nose, throat, roof of the mouth or ears.
- A cough.
- Swollen, blue coloured skin under your eyes.
- Postnasal drip (mucus dripping from the back of the nose down the throat).
Some less common symptoms of hay fever include:
- Loss of sense of smell.
- Facial pain.
- Frequent headaches, particularly around the temples and forehead.
- Fatigue or tiredness.
If you have asthma, your symptoms may worsen when you have hay fever.
Symptoms may include:
- A tight feeling in your chest.
- Shortness of breath.
- Wheezing and coughing.
These symptoms occur as your body tries to protect you from hay fever pollen. Your symptoms are meant to protect you by trapping or expelling the allergen or by preventing it from entering your body. For example, sneezing aims to expel allergens; swollen eyes and nasal passages aim to prevent allergens from entering your body.
As well as the physical symptoms they experience, people with hay fever may also experience other negative effects, including:
- Reduced quality of life
Hay fever can cause people to avoid leaving the house, meaning they don’t attend work or school or miss out on social or leisure activities. They may also experience less enjoyment of activities they do participate in.
- Development of other conditions
As mentioned earlier, people with hay fever are significantly more likely to develop asthma, eczema and food allergies. These conditions may only cause symptoms when the individual is also experiencing hay fever or may be a year-round condition.
- More severe asthma
Hay fever can worsen the symptoms of asthma, causing a person to experience worsened coughing, wheezing and even difficulties breathing.
Hay fever can cause prolonged sinus congestion. This can cause inflammation or an infection of the membrane lining the sinuses and increase an individual’s susceptibility to sinusitis.
- Lower self-esteem
Some of the symptoms, such as red or swollen eyes, a runny nose and a cough, can cause some people to become self-conscious or experience lower self-esteem.
- Poor sleep, fatigue and tiredness
Symptoms of hay fever can lead to fatigue or make it difficult to sleep. This can lead to tiredness and exhaustion and affect an individual’s concentration, cause irritability or stress and affect their overall health.
How to treat hay fever yourself
Although there is currently no known cure for hay fever, there are certain things you can do to ease the hay fever symptoms yourself.
Below are some tips you should follow to help alleviate hay fever symptoms when the pollen count is high:
- Stay indoors, if possible, when the pollen count is high.
- Keep windows and doors shut, especially if there is any breeze or wind.
- Use a hoover regularly and ensure you clean surfaces in your home thoroughly to remove any pollen particles.
- Shower and change your clothes after you have been outside to ensure there is no pollen on your body, hair or clothing.
- Put Vaseline or a similar substance around your nose to trap any pollen.
- Use a pollen filter on the air vents of your car.
- Wear wraparound sunglasses to protect your eyes from pollen.
- Check the weather forecast and plan your day based on when the pollen count is highest.
As well as the things you should do, there are some things that you should avoid doing:
- Avoid gardening and cutting grass and do not plant flowers or plants in your garden that are wind-pollinated.
- Don’t keep fresh flowers in the house.
- Don’t smoke or be in close contact with someone who is smoking.
- Avoid drying your clothes and other laundry outside.
- Avoid being around pets that have been outdoors.
- Wear a mask if you work outside or are outside for long periods.
How to stay away from triggers
Hay fever symptoms are triggered by exposure to pollen or high pollen counts. Being aware of triggers and actively trying to reduce your exposure to triggers can help to reduce your symptoms.
Some ways that you can stay away from triggers include:
Be aware of the type of hay fever you have
As different pollen allergies occur at different times of the year, being aware of which pollen you are allergic to can help you to prepare for the occurrence of any hay fever symptoms.
Reduce your exposure to hay fever triggers
Reducing your exposure to pollen can help to prevent or alleviate your symptoms. Wearing sunglasses and a pollen mask, avoiding outdoor activities such as gardening and walking the dog, and not drying your laundry outside are some simple ways you can avoid exposure to pollen.
Be aware of the pollen count
Being aware of the pollen count and weather factors that can affect your hay fever, such as heat and wind, can help you to know if your hay fever is likely to be triggered that day. You can then stay away from triggers or take preventative medication to prevent hay fever symptoms.
Keep indoor air clean
Keeping the air in your house clean can help to prevent pollen particles from entering your home. When the pollen count is high, avoid leaving windows and doors open. You could use a dehumidifier or air conditioning in your home to help clean and circulate the air. A high-efficiency particulate air (HEPA) filter can be used in your house or car to help filter any pollen out of the air.
Visit the seaside
Pollen counts are significantly higher in cities and the countryside. The sea breeze that you can feel close to the coast helps to blow pollen inland, meaning the pollen count is lower the closer you are to the coast. On a hot summer day, it can often be very difficult to stay indoors in order to avoid pollen. Visiting the seaside can help you avoid triggers and still enjoy being outdoors without experiencing symptoms and can be a great way to spend time outdoors, even if the pollen count is high.
