Hayfever season is upon us but there are solutions, write Connie Katelaris and Janet Davies.
Many adults struggle through spring and summer with watery eyes, running nose, itchy throat and the hallmark hayfever symptom, sneezing.
When people with hay fever are exposed to particular pollens, their body mistakenly treats this is a threat and triggers an allergic reaction.
Inflammatory cells quickly release mediators such as histamine and that is when the symptoms kick in.
In some people with hay fever, pollen allergens can trigger allergic symptoms in the lower airways as well as the nose, making it difficult to breathe.
Under certain climatic conditions, such as after thunderstorms, pollen allergy can trigger asthma attacks, even in those without a history of asthma.
Hay fever can have a profound effect on our ability to function normally.
The problem seems to be getting worse, or at least consumers are increasingly looking to alleviate their symptoms, as purchases of drugs to treat hay fever have climbed.
WHY YOU HAVE IT
Grass pollens are the major outdoor allergen trigger for hay fever. The timing and severity of the grass pollen season varies considerably between years and places, according to a recent analysis of 17 sites across Australia and New Zealand.
MANAGING SYMPTOMS
Several oral medications, nasal sprays and eye drops to treat hay fever are available over the counter at pharmacies. They work in different ways and have different pros and cons.
Antihistamines have been used to manage hay fever for decades and can be the first-line treatment for those with mild or occasional hay fever.
When you can predict exposure to an allergen, such as when lawn-mowing or going on a picnic in spring, taking an antihistamine before the exposure will provide better protection.
They are also safe to use in the long term.
Opt for the newer, non-sedating varieties of antihistamines.
The older drugs, which are still available, cause drowsiness and have been shown to contribute to workplace accidents in adults and impaired learning in children.
Antihistamines in general are good for itching, sneezing and watering symptoms, but do not relieve nasal blockage very well.
Decongestant tablets and sprays can do this job, but they are limited to relieving symptoms only and do not resolve the underlying inflammation.
Overuse of decongestant nasal sprays can lead to longer-term problems with nasal blockage, so limit their use to a few days only.
For people with moderate to severe and persistent symptoms of hay fever, the most effective medications are the intranasal steroid sprays.
These sprays have a ''preventive'' action and are most effective when use begins before the pollen season.
If not, they will start relieving symptoms after a few days.
The sprays must be used every day during the season to allow the best chance of success and to minimise side effects in the nose.
They have also been shown to reduce allergic eye symptoms.
Some people worry that these are ''steroid'' sprays, but they differ greatly from traditional oral steroids.
The modern topical steroid sprays are barely absorbed into the body so do not have the much-feared muscle-building steroid side effects.
A small percentage of people will experience some nasal bleeding, even if using the spray correctly; this is the most common side effect.
Some people with hay fever will have troublesome eye symptoms, usually itching, watering and redness.
If this is not relieved with topical nasal sprays, topical antihistamine eye drops can be very effective.
Rinsing the eyes with an artificial tear solution of saline fluid can also be very soothing.
For people with severe and prolonged symptoms or who cannot gain adequate control with available medications, allergen-specific immunotherapy is available.
This should be prescribed by an allergy specialist who determines the correct ''vaccine'' for the therapy.
The immunotherapy programme may extend over three to four years and is the only therapy that can provide long-lived benefit.
If you suffer from regular hayfever symptoms and medications do not seem to be working, talk to your doctor.
They can help guide you to the safest and most effective treatment option. - theconservation.com
Connie Katelaris is professor of immunology and allergy, UWAS and head of unit at South Western Sydney Local Health District. Janet Davies is a senior research fellow, Lung and Allergy Research Centre at the University of Queensland.
