Hay fever, or seasonal allergic rhinitis, is a common allergic reaction to allergens like pollen or dust.
These airborne particles get into the upper respiratory passages, causing a reaction that results in the mucous membranes (mucosa) of the nose and eyes becoming inflamed, causing a runny nose and watering eyes, among other symptoms.
Depending on the type of hay fever you have, it will usually be worse between February and September. The warm, humid, and windy weather combined with the normal higher pollen count means a more substantial amount of allergens present.
The symptoms of hay fever and allergic rhinitis appear when an allergen - namely pollen - comes into contact with your nose, eyes, mouth, and throat. This causes a reaction, generating the common symptoms.
The root of this allergic reaction is your body making allergic antibodies (IgE) to the allergens. This is because the body mistakes the particles for harmful organisms. These antibodies create an exaggerated response when you come into contact with these allergens, like watering itchy eyes or a runny nose.
Allergic rhinitis is seasonal. However, perennial allergic rhinitis is present all year round. The latter is typically tied to indoor allergens like house dust mites and moulds.
The symptoms can often be confused with a cold as they are similar. However, hay fever can last for weeks or months, whereas a cold will usually clear up after 1 to 2 weeks.
Although it isn’t infectious, allergic rhinitis is incredibly common. It affects between 10% and 30% of all adults, and up to 40% of children.
The commonly used name ‘hay fever’ is misleading as it isn’t confined to the time of year hay is collected, and it never causes a fever.
You are genetically predisposed to developing a type of allergic rhinitis if you also have other atopic conditions such as eczema or asthma.
If a person has seasonal allergic rhinitis, their symptoms will be present anywhere between February and September. This time frame is commonly referred to as ‘hay fever season.’
As seasonal allergic rhinitis is mainly triggered by pollen, it will depend on which pollens they are allergic to.
However, if a person has perennial allergic rhinitis, they may experience symptoms year round. This is due to their triggers not being associated with the seasons, but instead more constant allergens like household dust mites or pets.
It was once thought that allergic rhinitis developed in childhood, but it is now known to develop at any age.
Adults can suddenly start reacting to allergens even if they didn’t as children, and currently, it is unclear why this happens.
Children are still more likely to develop hay fever than adults, especially if they have other allergy-related conditions such as eczema or asthma. Children’s symptoms usually lessen by the time they reach 40 years old.
In general, the UK has a high number of people living with hay fever and its symptoms - as many as 1 in 4.
There are a few locations that were brought to light as ‘hot spots’ after a study comparing the number of patients prescribed antihistamines in relation to the total number of patients in the area.
These places, in descending order, were:
People with hay fever or perennial allergic rhinitis experience their symptoms after breathing in airborne allergens that they have become sensitive to. These allergens create an exaggerated response from the immune system, resulting in typical hay fever symptoms.
Symptoms can affect the nose, eyes, throat, and sinuses. People with hay fever will experience a mixture of symptoms, which include:
Allergic rhinitis can also be known to cause, or play a part in:
Depending on the type of allergic rhinitis a person suffers from, different kinds of allergens will trigger their symptoms.
Seasonal allergic rhinitis (hay fever) is triggered exclusively by pollen, whereas perennial rhinitis is caused by a number of other things.
If a person has both types, during hay fever season they will be subject to a higher volume of triggers making their symptoms worse.
The triggers for seasonal allergic rhinitis are tree, grass, and weed pollen released between February and September.
Roughly 25% of people with hay fever are allergic to tree pollen, which is present between February and June.
Some trees don’t cause hay fever - like flowering trees such as cherry - as they have larger, sticky pollen that travels on insects. Instead, the trees that have tiny pollen cause symptoms. Their pollen is small enough to be carried on the wind, meaning it can travel for miles. Breathing in just a small amount is enough to trigger symptoms.
Some of the trees that could cause symptoms are:
In the UK, a staggering 9 in 10 people with hay fever are allergic to grass pollen, making it the most common type of pollen allergy.
Grass pollen is another airborne type that is present from May to September, though the peak ends late July.
The main grasses that cause hay fever in the UK are:
Weed pollen is mostly released from June to September. Although an allergy to weed pollen isn’t as common as the other types, if you experience symptoms later into the year, there is a good chance that this type is one of your triggers.
