Hay Fever

Also known as: Mate hei, Rhinitis

• Hay fever, also known as allergic rhinitis, occurs when a person’s nose lining and/or eyes become inflamed after being exposed to an allergen (something that provokes an allergic response such as pollen, or dust).
• This causes sneezing, coughing and red, itchy eyes, among other symptoms.
• Hay fever is very common in New Zealand.

There are two types of hay fever:

1. Seasonal allergic rhinitis: this is the type of hay fever that occurs at certain times of the year when allergens are in season e.g. grass pollen during spring and summer.
2. Perennial allergic rhinitis: this kind of hay fever can happen at any time of year as the allergens aren’t seasonal e.g. pets and dust mites.

• When the cells in a person’s nose lining or eyes come into contact with an allergen, histamine is released, causing inflammation.

Most of the time, various types of grass pollen are responsible for hay fever, but people can also be allergic to:

• Dust mites
• Pet dander (fur and skin flakes)
• Mould spores
• Cockroach poo

Seasonal

• When hay fever is caused by airborne pollen, it is seasonal. This tends to occur in spring or summer. The period of time in which pollen is around will depend on the species of plant the patient is allergic to and their location.

• Sneezing
• Itchy, runny and/or blocked nose
• Itchy, red eyes which may also be puffy
• Watering eyes
• Itchy, sore and/or blocked ears
• Itchy throat and/or mouth
• People who get severe hayfever may also:
• Be more likely to get sinus and eye infections
• Struggle to get a good night’s sleep
• Have trouble managing their asthma (if they have it)

Diagnosis

• Hay fever can be confused for a common cold or nasal polyps. A doctor will consider the patient’s symptoms and the timing of them, and check their nose, eyes and throat for any indicators of irritation or congestion.
• If it’s still not clear, a doctor may send the patient for a blood test or skin prick test to figure out what they’re allergic to. A GP may also consider sending a patient to an allergy specialist if symptoms are severe and ongoing .
• A skin prick test is when a doctor pricks a patient’s skin and adds a tiny drop of allergen substance to it. If the patient is allergic, the skin around the prick becomes red or darker, swollen and sometimes itchy—the reaction usually occurs within 15 minutes. Up to 30 different allergens may be tested at one time.

• The best treatment for hay fever is to avoid any allergens. Sometimes this is easier said than done, so medications can be helpful to prevent hay fever or manage the symptoms.
• Most treatments will involve antihistamine tablets or a nasal steroid (see below).
• Some patients who have severe hay fever may find allergen immunotherapy (AIT) helpful. Immunotherapy builds up a person’s resistance to an allergen over time, by exposing them to small amounts of it more often. A doctor will administer a small amount of the allergen under a patient’s tongue, in their nose or by injection. This happens periodically for 3–5 years until their immune system reacts differently to the allergen.

Medication

• There are a number of medications that can be used to help manage hay fever including:
• Antihistamines, either in tablet form or nasal sprays
• Corticosteroid nasal sprays
• Decongestants—these should only be used for a short time
• Eye drops—both medicated and non-medicated
• Combination medications e.g. an antihistamine and a decongestant

Common over-the-counter medications

• Antihistamines, nasal sprays, eye drops and combination medications can all be purchased over-the-counter.

Proactive protection

If you have hay fever, the best thing you can do is avoid what you’re allergic to.

Pollen can be tricky to avoid but some things you can do to help include:

• Staying indoors as much as you can while the pollen count is high, particularly on windy days
• If you have a garden, opt for plants that are pollinated by birds and insects rather than plants that release airborne seeds
• Keeping your windows and doors shut
• Changing and washing your clothes after going outside
• Showering or splashing your eyes with cold water after you’ve been outside
• Vacuuming your home often, ideally with a vacuum that has a high-efficiency particulate absorbing (HEPA) filter
• Dusting often with a damp cloth
• Asking someone else to mow your lawn
• Wearing wraparound sunglasses to help protect your eyes from pollen
• Installing pollen filters in the air vents of your car

If you’re allergic to dust mites, here are some things you can do to help:

• Install a good ventilation system in your home to prevent dampness (dust mites love moist conditions)
• Opt for a vinyl or leather couch rather than soft, cloth materials
• Use dust mite covers on mattresses and pillows
• Vacuum often using a vacuum cleaner that has a HEPA filter—better yet, get someone else to do it
• Dust with a damp cloth regularly
• Frequently wash any soft toys in the house with hot water, or place them in a freezer for a couple of days
• If you’re allergic to pet dander, the best thing you can do is to not have a pet or opt for a hypoallergenic breed. Alternatively, you can try:
• Keeping your pet outside and out of your bedroom
• Washing them regularly

• Hay fever can make asthma more difficult to manage. If you have asthma, see your doctor at the end of autumn to prepare for spring (hay fever season).
• If you’re having trouble managing your allergies, book in with one of our Tend GPs.

• Depending on what a person is allergic to, hay fever will last for different amounts of time. People who are allergic to grass pollen may experience bouts on and off over spring and summer.
• The period of symptoms will also depend on the severity and what treatments are being used.