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Hay fever


Disease: Hay fever Hay fever
Category: Allergies

Disease Definition:

Also called allergic rhinitis, hay fever causes cold-like symptoms including congestion, sinus pressure, sneezing and a runny nose. However, hay fever is caused by an allergic response to indoor or outdoor airborne allergens such as pollen, dust mites or pet dander, while a cold is caused by a virus. For some people, hay fever could get worse at certain times of the year, mostly in the spring, summer or fall. Other people have hay fever year-round. Hay fever is one of the most common allergic conditions affecting about one in five people.


In some cases, the symptoms of hay fever may be a minor, temporary nuisance. However, if the symptoms are more persistent, they might make someone miserable, affecting the performance at work, school or leisure activities. Although finding the right hay fever treatment makes a big difference for most people, however, it won't completely eliminate the symptoms.

Work Group:

Symptoms, Causes


Usually, immediately after someone has been exposed to specific allergy-causing substances (allergens), the signs and symptoms of hay fever will develop and may include:


  • Cough
  • Sneezing
  • Nasal congestion and runny nose
  • Decreased sense of smell or taste
  • Swollen, blue-colored skin under the eyes (allergic shiners)
  • Watery or itchy eyes
  • Sinus pressure and facial pain
  • Itchy nose, roof of mouth or throat


The signs and symptoms of hay fever may interfere with someone's daily activities and have an impact on their quality of life including sleeplessness, fatigue and irritability.


Triggered by grasses, weeds or tree pollen, someone's symptoms may start or worsen at a particular time of year. On the other hand, someone may have year-round symptoms in case they're sensitive to indoor allergens including cockroaches, pet dander, dust mites or mold.


Hay fever is most likely to start during childhood or early adulthood despite the fact that it could begin at any age. Over years, the severity of hay fever reactions could change, which is quite common. In most cases, the symptoms of hay fever tend to diminish slowly, usually over decades.



When compared with a cold, the signs and symptoms of hay fever may be different.


For instance, the signs and symptoms of hay fever usually include a runny nose with thin, watery discharge without fever. These symptoms start immediately after a person has been exposed to allergens and last as long as they are exposed to these allergens. While the signs and symptoms of a cold usually include a runny nose with watery or thick yellow discharge and a low-grade fever. These symptoms start one to three days after exposure to cold virus and last five to seven days.


A person's immune system mistakenly identifies a harmless airborne substance as something harmful during a process called sensitization and starts producing allergy-causing antibodies. These antibodies recognize the substance the next time they come in contact with it and signal the immune system to release chemicals into the bloodstream such as histamine, causing a reaction that leads to the irritating signs and symptoms of hay fever.


Either seasonal or year-round (perennial) allergens trigger hay fever. Some people have allergy symptoms that linger all year long but get worse during certain times of the year.


These are some of the seasonal hay fevers triggers:


  • Weed pollen, which is common in the fall
  • Tree pollen, which is common in the spring
  • Spores from fungi and molds, which could be worse during warm-weather months
  • Grass pollen, which is common in the late spring and summer.


These are some of the year-round hay fever triggers:


  • Cockroaches
  • Dust mites
  • Spores from indoor and outdoor fungi and molds
  • Dander, which is the dried skin flakes and saliva from pets including dogs, cats or birds.


Despite its name, hay fever is almost never triggered by hay and it doesn't cause a fever. Hay fever does not mean that a person's allergic to hay.



Some of the other health problems that usually occur along with hay fever may include:



Eczema is also called dermatitis and causes swollen, red or itchy skin.


In case a person has asthma, some of their signs and symptoms may be coughing, wheezing, a tight feeling in the chest, difficulty breathing and shortness of breath.

Ear infection:

Hay fever in children is often a factor in middle ear infection, also called otitis media.


Sinusitis is an infection or inflammation of the membrane that lines the sinuses. Someone's susceptibility to sinusitis may increase in case they have prolonged sinus congestion due to hay fever.


To help relieve hay fever symptoms there are a number of over-the-counter and prescription medications which include eyedrops, nasal sprays, pills and liquids. A combination of allergy medications provides relief for most people. To determine what works best for someone, several medications may have to be tried first. A person may need a prescription medication from their doctor or over-the-counter medications could be enough to relieve symptoms.


