Do you or someone you know struggle with hay fever? What hay fever medicine do you reach for, and do you know if it’s the best option for you? For some people, allergic rhinitis (hay fever) symptoms can be slightly annoying, but for others they can make each day an unbearable struggle of constant sneezing, blocked noses and itchy eyes.
Nasal sprays, antihistamine tablets, and eye drops are just some of the options available to manage your symptoms. In this guide, we explain hay fever and your options for managing symptoms.
Hay fever, also called allergic rhinitis, occurs when your immune system reacts to allergens, such as pollen from grasses, trees and weeds. There are two types of allergic rhinitis: seasonal allergic rhinitis and perennial allergic rhinitis.
In New Zealand, seasonal allergic rhinitis is more common in the spring and summer months when pollen from plants is carried through the air.
Perennial allergic rhinitis occurs year-round, often triggered by dust mites, mould, and pet dander (tiny flakes of skin shed by animals).
The symptoms of hay fever include:
The symptoms of hay fever can often be like a cold or flu. If you also have muscle aches and pains or a fever, it is more likely to point towards a cold or flu. Ask a pharmacist or doctor if you are unsure.
Reducing your exposure to allergens can help manage hay fever, and medicines can provide additional symptom relief. Below, we outline the medicines often used to manage the symptoms of hay fever.
Antihistamines are commonly used by people with allergies. They work by blocking the effects of histamine, a chemical released by your body during an allergic reaction. This can ease sneezing, itching, runny noses and watery eyes caused by allergies. Antihistamines come in a variety of forms including tablets, nasal sprays, liquids, and eye drops.
Common antihistamine medicines available as tablets include cetirizine, loratadine and fexofenadine. There is no single tablet that works best for everyone, but some antihistamines might work better for you than others. Some antihistamines can make you feel sleepy or drowsy, while others are less likely to cause drowsiness. Even medicines described as non-drowsy can affect some people. Azelastine is an example of an antihistamine used in nasal sprays.
Steroid nasal sprays work by reducing the inflammation inside your nose caused by allergens. They treat the congestion caused by inflammation as well as sneezing, itching, and a runny nose.
Some examples of corticosteroid nasal sprays available in New Zealand include fluticasone, budesonide, and beclomethasone.
These sprays work best when used regularly every day. It can take a few days to a couple of weeks for the full benefit to be felt. If you can predict when your hay fever will begin, you can start before you expect your allergies to begin. People with seasonal hay fever will usually need to use these sprays during the hay fever season. Follow the directions for your specific product.
Some combination allergy products contain an antihistamine and a corticosteroid, providing dual action relief by blocking histamine and reducing nasal inflammation. Dymista is an example of one of these products. It contains azelastine and fluticasone.
Decongestants are used for the short-term relief of a blocked nose (nasal congestion). Decongestants are available as tablets, capsules, and nasal sprays. These medicines work by narrowing the blood vessels in your nose and sinuses, reducing swelling and making it easier to breathe.
Common nasal decongestants include oxymetazoline and xylometazoline. Common oral decongestants are phenylephrine and pseudoephedrine, but these are not routinely used for hay fever treatment.
Decongestants aren’t suitable for everyone, and some require pharmacist consultation or a prescription. Ask your pharmacist for advice to make sure they are suitable for you. Using decongestant nasal sprays beyond the recommended period can cause rebound congestion. Follow the duration stated on the product label.
Itchy and watery eyes are a common symptom of hay fever. There are a range of different eye drops with different actions. Eye drops used for the treatment of eye allergies can contain antihistamines, mast cell stabilisers, decongestants or steroids (sometimes in combination). Steroid eye drops require prescribing and monitoring by an eye-care professional.
Lubricating eye drops can also be used to wash allergens from the eye surface.
Saline is a mixture of salt dissolved in sterile water. Saline nasal products can be used to clear allergens, dust or irritants from the nasal passages and reduce the symptoms of hay fever. They don’t contain any medicines and won’t cause rebound congestion. Saline nasal products you can buy include saline drops, saline mists or sprays, and saline washes or rinses.
If you are mixing a nasal rinse, follow the product instructions and use water that has been boiled and cooled. Do not use untreated tap water.
When looking for a treatment for your hay fever symptoms, here are the key things to remember. Antihistamine tablets are commonly used to help with sneezing, itching, and a runny nose. For persistent symptoms and nasal congestion, a corticosteroid nasal spray is generally more effective. If itchy eyes are a problem, you can get targeted relief using eye drops. The table below might be helpful when you are looking for a treatment.
Remember, product age limits, directions and suitability can vary, so it’s important to always read the label. Ask your pharmacist if you need help choosing.
Speak to your healthcare provider or pharmacist if your hay fever treatment is not controlling your symptoms, you are unsure what’s causing your symptoms, or your symptoms are affecting your daily life. For severe, ongoing allergies, seeing a specialist for an assessment may be worthwhile. They can suggest additional treatment options such as allergen immunotherapy.
Hay fever can make asthma harder to control. Speak to your healthcare provider if you develop wheezing, chest tightness or breathlessness.
Allergy New Zealand (external link)