Some of the weeds whose pollen causes problems include:
Perennial allergic rhinitis triggers are different to their seasonal counterparts. Instead, these are present all year round.
Dust mites are too small to see with the naked eye and are closely related to ticks and spiders.
They live in warm and humid environments like bedding, carpets and rugs, and upholstered furniture, feeding on the shed skin cells of humans.
They are the most common indoor allergen and can cause symptoms all year round.
However, contrary to what you might think, it’s not the actual dust mites that trigger perennial allergic rhinitis symptoms. Instead, it’s the faeces and decaying bodies of dead dust mites. Pleasant!
This debris releases protein particles that are even smaller than pollen. These particles become airborne when disturbed, and if they make their way into a person’s airways, they can trigger symptoms.
Mould is a fungus that grows in a variety of places indoors and outside. There are thousands of different types of mould, some invisible to the eye, and others easy to spot.
One of these moulds that we have all seen or battled at some point is Alternaria. It is commonly found in bathrooms growing in dark dots, lines, or circles. Each area can spread to the size of a dinner plate if left to grow.
As well as enjoying the damp environment of our bathrooms, Alternaria grows naturally on just about any object or source that can provide it with enough water to grow. This includes:
Another common mould you’re likely to encounter is Cadosporium. It tends to grow on rotten organic material and anything that is affected by water damage.
While the moulds themselves don’t trigger symptoms, it is instead their spores that cause a reaction.
Spore numbers increase when a damp environment suddenly increases in temperature. An example would be the sun coming out after rain on a warm day, or the heating being turned on in a damp house.
Many people are pet owners, but unfortunately our furry friends can be the cause of many allergy-related conditions, perennial allergic rhinitis included.
Cats and dogs are the key culprits, mainly down to the fact that they tend to be more free roaming over other pets such as rabbits.
A common misconception is that allergies are caused by a pet’s fur, but it is instead the proteins present in their dander, flakes of skin, urine, and saliva that trigger a reaction. Other allergens like pollen or mould spores can also be carried in a pet’s fur, adding more allergens to the mix.
Unfortunately, there are no truly “hypoallergenic breeds” of cats or dogs as dander isn’t affected by the length of a pet’s fur, nor the amount a breed sheds.
If you are living with a pet that you think is triggering your perennial allergic rhinitis, giving up your pet isn’t always the only option to bring symptoms under control. An allergist or immunologist will be able to confirm your triggers and put together a management plan for you. This means there is potential to improve your quality of life and still keep your pet.
Many people who have perennial allergic rhinitis switch to natural flooring such as coir carpet or sisal carpet. These floorings are a less ideal home for dust mites, and it is more difficult for particles to trapped within them.
Unlike the other conditions we have covered, allergic rhinitis only has two types:
It is possible to have either type or a combination of the two, depending on what triggers a person’s hay fever symptoms. This is due to some triggers being seasonal, and some being present all year round.
Commonly just referred to as allergic rhinitis, this type is defined by the seasons. People whose symptoms are triggered exclusively by pollen suffer from hay fever. Their symptoms are tied to the times of year that pollen is released by grass, trees, and weeds.
This time of year is also known as ‘hay fever season’, which can start as early as February and last until late September.
It causes all the recognised hay fever symptoms including a blocked nose, sneezing, and itchy watering eyes.
In perennial allergic rhinitis symptoms are present throughout the year. This is because symptoms are caused by substances other than pollen, including house dust mite faeces, animal proteins from skin or saliva, and industrial dust, vapours, and fumes.
Although similar to hay fever, the symptoms of perennial allergic rhinitis mainly affect the nasal area inducing a runny, congested nose and sneezing.
Over time, those living with this condition can experience a reduced sense of smell and headaches. Infections of the middle ear and sinuses are also possible.
Some people with perennial allergic rhinitis may also develop nasal polyps which are round, soft growths on the lining of the nasal passage or sinuses. They can form due to chronic inflammation, recurring infection, or allergies.
Sometimes these polyps may need to be surgically removed if they cause extreme discomfort.
Another type of rhinitis is non-allergic rhinitis.
