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Dr Olympia Tsilochristou MD PhD
Consultant Allergist
Dr Olympia Tsilochristou - My Allergy Clinic
Hay fever, also known as allergic rhinitis, is the outcome of an allergic reaction that occurs mainly in the nose and eyes when the immune system overreacts to allergens present in the air. It affects about 26% of the adult population in the UK and is more common if there is a family history of hay fever. The most prevalent triggers for this in the UK are tree and grass pollen and house dust mites however mould spores can also be an issue. Unfortunately, our beloved pets can also cause hay fever symptoms with many pet owners struggling to enjoy the company of their devoted companions.
When the individual with hay fever comes in contact with these allergens, their immune cells in the nose and eyes release various chemicals with the main one called histamine which causes symptoms such as sneezing, a runny nose, itchy/watery eyes, and itchy throat/ears. For these symptoms, oral antihistamine (most available over the counter) should be helpful. However, some other elements of the immune system cause nasal congestion as part of the reaction and for this the patient requires the regular use of steroid nasal sprays.
Hay fever is a chronic inflammatory condition and for some people it is lifelong and it may evolve into asthma. Unfortunately, its impact to the individuals affected and to the society in general has long been underestimated. Indeed, the patient with hay fever is not an individual who just sneezes more than others do! Hay fever patients can have particularly disruptive symptoms with difficulty concentrating in their studies or work leading to underperformance. A study that was done in the UK some years ago, showed that patients with severe seasonal hay fever are significantly more likely to have a >50% impairment in their work productivity than those with mild hay fever while an international study had clearly demonstrated that hay fever precludes students from achieving their full potential.
Nevertheless, it is important to keep in mind that for those patients with severe hay fever symptoms, especially if they are not doing well despite taking the steroid nasal spray and the oral antihistamine, the option of allergen immunotherapy (aka desensitisation) can be considered. Allergen immunotherapy addresses the cause of the hay fever symptoms i.e. the actual allergy and intends to increase the tolerance towards the allergen it is received for. Therefore, allergen immunotherapy reduces the hay fever symptoms and the need for the related medications and ultimately improves quality of life. Studies also suggest that immunotherapy can stop the progression of hay fever into asthma. Immunotherapy was previously done mostly via injections but nowadays we can prescribe sublingual immunotherapy that is a dissolvable tablet placed under the tongue once daily for 3 years. It is a treatment that lasts long but it is the only way to change the mistake the immune system makes by misrecognising the allergen as an enemy and overreacting. Therefore, speaking with an Allergist about your hay fever symptoms will be helpful as the trigger can be identified and an appropriate management plan can be set to ensure you do not suffer!
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