Hay fever (seasonal allergic rhinitis) is one of the most common allergies in the UK, affecting up to one in four people. It is caused by an allergic reaction to pollen, which triggers the release of histamine in the body. This leads to symptoms such as sneezing, a runny or blocked nose, itchy or watery eyes and an itchy throat.
Hay fever symptoms are usually worse between late March and September, when the pollen count is at its highest. Tree pollen tends to peak from late March to mid-May, grass pollen from mid-May to July and weed pollen from late June to September. Symptoms can vary in severity from year to year, depending on weather conditions and pollen levels.
Hay fever treatments are available in three main formats: antihistamine tablets, corticosteroid nasal sprays and anti-allergy eye drops. Many people find that a combination of treatments provides the most thorough symptom relief.
- Antihistamine tablets work by blocking the effects of histamine, the chemical your body releases during an allergic reaction. Non-drowsy options include fexofenadine, cetirizine and loratadine. These are usually taken once daily and can provide relief for up to 24 hours.
- Nasal sprays containing corticosteroids (such as mometasone furoate, beclometasone and fluticasone) help to reduce inflammation in the nasal passages and can relieve congestion, sneezing and a runny nose. They are most helpful when used regularly throughout the hay fever season.
- Eye drops such as sodium cromoglicate and Opticrom can help to relieve itchy, red and watery eyes caused by hay fever.
The most suitable hay fever tablet depends on your symptoms, how your body responds to different antihistamines and whether you need a non-drowsy option. The three most commonly used non-drowsy antihistamines are fexofenadine, cetirizine and loratadine.
Cetirizine and loratadine are available over the counter and are often the first options tried. Fexofenadine (available as Telfast or Allevia) is a stronger non-drowsy antihistamine option and is available in some brands both over the counter and on prescription. If one antihistamine does not work well for you, switching to a different one may help, as individuals can respond differently to each type.
Hay Fever: Our Pharmacist's Advice
"Many of our patients find that a single antihistamine tablet is enough to manage their symptoms, but for those with more persistent hay fever, combining an antihistamine with a corticosteroid nasal spray can make a significant difference. If your hay fever symptoms are predictable each year, it can help to start using a corticosteroid nasal spray before symptoms usually begin and continue using it regularly throughout the season.
If you have been using the same antihistamine for some time and feel it is becoming less helpful, try switching to a different one rather than increasing the dose. Fexofenadine, cetirizine and loratadine all work slightly differently, and some people respond better to one than another. For eye symptoms specifically, adding anti-allergy eye drops to your routine is often more targeted than relying on tablets alone."
Non-drowsy antihistamines (also known as second-generation antihistamines) include fexofenadine, cetirizine and loratadine. They are less likely to cause drowsiness and are generally recommended as the first choice for daytime hay fever relief.
Drowsy (first-generation) antihistamines such as chlorphenamine (the active ingredient in Piriton) and promethazine are more likely to cause sedation. They may be useful if hay fever symptoms are disrupting your sleep, but they can impair concentration and are not recommended before driving or operating machinery.
Antihistamine tablets can be helpful when taken before symptoms begin, particularly if your hay fever tends to flare up at the same time each year. If you know which type of pollen affects you, consider starting your tablets one to two weeks before the relevant pollen season typically begins. For grass pollen, this is usually around mid-May; for tree pollen, late March.
If symptoms have already started, antihistamines will usually begin to provide relief within one to two hours of taking a dose. For nasal sprays, it may take several days of regular use before you notice their full benefit.
Hay fever season in the UK typically runs from late March to September. The specific timing depends on which type of pollen you are allergic to. Tree pollen is usually highest from late March to mid-May, grass pollen from mid-May to July and weed pollen from late June to September. Some people may experience symptoms outside these periods if they are sensitive to mould spores or other airborne allergens.
Common hay fever symptoms include sneezing, a runny or blocked nose, itchy or watery eyes, an itchy throat or ears and a feeling of pressure around the face. Some people also experience headaches, fatigue, a cough or a reduced sense of smell during the hay fever season. Symptoms can range from mild to severe and tend to be worse on warm, windy days when the pollen count is high.
Hay fever is a type of allergic rhinitis. The term "hay fever" usually refers specifically to seasonal allergic rhinitis caused by pollen, whilst allergic rhinitis can also be triggered year-round (perennial allergic rhinitis) by allergens such as dust mites, pet dander or mould. The treatments are similar, and many of the antihistamines and nasal sprays available from Pharmica can be used to treat seasonal allergic rhinitis.
Alongside medication, several practical measures may help to reduce hay fever symptoms. These include wearing wraparound sunglasses outdoors to protect your eyes, showering and changing your clothes when you come inside to remove pollen, keeping windows closed during high pollen times, applying a thin layer of petroleum jelly around the nostrils to trap pollen and drying clothes indoors rather than on an outside line.
Nasal saline sprays (such as Sterimar) can help to wash pollen from the nasal passages and may provide additional relief when used alongside antihistamine tablets or corticosteroid nasal sprays.
Hay fever and the common cold share several symptoms, including sneezing, a runny nose and a sore throat. However, hay fever symptoms tend to last for weeks or months during the pollen season, whilst a cold usually resolves within seven to ten days. Hay fever also typically causes itchy eyes and does not cause a fever, body aches or coloured nasal discharge, which are more commonly associated with colds or infections.