Seasonal hay fever: what are the warning signs and what can I do about it?

Hay fever, or allergic rhinitis, is a common condition that affects between 10–15% of children and 26% of adults in the UK.

Seasonal hay fever can make sunny spring and summer days feel more like an endurance test. Too many people with hay fever just accept the red itchy eyes and runny nose — but there are excellent hay fever treatments available that can reduce symptoms, help manage the condition and restore your quality of life.

We talked to Dr Chris Rutkowski, a renowned Consultant Allergist working at OneWelbeck and the World Allergy Organisation Centre of Excellence at Guy’s and St Thomas’s Hospital.

“If you've got hay fever, which is affecting your quality of life, it's important to see an experienced allergist,” Dr Rutkowski explained. “We can offer a comprehensive service that involves the correct diagnosis of your hay fever, skin prick and blood tests to identify what is triggering your allergy, treatment that controls your symptoms immediately, and immunotherapy which addresses the mechanism of your condition and helps reduce hay fever symptoms in the long-term.”

In this article, we will explain exactly what seasonal hay fever is, what the warning signs and symptoms are, and how Dr Rutkowski and the allergy team at OneWelbeck can help you identify your triggers, manage your hay fever and live a full and active life, whatever the season.

Hay fever is a common allergic condition that affects your nose, sinuses and eyes. It occurs when your immune system overreacts to allergens like grass and tree pollen, house dust mites or animal dander, making your eyes and nasal passages itchy and inflamed.

Dr Chris Rutkowski explained, “We should be tolerant of things around us. Our bodies should be able to ignore them without any symptoms — but allergy means that unfortunately, our immune system decides to fight with the environment.

“Pollens such as tree pollen and grass pollen can give us seasonal hay fever in the spring and summer months. If you have symptoms all year round, it is called perennial rhinitis, which can be due to an allergy to house dust mites or even your own pet.”

Many patients have an atopic tendency and/or family history of other allergic disorders such as eczema, food allergy, asthma, or indeed hay fever. It is likely that a combination of genetic factors and the environment predisposes us to allergies.

Everyone is different and the symptoms of hay fever can vary from person to person, but there are some classic signs to look out for:

• Sneezing
• Runny, itchy and stuffy nose — inflammation of your nasal passages can make them sore, swollen and likely to produce lots of mucous
• Itchy, red and watery eyes
• Itchy or scratchy throat and ears
• Post nasal drip with mucus running down from your nose — this can give you a sore throat and a cough
• Breathlessness and chest tightness (seasonal asthma)
• Tiredness and fatigue which is made worse by congestion and sleepless nights
• Headaches

Your hay fever symptoms can range from a mild sniffle to severe inflammation that can interfere with your work, social activities, school and sleep. If hay fever causes seasonal asthma, it could affect your ability to breathe and even put your life at risk.

“Hay fever can be annoying and can really mess up your life — but there are ways of changing the natural history of the disease,” Dr Rutkowski says. “We can suppress and control symptoms by changing how your immune system interacts with pollen/house dust mites/pet allergens. This is called immunotherapy or desensitisation.”

Exposure to allergens triggers hay fever. Your immune system recognises these substances as harmful, even though they don’t cause problems for most people.

Common allergens that trigger hay fever include:

• Pollen from trees, grasses, and weeds is a common allergen that triggers seasonal hay fever
• Dust mites, animal dander from pets, such as cats and dogs and mould spores can cause symptoms all year

Some factors, like pollution, can make allergies worse. Dr Rutkowski says, “Hay fever and allergic asthma are often much worse, for example, in kids growing up in inner cities or built-up areas with lots of motorways because of the pollution.”

Dr Rutkowski says: “If your hay fever symptoms are seasonal you may be able to work out the trigger. For example, if you suffer in March and April, that is the peak of the silver birch pollen season, or if you have really bad symptoms in June and July, you may have grass pollen allergy.”  However it is crucial to be allergy tested to identify the exact allergen(s) that triggers your hay fever and help you manage them more effectively. At OneWelbeck, we offer specialist allergy testing. We can support you to reduce your exposure to these allergens, treat your symptoms and offer allergen specific immunotherapy to reduce your body’s response to the relevant allergen.

