Hay fever is an allergic reaction to pollen and grasses. It is most common in spring and summer when flowers are blooming and pollen is blown around by dry winds.

Symptoms include sneezing, runny or stuffy nose, itchy ears, nose and throat, itchy or watery eyes and headaches. These will often occur until the season changes, and there is less pollen in the air.

It is also called seasonal allergic rhinitis.

About 19% of Australians are affected by hay fever, mostly adults.

Many people don’t know about the various treatments available to manage hay fever, and just accept the symptoms. However, hay fever can be improved, and treatments work best when they are tailored for each person.

It can really help to reduce your exposure to the things that give you hay fever (called allergens), and to take appropriate medicine, either when you have hay fever symptoms or regularly to prevent the symptoms.

If you get symptoms all year round, you may be allergic to other substances, such as dust-mites, mould, or animal hair. Your general practitioner may be able to help find which allergens are causing your symptoms. If more complex tests or treatments are needed, the GP may refer you to an allergy specialist. Some tests and specialist appointments may be covered by Medicare, so always check with the clinic when making your booking.

Try to find out what sets your symptoms off. These triggers are called your ‘allergens’. You may be allergic to very specific pollens and plants – for example, not all grassy fields may set you sneezing, only those in a specific place or at a certain time of year.

Allergens getting into your nose and eyes are what cause the irritation and symptoms.

• Check out the pollen calendar to help you identify plants that may trigger hay fever and when they’re most likely to be flowering. You can find out what they look like too, so you can avoid locations where these plants might be growing.
• Keep an eye on the pollen count and forecast for your city or region. Several Australian cities have websites and mobile apps that monitor pollen counts from September to December every year. You can check if your city does on the Asthma Australia pollen count page.
• Smear petroleum jelly (such as Vaseline) inside your nose when you are outdoors. This helps trap pollen and stops it reaching the inner lining of your nose.
• Stay indoors as much as possible in spring when the pollen count forecast is high, and on windy days or after thunderstorms.
• Wear sunglasses and frequently splash your eyes with water. This will help protect your eyes from irritation and flush out any pollen.
• Stay away from parks and gardens when grass is being mowed. If you can’t avoid this, wearing a mask may help.
• Shower after playing sport and other outdoor activities to rinse off any pollen you’ve been exposed to.
• Use air conditioning and keep windows closed in the car, especially when pollen levels are high.

There are many medicines available to help with symptoms of hay fever. The more commonly used types are described below. (Except for some corticosteroids, most don’t need a prescription.) Always consult your doctor or pharmacist for advice on the best treatment for you.

You can use the Medicine Finder to check the active ingredients in hay fever medicines.

Antihistamines

Antihistamines help with rapid relief of hay fever symptoms like itchy eyes, sneezing and a runny nose. They are not good at relieving nasal congestion.

• For mild hay fever, an antihistamine may be the only medicine you need.
• All available antihistamines work equally well to relieve hay fever symptoms.
• Some antihistamines may make you drowsy, which could make it unsafe for you to drive or operate machinery.
• Some antihistamines may not be suitable if you are pregnant or breastfeeding.
• Antihistamines can be taken as tablets or as nose sprays. A nose spray has a faster onset of action than a tablet. If you are using a nose spray, follow the instructions carefully to make sure you get maximum benefit

Corticosteroids

Corticosteroid sprays help prevent symptoms of hay fever, including a blocked nose (nasal congestion). These nose sprays can provide some relief within 3–7 hours, but the real benefit comes when used regularly according to instructions over a period of several days.

• Corticosteroid spray is particularly useful for more severe hay fever.
  
• Make sure you use the spray for as long as directed to ensure the long-term preventative effects.
  
• Follow the instructions to get maximum benefit.
  

Antihistamine and corticosteroid combination sprays offer the advantage of rapid relief of symptoms combined with longer term hay fever prevention.

Decongestants

Decongestants are another type of medicine that can provide rapid relief from a blocked or stuffy nose (nasal congestion) if antihistamines and corticosteroid sprays fail.

• Decongestant medicines should not be given to young children (0–6 years of age). 
• Only give these medicines to older children (6–12 years) if recommended by your health professional.
  
• Decongestants can cause side effects like insomnia and irritability, and are not suitable if you have a heart condition or high blood pressure.
  
• Decongestant sprays should not be used longer than a few days as they can actually lead to a blocked or stuffy nose (known as rebound congestion).
  

Saline

Saline solution (salt water) drops or spray may also be useful to wash away pollen in the nose and help with a blocked or stuffy nose.

The packaging of some antihistamine medicines contains a warning about using these medicines while breastfeeding. 

If you are breastfeeding and need hay fever relief, talk with your health professional. They can help you decide which treatment option – nasal spray, eye drops or an antihistamine – might be most suitable for your situation.

• Antihistamines containing the active ingredient loratadine are usually the first choice for treating hay fever symptoms in women who are breastfeeding. This is because when used as directed only a small amount of loratadine passes into breast milk, and is unlikely to affect a breastfed baby.
  
• Other non-sedating antihistamines (eg, fexofenadine, cetirizine) are also considered safe for short-term use when breastfeeding.
  
• Sedating antihistamines – a different class of antihistamines (eg, promethazine, trimeprazine) – should only be used if recommended specifically by your doctor. These medicines can pass into breast milk, and make your baby irritable and drowsy.
  

You can use the Medicine Finder to check the active ingredients in the available antihistamines.

Thunderstorm asthma is a severe asthma attack brought on by pollen during thunderstorm activity. It can happen to people who don’t usually get asthma, and can be very dangerous.

Pollen can trigger asthma as well as hay fever symptoms. Asthma occurs in 30% of people with hay fever, and hay fever occurs in 80% of people with allergic asthma.

Thunderstorms can trigger asthma in people allergic to pollen.

• Strong winds that come with thunderstorms can distribute pollen grains over long distances.
• Rain can cause grains of pollen in the air to explode into tiny pollen particles which can more easily move through the upper airways into the lungs, triggering asthma.

If your asthma is triggered by pollens, and is worse in the peak hay fever season, it is important that you have a current asthma action plan which includes how to treat asthma attacks, and a plan for preventing asthma by regularly using a preventative medicine (like a corticosteroid spray).

Try to avoid being outside on high pollen days, particularly during windy days and thunderstorms. 

Find out more about thunderstorm asthma at National Asthma Council Australia

• For information on prescription, over-the-counter and complementary medicines, call the Medicines Line (1300 MEDICINE)
• Find out about asthma and hay fever at Asthma Australia
• Find detailed patient information at Australasian Society of Clinical Immunology and Allergy (ASCIA)