Hay fever: Causes, Symptoms, Treatment

Hay fever, also known as Seasonal Allergic Rhinitis, is an inflammatory condition of the upper airways that occurs in response to exposure to airborne allergens.

According to ARIA (Allergic Rhinitis and its Impact on Asthma), which is a non-governmental organization in collaboration with the World Health Organization (WHO), allergic rhinitis affects 500 million people worldwide and over 100 million in India, Pakistan and surrounding countries. It develops before the age of 20 years in 80% of cases and peaks in adolescence. The International Study of Asthma and Allergies in Childhood (ISAAC), estimated that the global prevalence of self-reported pollen allergy (hay fever) in 13 to 14 year old children was 22.1%.

Symptoms Of Hay Fever

The symptoms of hay fever are caused by the body’s response to airborne allergens such as mold spores or pollen of trees, grass and weed. When your body is exposed to such allergens, it produces antibodies as a response. The main function of these antibodies is to attack the allergen; however, the production of antibodies also causes a release of histamine, which is a chemical that causes the symptoms of hay fever.

The symptoms include:

• Runny or blocked nose
• Itchy, red or watery eyes
• Itching sensation in the nose, throat, roof of the mouth and ears
• Cough
• Headache
• Fatigue

Many of the symptoms for hay fever overlap with those of a common cold, although the two conditions are brought about by different causes. Hay fever is triggered by allergens, whereas a cold is caused by germs. The signs to differentiate between the two conditions are as follows,

• No fever in the case of hay fever, whereas a cold may be accompanied by a low-grade fever
• Clear, runny mucus in the case of hay fever. A common cold can often cause thick, green or yellow mucus production.
• Hay fever typically lasts longer than a common cold

Triggers For Hay Fever

The triggers for hay fever can be broadly classified into two categories:

1. Outdoor Allergens

• Tree pollen
• Grass pollen
• Ragweed pollen

2. Indoor Allergens

• Dust mites
• Pet dander
• Cockroaches
• Mold and fungal spores

In addition to the above triggers, the symptoms may also worsen if they are exposed to the following,

• Cigarette smoke
• Air pollution
• Strong odours, such as perfumes, hair sprays and fumes
• Laundry detergents and cleaning solutions

Diagnosis Of Hay Fever

Taking a complete history and carrying out a physical examination are the keys to diagnosing hay fever. In addition, certain diagnostic tests, such as the skin prick test, are required to identify the allergic response to an offending allergen.

Complications Associated With Hay Fever

If hay fever is not treated in time, it can lead to other complications such as,

• Conjunctivitis
• Nasal polyps, which are fleshy growths in the nasal passages that can obstruct breathing
• Sinusitis
• Worsening asthma
• Ear infection

Management And Treatment Of Hay Fever

The first approach to managing hay fever is by avoiding exposure to allergens. The following precautions are helpful in reducing exposure:

• Monitor pollen counts and stay indoors during peak times, such as mid-morning and early evening or on windy days
• Keep doors and windows closed when the pollen count is high
• Vacuum and mop floors regularly.
• Use a dehumidifier to prevent the growth of mold
• Wash bedding frequently in hot water to reduce exposure to dust mites
• Before you step outdoors, apply Vaseline around your nostrils as it will trap the pollen and prevent it from entering your nasal passages
• Protect your eyes with glasses to minimise the amount of pollen that enters the area
• Wear a pollen mask
• Shower and change clothes immediately after returning home as pollen has a tendency to cling to fibres
• Wash hands immediately after petting any animal.

Although limiting exposure will go a long way in managing hay fever, certain medications may be required to treat the symptoms:

• Antihistamines

As the name suggests, these medications counter the effects of histamines and alleviate symptoms such as sneezing, runny nose and itchy eyes

• Nasal Sprays

Intranasal corticosteroids are one of the most effective medications for treating . They relieve the symptoms by reducing the inflammation caused by the allergic reaction

• Decongestants

Nasal decongestants help clear up blocked passages and thus improve breathing

References:

1.  https://effectivehealthcare.ahrq.gov/topics/allergy-seasonal/research-protocol
2. https://ciplamed.com/content/allergic-rhinitis-from-beginning-to-end
3. https://www.worldallergy.org/UserFiles/file/WorldAllergyWeek2016FactSheet.pdf
4. https://my.clevelandclinic.org/health/diseases/8622-allergic-rhinitis-hay-fever
5. https://www.nhs.uk/conditions/hay-fever/
6. https://www.healthline.com/health/hay-fever-symptoms
7. https://www.allergyuk.org/information-and-advice/conditions-and-symptoms/11-hay-fever-allergic-rhinitis
8. https://ciplamed.com/content/allergic-rhinitis-0
9. https://www.mayoclinic.org/diseases-conditions/hay-fever/symptoms-causes/syc-20373039