Keep a hay fever diary
Keep track of when your hay fever symptoms occur, what you were doing at the time, the weather, the date, and the pollen count. As many people’s triggers are different, this can help you to find patterns in your triggers and the occurrence of your symptoms.
What is a high pollen count?
People with hay fever typically experience symptoms when the pollen count is high. So what is a high pollen count?
The pollen count is the number of grains of pollen that are present in one cubic metre of air. In order to calculate the pollen count, air samples are collected over 24 hours. This information is then considered alongside the weather conditions to forecast the pollen levels for upcoming days.
To collect air samples, a Burkard trap is placed on rooftops at least two or three storeys high. Placing the trap higher ensures that the air sample contains fewer pollutants and dust and offers a more accurate pollen count.
Inside the Burkard trap, there is a spindle with sticky paper wrapped around it. The spindle rotates slowly, drawing air in. As air flows through the trap, pollen particles are collected on sticky paper and then counted using a microscope.
What is considered a high pollen count depends on the type of pollen you are counting.
Below are the pollen counts for the most common types of pollen that cause hay fever.
|Pollen Count||Type of Pollen|
|VERY HIGH||704 +||342 +||267 +|
The Met Office uses its weather data and pollen information to produce five-day pollen forecasts across the UK, starting in March every year. Bear in mind that different people are more sensitive to pollen. This could mean you experience more severe hay fever symptoms than others, even if the pollen count is not considered very high.
Diagnosis of hay fever
In many cases, you will not need to visit your GP in order to receive a diagnosis of hay fever. The majority of people can be diagnosed by and receive treatment from a pharmacist based on a description of their symptoms.
However, in some cases, you may have to visit your GP to undergo allergy testing or for additional treatment.
Some examples of when you may need to visit a GP include:
- If your symptoms are severe or unusual.
- If you experience symptoms year-round.
- If usual treatments do not alleviate your symptoms.
- If you have experienced complications as a result of hay fever.
- If your symptoms affect your quality of life.
- If you experience other conditions such as asthma, eczema or chronic sinus infections.
In some situations, your GP may refer you for an allergy test.
There are two main types of allergy testing:
1. Skin prick test
This involves a doctor or immunologist placing the pollen allergen on your arm and then pricking the surface of your skin with a needle in order to introduce the allergen to your immune system. If you have a pollen allergy, you should have a reaction on your skin, such as itching, swelling or redness.
2. Blood test
A doctor will take a sample of your blood and test it to see if the Immunoglobulin E (IgE) antibody is present in your blood. IgE is an antibody that your body produces in reaction to pollen if you have hay fever.
When visiting either a GP or a pharmacist to receive a diagnosis or treatment for hay fever, you should first consider your symptoms. This is because different pollen types can cause symptoms at different times of the year.
Being aware of when your hay fever symptoms occur can help you to determine which type of pollen you are allergic to. You should also consider how long your symptoms occur for. If you only experience symptoms for a few days or a week, it is more likely you have a cold, rather than a pollen allergy.
Treatment of hay fever
As well as the home treatments we have already looked at, one of the most common ways for treating hay fever is with over-the-counter medication that you can obtain from a pharmacy. There are several different treatments that are designed to treat different hay fever symptoms.
These work by blocking the chemical, histamine, that your body releases in response to pollen. Histamines cause many of the common hay fever symptoms, including itching, sneezing and watery eyes. Antihistamines can be used to treat all of these symptoms or as a preventative measure when pollen levels are high to prevent symptoms from developing.
- Corticosteroid nasal sprays and drops:
Corticosteroids are a type of steroid that is anti-inflammatory. They can reduce inflammation of your nose and nasal symptoms, including a blocked nose, sneezing, and itchy or watery eyes. Corticosteroids should not be used for more than 2-4 weeks.
- Nasal decongestants:
This is a nasal spray used to relieve a blocked nose by reducing swelling in the blood vessels in your nose. Nasal decongestants should only be used for a week or less.
- Eye drops:
These relieve symptoms that affect your eyes, including redness, itching, watering and allergic conjunctivitis. They can help to reduce any inflammation in your eyes.
If you have persistent or severe hay fever symptoms that are not relieved by medication, your GP may recommend you for immunotherapy. The aim of immunotherapy is to achieve long-term pollen desensitisation. Immunotherapy involves you gradually being introduced to a small amount of pollen in a controlled environment, such as a medical centre.The pollen can be administered via an injection, known as systemic injection immunotherapy (SIT), or by a tablet that dissolves underneath your tongue, known as sublingual immunotherapy (SLIT). Immunotherapy usually begins three months before the start of the pollen season and the amount of pollen you are exposed to will be gradually increased. It usually takes around three years of immunotherapy to maximise the results.