But unlike a cold, hay fever isn't caused by a virus. Hay fever is caused by an allergic response to outdoor or indoor allergens, such as pollen, dust mites or pet dander.
Hay fever can make you miserable and affect your performance at work or school and interfere with leisure activities. But you don't have to put up with annoying symptoms. Learning how to avoid triggers and finding the right treatment can make a big difference.
Time of year can be a factor Your hay fever symptoms may start or worsen at a particular time of year, triggered by tree pollen, grasses or weeds, which all bloom at different times. If you're sensitive to indoor allergens, such as dust mites, cockroaches, mold or pet dander, you may have year-round symptoms. Many people have allergy symptoms all year long, but their symptoms get worse during certain times of the year.
Is it hay fever? Or is it a cold? Signs and symptoms can be different. Here's how to tell which one's causing your symptoms:
Nasal corticosteroids. These prescription nasal sprays help prevent and treat the nasal inflammation, nasal itching and runny nose caused by hay fever. For many people they're the most effective hay fever medications, and they're often the first type of medication prescribed. Examples include fluticasone propionate (Flonase), triamcinolone (Nasacort AQ), mometasone (Nasonex) and budesonide (Rhinocort). Nasal corticosteroids are a safe long-term treatment for most people. Side effects can include an unpleasant smell or taste and nose irritation. Steroid side effects are rare.
Antihistamines. These preparations are usually given as pills. However, there are also antihistamine nasal sprays and eyedrops. Antihistamines can help with itching, sneezing and runny nose but have less effect on congestion. They work by blocking histamine, a symptom-causing chemical released by your immune system during an allergic reaction. Older over-the-counter antihistamines such as diphenhydramine (Benadryl) work as well as newer ones, but some types can make you drowsy. Newer oral antihistamines are less likely to make you drowsy. Over-the-counter examples include loratadine (Claritin, Alavert), cetirizine (Zyrtec Allergy) and fexofenadine (Allegra). Prescription antihistamines include levocetirizine (Xyzal) and desloratadine (Clarinex). The prescription antihistamine nasal sprays azelastine (Astelin, Astepro) and olopatadine (Patanase) can relieve nasal symptoms. Antihistamine eyedrops help relieve eye itchiness and eye irritation caused by hay fever.
Decongestants. These medications are available in over-the-counter and prescription liquids, tablets and nasal sprays. Over-the-counter oral decongestants include Sudafed and Drixoral. Nasal sprays include phenylephrine (Neo-Synephrine) and oxymetazoline (Afrin). Oral decongestants can cause a number of side effects, including increased blood pressure, insomnia, irritability and headache. Don't use a decongestant nasal spray for more than two or three days at a time because it can actually worsen symptoms when used continuously (rebound congestion).
Cromolyn sodium. This medication is available as an over-the-counter nasal spray that must be used several times a day. It's also available in eyedrop form with a prescription (Crolom). It helps relieve hay fever symptoms by preventing the release of histamine. Cromolyn sodium doesn't have serious side effects, and it's most effective when you begin using it before your symptoms start.
Leukotriene modifier. Montelukast (Singulair) is a prescription tablet taken to block the action of leukotrienes — immune system chemicals that cause allergy symptoms such as excess mucus production. It's especially effective in treating allergy-induced asthma. It's often used when nasal sprays can't be tolerated, or when you have mild asthma. It can cause headaches. In rare cases, montelukast has been linked to psychological reactions such as agitation, aggression, hallucinations, depression and suicidal thinking. Seek medical advice right away for any unusual psychological reaction.
Nasal ipratropium. Available in a prescription nasal spray, ipratropium (Atrovent) helps relieve a severe runny nose by preventing the glands in your nose from producing excess fluid. It's not effective for treating congestion, sneezing or postnasal drip. Mild side effects include nasal dryness, nosebleeds and sore throat. Rarely, it can cause more-severe side effects, such as blurred vision, dizziness and difficult urination. The drug is not recommended for people with glaucoma or men with an enlarged prostate.
Other treatments for hay fever include:
Allergy shots (immunotherapy). If medications don't relieve your hay fever symptoms or cause too many side effects, your doctor may recommend allergy shots (immunotherapy or desensitization therapy). Over a period of three to five years, you'll receive regular injections containing tiny amounts of allergens. The goal is to get your body used to the allergens that cause your symptoms, and decrease your need for medications. Immunotherapy may be especially effective if you're allergic to cat dander, dust mites, or pollen produced by trees, grass or weeds. In children, immunotherapy may help prevent the development of asthma.
Rinsing your sinuses. Rinsing your nasal passages with distilled, sterile saline (nasal irrigation) is a quick, inexpensive and very effective way to relieve nasal congestion. Rinsing directly flushes out mucus and allergens from your nose. Look for a squeeze bottle or a neti pot — a small container with a spout designed for nose rinsing — at your pharmacy or health food store. Use water that's distilled, sterile, previously boiled and cooled, or filtered using a filter with an absolute pore size of 1 micron or smaller to make up the saline irrigation solution. Also be sure to rinse the irrigation device after each use with similarly distilled, sterile, previously boiled and cooled, or filtered water and leave open to air-dry.
– Close doors and windows during pollen season.
– Don't hang laundry outside — pollen can stick to sheets and towels.
– Use air conditioning in your house and car.
– Use an allergy-grade filter in the ventilation system.
– Avoid outdoor activity in the early morning when pollen counts are highest.
– Stay indoors on dry, windy days.
– Use a dehumidifier to reduce indoor humidity.
– Use a high-efficiency particulate air (HEPA) filter in your bedroom.
– Avoid mowing the lawn or raking leaves, which stirs up pollen and molds.
– Wear a dust mask when doing outdoor activities such as gardening.
– Use allergy-proof covers on mattresses, box springs and pillows.
– Wash sheets and blankets in water heated to at least 130 F (54 C).
– Use a dehumidifier or air conditioner to reduce indoor humidity.
– Vacuum carpets weekly using a vacuum with a small-particle or HEPA filter.
– Consider removing carpeting in the bedroom if you're highly sensitive to dust mites.
– Block cracks and crevices where roaches can enter.
– Fix leaky faucets and pipes.
– Wash dishes and empty garbage daily.
– Sweep food crumbs from counters and floors.
– Store food, including pet food, in sealed containers.
– Consider professional pest extermination.
– Remove pets from the house, if possible.
– Bathe your pets on a weekly basis. Using wipes to reduce dander also may help.
– Keep your pets out of the bedroom.
– Clean floors often with a vacuum cleaner that has a HEPA filter.
Simple changes to your lifestyle and environment can reduce your exposure to allergens so you can feel better and enjoy the spring weather instead of suffering through it!
- Vanessa Andricola, Pharm. D.