Non-allergic rhinitis is not caused by an allergic reaction, unlike its counterparts. However, it does share many of the same nasal symptoms like a blocked, runny nose, sneezing, and so on.
Instead of allergens, non-allergic rhinitis is usually caused by swollen blood vessels and fluid build up in the nasal tissues. This stimulates the mucus glands in the nose to overproduce.
Non-allergic rhinitis can be caused by a number of things, including:
Although it may appear similar, it is essential to determine whether your symptoms are caused by non-allergic or allergic rhinitis. Doing so will affect how you manage and treat your condition.
Like other atopic conditions, there is no absolute cure for either type of allergic rhinitis. Instead, those living with the conditions find ways to manage their symptoms.
Management can take shape in the form of medications, lifestyle choices, habits, and products. Finding the right mixture of management methods is the key to effectively managing allergic rhinitis.
During hay fever season keep an eye on the daily pollen count. On days where the count is higher, stay indoors whenever possible.
Pollen levels are typically higher on warm, dry days, and lower on cooler wet days. This is because rain washes pollen from the air.
It’s not always possible to stay inside when the pollen count is higher, so instead, you will need to adopt methods to reduce your contact with it as much as possible.
Applying a layer of Vaseline around your nose will help trap any pollen before it gets into your airways to cause irritation. Wearing wrap-around sunglasses can also stop pollen from getting into your eyes and irritating them too.
After being outside, take a shower and wash your hair to get rid of any pollen caught on you, and change your clothes as there will be pollen trapped in their fibres.
After washing your clothes, dry them indoors to avoid pollen attaching to them. If your symptoms are triggered by dust mites or dander, keep windows closed to avoid any allergens being disturbed by a draft, and keep any pets out.
To the dismay of some, and the joy of others, it’s best to avoid cutting the grass and leaving that job to someone else. If you must do this task yourself or tending to your garden is a hobby you love, protective gear may be in order.
Wearing a mask to help filter pollen will help make outdoor tasks much more bearable. However, it’s best not to wear them for hours on end as they can get hot and a little uncomfortable. They also need to fit well and make a seal to minimise inward air leakage. This means that defaulting to a surgical mask isn’t always the best option.
You will want to protect your eyes from allergens as well, so wearing wrap around glasses or even goggles can be beneficial.
Granted, neither of these options are particularly fashionable, but not all outdoor tasks are social occasions.
With pollen in mind, be wary of bringing plants into your home. Fresh flowers are especially likely to cause flare-ups, so avoid them as much as possible. Instead, stick to plants that rarely flower like the Sansevieria.
Although vacuuming can disturb allergens like dust mites and dander, regularly cleaning will minimise the number of spores and particles that can become airborne.
Choose a vacuum fitted with a high-efficiency particulate air (HEPA) filter. These filters pick up tiny particles like allergens that regular vacuums would recirculate back into the air. When choosing a vacuum, check that it is fitted with a true HEPA filter that has been proven to trap a minimum of 99.97% of particles of 0.3 microns.
Other HEPA filters are available, but only true ones will have the best particle trapping power.
When dusting use a damp microfiber cloth to minimise the amount of particles that will become airborne.
You can also wear a mask when cleaning to help filter allergens from the air you breathe.
After a thorough clean it can take up to two hours for the dust to resettle, so either keep your mask on for this time or arrange for cleaning to be done when you’re not home.
Removing mould in your home, or keeping it to a minimum is of utmost importance when it’s one of your triggers. Luckily, this can be much easier than avoiding dust or pollen as you simply need to remove the right conditions for it to grow.
Carpets can trap allergens in them, especially if they have a thick pile. They make the ideal home for dust mites and harbour animal dander. Even chemical free pure wool carpets can provide the perfect home for allergens, so switching wall to wall carpet out for another option would be worth considering.
Hardwood or cork flooring would make a good alternative as they won’t trap particles within them. Instead, they rest on the surface and are more visible, which would in turn prompt more regular cleaning, removing said particles.
Hardwood flooring can also be mopped instead of vacuumed, meaning fewer particles will become airborne in the process.
If hardwood or cork flooring isn’t to your taste, you could instead try seagrass carpets and rugs. Made from natural fibres, seagrass carpets also have the added bonus of being static-free. This means that they repel dust and dirt, making cleaning up these particles much easier as they won’t be trapped in the carpet’s fibres.
