Hay fever: symptoms, treatment, how long it lasts and what helps

The NHS lists the symptoms of hay fever below. They are usually worse between late March and September, especially when it is warm, humid and windy, when the pollen count is at its highest. NICE Clinical Knowledge Summaries (CKS) describes the typical symptoms as sneezing, nasal itching, a runny nose (rhinorrhoea) and congestion.

• Sneezing and coughing.

• A runny or blocked nose.

• Itchy, red or watery eyes.

• An itchy throat, mouth, nose and ears.

• Loss of smell.

• Pain around the sides of your head and your forehead, and headache.

• Feeling tired.

The NHS says to speak to a pharmacist if you have hay fever, as they can give advice and suggest the best treatments, such as antihistamine drops, tablets or nasal sprays, and steroid nasal sprays. Some antihistamines can make you very sleepy, so ask about non-drowsy antihistamines if you need them.

The NHS says to see a GP if your symptoms are getting worse or do not improve after taking medicines from the pharmacy. The GP might prescribe a steroid treatment. If steroids and other treatments do not work, the GP may refer you for immunotherapy, where you are given small amounts of pollen as an injection or tablet to slowly build up your immunity. This kind of treatment usually starts a few months before the hay fever season begins.

The NHS says there is currently no cure for hay fever and you cannot prevent it, but you can do things to ease symptoms when the pollen count is high. Allergy UK adds that pollen counts tend to be higher in the early morning and evening, and recommends monitoring pollen forecasts and limiting outdoor activities on high pollen days.

The NHS says hay fever is an allergic reaction to the fine powder that plants produce, called pollen, usually when it comes into contact with the mouth, nose, eyes and throat. Allergy UK says the medical term is allergic rhinitis, and that early in the year, pollen from trees commonly planted in the UK such as alder, birch and hazel can cause symptoms.

NICE CKS defines allergic rhinitis as an IgE-mediated inflammatory disorder of the nose that occurs when the lining of the nose becomes sensitised to allergens. When caused by grass and tree pollen it is known as hay fever, while perennial symptoms throughout the year are typically due to house dust mites and animal dander. It says allergic rhinitis is common, affecting around 23 to 30% of the population in Europe, and usually begins in childhood and adolescence.

The NHS says hay fever can last for weeks or months, unlike a cold, which usually goes away after 1 to 2 weeks. Symptoms are usually worse in the pollen season, between late March and September. NICE CKS classifies symptoms as intermittent (less than four days a week or four consecutive weeks) or persistent (more than four days a week and more than four consecutive weeks).

NICE CKS lists complications including reduced quality of life, impaired school and work performance, disturbed sleep, reduced concentration, and possible development of asthma, sinusitis and nasal polyps. Allergy UK says unmanaged hay fever symptoms can give rise to asthma or make existing asthma worse, which may lead to a serious attack. If you have asthma symptoms of a tight chest, wheeziness and difficulty breathing, urgent medical help should be sought.

The NHS says to see a GP if your symptoms are getting worse or do not improve after taking medicines from the pharmacy. NICE CKS says referral to an allergy or ENT specialist is considered if there are red flag features suggesting an alternative or serious diagnosis, if symptoms persist despite optimal management in primary care, or if the diagnosis is uncertain because allergy testing may be needed.

On the NHS, most hay fever is managed with pharmacy advice and over-the-counter medicines, with a GP prescribing steroid sprays and referring for allergy tests or immunotherapy if needed.

Private allergy clinics can offer allergy testing and immunotherapy planning. Ask what testing is expected to add, which pollens are involved, and when immunotherapy would need to start in relation to the season.