Tests can confirm that you have hay fever and identify the specific allergens that are causing your symptoms. At OneWelbeck, we offer a number of tests for hay fever.

Skin prick test

As part of a skin prick test, we prick your skin with a number of suspected allergens and observe the skin for a reaction. If you are allergic to one of the allergens, you will see a raised red bump (hive) at the site of the prick.

Blood allergy test

During a blood allergy test, we measure specific IgE antibodies in your blood. If you have an allergy, your body produces these antibodies against a specific trigger such as pollen, dust mites, pet allergens.

Dr Rutkowski explains, “We put together your history, your symptoms, which part of the year you suffer in and your test results to confirm the diagnosis and design a treatment programme for you.”

Hay fever can develop at any age. Around one in four adults in the UK will experience hay fever.

Several factors can cause adult-onset hay fever. Dr Rutkowski tells us that “Adults can develop hay fever because of changes to their environment such as exposure to a different type of pollen, perhaps in combination with having a genetic predisposition.”

Hormonal changes also have an impact on the development of allergy.

At OneWelbeck, we use a holistic approach to help you manage your symptoms and help you live well with hay fever.

We can advise on preventing allergen exposure, as well as the right oral and topical medications for you. We can also desensitise you to the relevant  allergen using immunotherapy.

Below are some of the methods you can use to manage hay fever and alleviate your symptoms.

Avoiding allergens

Reducing your exposure to known triggers can reduce your symptoms. This can include:

• Wearing wrap-around sunglasses
• Staying indoors on high pollen days
• Applying Vaseline to your nostrils to trap pollen
• Using air conditioning instead of opening windows
• Changing clothes and showering when you come into the house

But it’s all about balance; we want to help you to live a fulfilling life, so if your seasonal hay fever is restricting your ability to enjoy the spring and summer months, we can create a treatment plan to tackle your symptoms.

Medication

Over-the-counter medications — including non-drowsy antihistamines, eye drops and nasal steroid sprays — can control hay fever symptoms for many people.

Dr Rutkowski recommends avoiding using nasal decongestants for prolonged periods because they can make the problem worse when you stop using the treatment.

He added: “We can try to optimise your treatment using a combination of medical therapies —  they can control your symptoms, but they don't address the root cause of your condition. If you need further treatments such as oral steroids, or your symptoms interfere with your life — you can't go outside, you don't sleep well, you can’t concentrate on your exams — then it’s time to consider a more targeted treatment like immunotherapy.”

Immunotherapy

Immunotherapy, or desensitisation therapy, is a ground-breaking allergy treatment that can reduce your body’s response to allergens and ease hay fever symptoms.

Dr Rutkowski explains how the treatment works. “In immunotherapy, we give you increasing doses of the relevant pollen extract depending on your diagnosis (tree or grass pollen etc). It's either given under the tongue (sublingual immunotherapy), or as an injection known as subcutaneous immunotherapy.

“Top quality clinical trials clearly confirm that if you complete a three-year course of immunotherapy, then you can expect many years of very mild symptoms or, in some patients, no symptoms at all.”

Immunotherapy can only be prescribed by a specialist Allergist or Immunologist.

“The available preparations are better and the safety profile has improved. We can address the origin of the problem and ‘train’ your body to stop reacting to allergens, without interfering with other parts of your immune system.”

We can’t completely cure hay fever, but we can manage the condition well with a combination of treatment including immunotherapy and relevant lifestyle changes. Dr Rutkowski tells us that although not a cure, immunotherapy modifies the disease process so that many patients can feel like they no longer have hay fever. After treatment, you may be able to reduce your hay fever medication or find you don’t need treatment at all. Immunotherapy can be particularly beneficial for children.

“In children, immunotherapy is very effective in controlling hay fever symptoms and improving quality of life — and also in preventing the development of seasonal asthma.”

If hay fever is severe, you don’t have to hide inside until the season passes. An appointment with OneWelbeck’s allergy team is the first step to restoring your quality of life.

At OneWelbeck Skin Health and Allergy, we can accurately diagnose your allergy, identify the allergens that are triggering your hay fever, and give immunotherapy treatment which can change the natural history of your disease — instead of just suppressing your symptoms.

Schedule your consultation today by contacting our knowledgeable and dedicated team.