If you’re concerned about high traffic areas wearing away natural fibres quickly, coir flooring could be ideal. It’s made from tough fibres taken from the husk of coconuts, a nut known for its hardy nature.
Changing the flooring in your home isn’t an easy task, but if anything it should be a consideration for the bedroom to minimise any sleep disruption from allergens.
Sometimes prescribed steroids or other hay fever management medications might not work. In this instance, your GP might refer you for immunotherapy.
The process involves the patient receiving doses of pollen, either via a monthly vaccine or daily tablets are taken orally. Over a period an immunity or tolerance to pollen will hopefully build up resulting in long-term remission.
Currently, immunotherapy is primarily for seasonal allergic rhinitis where pollen is given to the patient. However, therapy for dust mite related perennial allergic rhinitis has started in Europe.
Studies have shown that for immunotherapy to be effective, it needs to be carried out for at least three years. Although the initial time investment is large, when compared to the lifelong need for nasal sprays, antihistamines, lifestyle changes etc. the therapy and time period become worthwhile.
With all of its possible benefits, immunotherapy does also come with the risk of triggering a severe allergic reaction. With this in mind, it is still considered a good option for those who do not respond to anti-allergic medications.
Managing allergic rhinitis can be challenging, especially since removing and avoiding allergens can feel near impossible. Luckily companies have developed products that can help in managing symptoms and minimising contact with allergens.
As well as using any medication prescribed by your GP or specialist, here are some products you can try to help with your hay fever.
Although the little tins are made for your lips, Vaseline original petroleum jelly can be applied around your nose to create a barrier. It can help to catch some pollen and allergen particles before they make it into your airways to cause irritation.
Keep one of the pots handy in your bag or pocket for when you’re on the go.
Salt pipes are an all natural, drug and preservative free method to help manage hay fever. Salt therapy can help to relieve the symptoms from hay fever, as well as asthma, allergies, and other coughing and sinus issues.
Salt pipes are easy to use and can help to cleanse the airways of impurities and congestion. Try the Cisca Easy Saltpipe from Holland and Barrett.
Hay fever affects millions of people during both hay fever season, and throughout the year. The severity of each case differs on a massive scale, and each person has their own story of their battle with allergic rhinitis.
Here we share stories from some of the people living with allergic rhinitis, how their symptoms affect them, and what they are doing in day to day life to manage these symptoms for a better quality of life.
It’s not something I ever really thought about before, but allergies have always been in my family. My dad grew up with asthma, my grandma has terrible psoriasis, and my sister has always had really painful and intense eczema which meant she had to quit being a makeup artist. But I was always the non-allergic one, it felt almost like an achievement.
I had my first experience with allergies in my late teens when I all of a sudden got hay fever during my school exams. It was the first summer I’d noticed it, and it came on so strong. My eyes would stream and cover my paper with water, my throat would burn, and everything felt so itchy; my scalp and my eyes specifically.
Every year since then I have been a full-blown hay fever sufferer, and I really mean sufferer because anyone who gets it badly knows how much it can really affect your day to day life.
The pills never seemed to work for me, so one year I went to a private doctor who offered me a light steroid injection. It was my sister’s wedding, and I didn’t want to feel so poorly on such an important day. It worked immediately, my hay fever was gone, and it didn’t return all summer.
It’s safe to say I became a bit addicted to having it every year, but after a few, I noticed some symptoms that made me think twice about continuing. I saved it for only if I really needed it and I’ve also realised that each summer is different and some years the pills do work, so I wait to see how bad it gets before panicking too much.
After having an allergy test, I realised specifically what type of hay fever I have (trees), so I know it comes earlier in the year. I know when to line my nostrils with vaseline, and I don’t bother eating local honey or trying remedies that aren’t linked to what I have, as I know exactly where my allergies come from.
In more recent years I have also experienced eczema which again, has been quite difficult to manage.
I think it’s an old wives tale that your skin allergies change every ten years, but I really feel like mine do. At 18 I got hayfever, at 28 I got eczema, so let’s see what 38 brings eh? Maybe they’ll all go away - here’s hoping.