Hay Fever

Hay fever or allergic rhinitis is a condition that may sometimes not be very easy to identify. Usually, when you sneeze a lot and feel your nose often runny or stuffy, your eyes, mouth or skin start to feel itchy, it means that you are suffering from hay fever. This is a condition that affects nowadays 40 to 60 million Americans.

Just like many other allergies, allergic rhinitis appears when the body’s immune system is sensitized and overreacts to something in the environment that typically causes no problem in most people. What is more, contrary to what the name suggests, you do not have to be exposed to hay to have hay fever and you also do not have to have fever to have this condition.

Allergic rhinitis takes two different forms:

  • Seasonal: Symptoms of seasonal allergic rhinitis can occur in spring, summer and early fall. During this period of the year, the seasonal allergic rhinitis appears because you are exposed to airborne mold spores or to pollens from grass, trees, and weeds.
  • Perennial: In this case, people face the symptoms all year-round. It is generally caused by dust mites, pet hair or dander, cockroaches or mold. Underlying or hidden food allergies rarely cause perennial nasal symptoms.

Some people may experience both types of rhinitis, with perennial symptoms getting worse during specific pollen seasons. There are also nonallergic causes for rhinitis.

Symptoms

Hay fever signs and symptoms can include:

  • Runny nose and nasal congestion
  • Watery, itchy, red eyes (allergic conjunctivitis)
  • Sneezing
  • Cough
  • Itchy nose, roof of mouth or throat
  • Swollen, blue-colored skin under the eyes (allergic shiners)
  • Postnasal drip
  • Fatigue

Seasonal factors

In case of the seasonal hay fever, the factors that trigger the symptoms during the specific periods of the year, are the following:

  • Tree pollen, which is common in early spring.
  • Grass pollen, which is common in late spring and summer.
  • Ragweed pollen, which is common in fall.
  • Dust mites, cockroaches, and dander from pets can occur year-round (perennial). Symptoms to indoor allergens might worsen in winter when houses are closed up.
  • Spoors from indoor and outdoor fungi and molds are considered both seasonal and perennial.

How do you know if you have hay fever or a common cold?

As the signs and symptoms are quite similar, there are though some differences that will help you differentiate one condition from the other.

Hay feverCold
Signs and symptomsRunny nose with thin, watery discharge; no feverRunny nose with watery or thick yellow discharge; body aches; low-grade fever
OnsetImmediately after exposure to allergens1-3 days after exposure to a cold virus
DurationAs long as you’re exposed to allergens3-7 days

Risk Factors

There are several risk factors that increase the risk of developing hay fever:

  • Having other allergies or asthma
  • Having atopic dermatitis (eczema)
  • Having a blood relative (such as a parent or sibling) with allergies or asthma
  • Living or working in an environment that constantly exposes you to allergens — such as animal dander
  • Having a mother who smoked during your first year of life

Complications

Even though hay fever may not seem a very serious disease, often times confused with a common cold, there are can appear several complications:

  • Reduced quality of life. Hay fever can interfere with your enjoyment of activities and cause you to be less productive. For many people, hay fever symptoms lead to absences from work or school.
  • Poor sleep. Hay fever symptoms can keep you awake or make it hard to stay asleep, which can lead to fatigue and a general feeling of being unwell (malaise).
  • Worsening asthma. Hay fever can worsen signs and symptoms of asthma, such as coughing and wheezing.
  • Sinusitis. Prolonged sinus congestion due to hay fever may increase your susceptibility to sinusitis — an infection or inflammation of the membrane that lines the sinuses.
  • Ear infection. In children, hay fever often is a factor in middle ear infection (otitis media).

Tests and Diagnosis

As soon as you meet your doctor, he will first do a physical examination. Moreover, he will review your medical history and based on it he will recommend you one of the following tests:

  • Skin prick test. You’re watched for an allergic reaction after small amounts of material that can trigger allergies are pricked into the skin of your arm or upper back. If you’re allergic, you develop a raised bump (hive) at the site of that allergen. Allergy specialists usually are best equipped to perform allergy skin tests.
  • Allergy blood test. A blood sample is sent to a lab to measure your immune system’s response to a specific allergen. Also called the radioallergosorbent test (RAST), this test measures the amount of allergy-causing antibodies in your bloodstream, known as immunoglobulin E (IgE) antibodies.

Treatment

Before you try any treatment, you can start with prevention. For instance, when you deal with seasonal allergy, an efficient option would be to limit the outdoor activities when pollen counts are high. Nasal irrigation and saline sprays can help remove allergen particles from your nose. Saline sprays are available over-the-counter, or you can make your own. Use salt and boiled, sterile, or distilled water, but not tap water. Pour or spray into your nose with a neti pot, nasal syringe, or squeeze bottle.

If your symptoms still persist, certain over-the-counter (OTC) and prescription medications work well. Your doctor will recommend you what is suitable for your symptoms. Moreover, if you have a severe allergy you might try immunotherapy, a long-term process that lowers your response.

Medications for hay fever include:

  • Nasal corticosteroids. These prescription nasal sprays help prevent and treat the nasal inflammation, nasal itching and runny nose caused by hay fever. Nasal corticosteroids are a safe, long-term treatment for most people. Side effects can include an unpleasant smell or taste and nose irritation. Steroid side effects are rare.
  • Antihistamines can help with itching, sneezing and a runny nose but have less effect on congestion. They work by blocking histamine, a symptom-causing chemical released by your immune system during an allergic reaction.
  • Decongestants. These medications are available in over-the-counter and prescription liquids, tablets and nasal sprays. There are some oral decongestants that can cause a number of side effects, including increased blood pressure, insomnia, irritability, and headache. Don’t use a decongestant nasal spray for more than two or three days at a time because it can actually worsen symptoms when used continuously (rebound congestion).
  • Cromolyn sodium. This is available as an over-the-counter nasal spray that must be used several times a day. It helps relieve hay fever symptoms by preventing the release of histamine.
  • Nasal ipratropium. This medicine is available in a prescription nasal spray. It helps relieve severe runny nose by preventing the glands in your nose from producing excess fluid. It’s not effective for treating congestion, sneezing or postnasal drip. It also has mild side effects like nasal dryness, nosebleeds and sore throat. Rarely, it can cause more-severe side effects, such as blurred vision, dizziness and difficult urination. The drug is not recommended for people with glaucoma or men with an enlarged prostate.
  • Oral corticosteroids are used sometimes to relieve severe allergy symptoms. Because the long-term use of corticosteroids can cause serious side effects such as cataracts, osteoporosis and muscle weakness, they’re usually prescribed for only short periods of time.

References:

http://www.webmd.com/allergies/understanding-hay-fever-diagnosis-and-treatment#2

http://acaai.org/allergies/types/hay-fever-rhinitis

https://medlineplus.gov/hayfever.html

https://www.aaaai.org/conditions-and-treatments/library/allergy-library/hay-fever-pollen-counts

http://www.mayoclinic.org/diseases-conditions/hay-fever/basics/treatment/con-20020827

http://www.medicinenet.com/hay_fever/article.htm

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