Hay fever advice | NHS


Hello, I’m Dr Glenis Scadding. I work at the Royal National
Throat, Nose and Ear Hospital in London as a consultant allergist
and rhinologist. Hayfever is an allergy. It’s an allergy to pollen, usually to grass pollen,
affecting people in June and July, but sometimes to other pollens, tree pollens in the spring and
weed and mould pollens in the autumn. About 100 years ago
hayfever was very rare. It’s become increasingly common and now it affects
about one in four of the population. Diagnosis is usually by the history. It’s pretty easy to recognise that people who don’t have any problems
all year round and who suddenly have problems
in June and July have hayfever. And there’s often no need
to do any particular test. If, however,
the symptoms are not so clear or they’re on a background
of chronic symptoms, it may be worthwhile undertaking tests for specific IgE, that’s the allergy antibody
against the relevant pollen. And you can do that on the patient
by skin-prick testing. You can also do it by a blood test. Hayfever can really steal the summer
away from a patient. If you have a nose which runs
every time you go out, eyes which itch, a nose which blocks up
so you can’t talk properly, then the summer becomes a misery and the patient ends up staying indoors,
unable to go out and have fun, and sometimes
even severely affected enough to be unable to go to work or school. Hayfever symptoms usually start once the pollen grains
reach a certain level of about ten grains
per cubic millimetre. They last throughout the season
but they will vary from day to day because the pollen count varies
according to the weather. It will go down if it rains hard
or if it’s cold, it’ll be high
if it’s a very warm, sunny day. Treatments are available for hayfever. For very mild disease, then an
antihistamine taken as required is fine. And there are
perfectly good antihistamines available over the counter
at pharmacists’. The thing to avoid, though,
is taking a sedating antihistamine. If you do that, then you may be sleepy, your driving ability may be impaired and your working and academic ability
may also be impaired even if you don’t feel sleepy. Two puffs again. One up, one back. For anything more than mild disease, the first-line treatment of choice
is an intranasal steroid spray. It’s very sensible to start this
before the hayfever season starts, at least a couple of weeks before
the patient normally gets symptoms, and it’s much better taken
every single day without fail.