Parents should talk with a doctor about the best treatment in case their child has hay fever. Some medications are only approved for adults. Parents should also make sure to read the labels carefully if they want to try an over-the-counter medication for their child.


Some of the medications for hay fever are:

Oral corticosteroids:

To relieve severe allergy symptoms, oral corticosteroids could sometimes be used such as prednisone. These medications are usually prescribed only for short periods of time because long-term use could cause some serious side effects such as muscle weakness, osteoporosis and cataracts.

Nasal corticosteroids:

The inflammation caused by hay fever could be prevented and treated with these nasal sprays. These are usually the first prescribed medications and are the most effective hay fever medications for many people. Someone may not notice any improvement until after they've used these medications for a week or so despite the fact that they start working after a few days of treatment. For most people, nasal corticosteroids are a safe long-term treatment. Nose irritation and unpleasant smell/taste are some of their side effects. Examples include beclomethasone, fluticasone, fluticasone and mometasone.


Although these oral medications and nasal sprays have little effect on congestion, but they could help with itching, sneezing and runny nose. These medications work by blocking histamine, which is an inflammatory chemical released by the immune system during an allergic reaction. Clemastine and diphenhydramine are older over-the-counter antihistamines that work just as good as new antihistamines do, but they make a person drowsy. Although new oral antihistamines are less likely to make someone drowsy, but they are more expensive. Some of the new over-the-counter antihistamines are cetirizine and loratadine. One example of a prescription antihistamine is fexofenadine. Azelastine is a prescription antihistamine nasal spray that begins relieving symptoms after minutes of use. This medication could be used eight times a day, but it could cause drowsiness. A bad taste in the mouth right after use is one of its side effects.


These are medications that are available in prescription and over-the-counter nasal sprays, tablets and liquids. Oxymetazoline and phenylephrine are some examples of nasal sprays; and Actifed, Drixoral and Sudafed are some examples of over-the-counter oral decongestants. Oral decongestants should be avoided if someone has hypertension because they could raise blood pressure. Another bad point about oral decongestants is that they could worsen the symptoms of prostate enlargement and make urination more difficult. Someone shouldn't use a decongestant nasal spray for more than two or three days at a time because when it is used for a longer time, it could end up causing rebound congestion.

Leukotriene modifiers:

This medication has proven to be effective in treating allergic asthma and hay fever. Montelukast is a prescription tablet that blocks the action of leukotrienes, which are immune system chemicals that cause allergy symptoms such as excess mucus production. Headache is one of its possible side effects, while abdominal pain, dental pain, dizziness and cough are some of its less common side effects. As is the case with antihistamines, this medication is not as effective as inhaled corticosteroids. It is usually used when mild asthma is present or when nasal sprays can't be tolerated.

Cromolyn sodium:

This medication must be used several times a day. It is available as an over-the-counter nasal spray. By preventing the release of histamine, it helps in relieving hay fever symptoms. This medication is most effective when started before signs and symptoms develop and it doesn't cause any serious side effects.

Nasal atropine:

By preventing the glands in the nose from producing excess fluid, this medication, ipratropium bromide, which is available in a prescription nasal spray, helps in relieving a severe runny nose. However, it won't treat sneezing, postnasal drip or congestion. Sore throat, nasal dryness and nosebleeds are some of its side effects. It may cause more-severe side effects in rare cases, such as difficult urination, blurred vision and dizziness. This medication is not recommended for men with an enlarged prostate or people with glaucoma.


Some of the other treatments for hay fever may include:

Nasal lavage:

A person may be recommended rinsing their nose with salt water to help with irritating nasal symptoms. Someone can either prepare their own saltwater solution using one quarter of a teaspoon of salt mixed with 2 cups of warm water, or they could use an over-the-counter nasal saline spray.
Both of these could be very effective at relieving congestion.


Someone may be recommended allergy shots (desensitization therapy or immunotherapy) in case medications don't relieve their hay fever symptoms. They will receive regular injections containing purified allergen extracts over a period of three to five years. Desensitizing the person to specific allergens, reducing their signs and symptoms and decreasing the need for medications are some of the things that this treatment aims at. If someone's allergic to cat dander, dust mites or pollen produced by trees, weeds and grass, immunotherapy may be particularly effective. Immunotherapy could also help prevent the development of asthma in children.


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