I’m a GP – here’s my hay fever survival guide as pollen bomb set to explode, says Dr Zoe Williams
IT might be lovely and sunny outside but for those battling hay fever, this time of year can be miserable.
Around one in four adults are plagued by hay fever – and most are allergic to grass pollen, which erupts from mid-May until July.
I have been inundated with questions from readers about how best to manage and prevent the nasty symptoms, from itchy eyes to a runny nose and scratchy throat.
So here I answer a couple of the queries that kept cropping up again and again. I hope it helps bring a little relief.
Q. WHAT are the best treatments for sufferers of hay fever and where can I get them?
A. The pharmacy is the first port of call on this one, especially as generic antihistamines (non-branded) and other hay fever treatments are available over the counter and are generally cheaper to buy than a prescription.
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Here is the order of what to try:
Prevention is better than cure: Avoidance of pollen can make a huge difference and should not be forgotten.
Check out the NeilMed sinus rinse device which many allergy doctors advise using.
Antihistamines plus steroid nasal spray: First-line medicine treatment is with either antihistamine tablets (cetirizine or loratadine) or a steroid nasal spray.
It can take a few days, and up to three weeks, for a steroid spray to build up to its full effect.
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So ideally, start it a couple of weeks before you anticipate symptoms.
Most people forget to but it is worth bearing in mind this delay and stick with using it even if you do not get an immediate relief of symptoms.
Additional treatments: Your pharmacist can advise on what additional treatments to try based on your symptoms.
These include alternative types of nasal sprays (sodium cromoglicate, ipratropium bromide or decongestant), and eye drops.
If you are still having symptoms, the next step is to see your GP, who may prescribe the antihistamine fexofenadine, or for those who also have asthma may consider a drug called montelukast.
Occasionally, short courses of steroids are used for severe cases, and some people who have no relief, despite all of the above can be referred for immunotherapy.
Q) IS it safe to take hay fever medication when I am expecting a baby?
A) Women who already have hay fever can find that they are more sensitive to pollen while pregnant, and in others they may experience hay fever for the first time.
Pollen avoidance is always advised as the first strategy, whether pregnant or not, and simple measures like Vaseline in the nostrils can make a big difference.
In terms of medication, the first-line treatment should be a steroid nasal spray or sodium cromoglicate nasal spray, and they should be started about two weeks before you expect symptoms will start, as they can take a while to have an effect.
As these are sprayed directly into the nose, only very tiny amounts get into the bloodstream. It is fine to use sodium cromoglycate eye drops too.
If symptoms persist despite this and especially if they are severe enough to negatively impact your physical or mental health – for example preventing you from exercising or sleeping well – then you should speak to your GP or pharmacist to consider taking antihistamine tablets.
There is no evidence that they are harmful to the baby, but they haven’t been specifically tested.
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Usually, the preferred one to take during pregnancy is loratadine.
This and cetirizine are usually OK to take while breastfeeding.