Hay Fever (Allergic Rhinitis): Symtoms & Treatment

Allergic rhinitis, commonly known as hay fever, is an allergic condition that can occur when you come into contact with certain allergens, such as pollen from trees, grasses and weeds.

If you have hay fever, you may notice that you develop a cough, itchy eyes, sneeze or a range of other symptoms when you breathe in pollen. Hay fever symptoms tend to develop in spring, summer, and fall, when pollen levels are at their highest.

Sometimes, hay fever isn’t caused by seasonal pollen and instead develops due to exposure to other allergens, such as pet hair or dust mites.

Dealing with hay fever can be a frustrating, stressful experience. Although there’s no cure for hay fever, there are a variety of steps that you can take to limit your exposure to allergens, as well as treatments that can help to relieve common symptoms.

Below, we’ve listed the symptoms of hay fever, as well as the allergens that may cause you to experience hay fever symptoms during spring, summer or fall. We’ve also explained how hay fever is diagnosed, as well as what you can do to treat and prevent its symptoms. 

Symptoms of Hay Fever

Hay fever has several common symptoms. If you have hay fever, you may experience one or several of the following symptoms:

• Coughing and postnasal drip (excess mucus in the back of your nose)
• Sneezing, often accompanied by a runny nose
• Blocked or clogged nose, similar to a cold
• Itching in and around your eyes, nose and throat
• Dark, blue-colored circles under your eyes
• Red, swollen or watery eyes
• Fatigue and general lack of energy
• Pressure in your nose and cheeks
• Difficulty smelling
• Popping and/or a congested feeling in your ears
• Headache
• Hives

The symptoms of hay fever can last for several weeks. Sometimes, hay fever symptoms can be quite severe. For example, you might sneeze often or experience sneeze attacks, in which you sneeze repeatedly and heavily.

Unlike a cold or the flu, hay fever isn’t caused by a virus and typically doesn’t cause symptoms such as fever. If you develop nasal discharge, it’s usually watery, thin and colorless, unlike the thick phlegm that can develop when you have a viral infection.

What Causes Hay Fever?

There are two different types of hay fever, or allergic rhinitis. Each has different causes and may affect you in different ways. 

The first is seasonal hay fever, which is caused by an allergy to the pollen released by grasses, trees and weeds. When these plants flower, their pollen travels through the air. If you have hay fever, exposure to this pollen through your nose and mouth can trigger an allergic reaction.

In addition to pollen from plants, seasonal hay fever can also be triggered by exposure to mold spores, which can travel through the air and enter your respiratory system. 

Seasonal hay fever is, as its name states, seasonal. Most people who have seasonal hay fever experience symptoms during spring, summer and fall, when levels of airborne pollen are usually at their highest.

Because levels of pollen differ throughout the year, you may notice that your hay fever is worse during certain parts of spring, summer or fall:

• In the spring, from late April throughout May, tree pollen is likely to trigger seasonal hay fever symptoms.
  
  
• In summer, from late May to mid-July, hay fever symptoms are often caused by pollen from grass or weeds.
  
  
• In fall, from late August until the beginning of winter, hay fever symptoms are often the result of ragweed pollen.

Many people with hay fever notice that they’re less likely to experience symptoms on damp or rainy days. This is because the rain tends to wash excess pollen to the ground, reducing your risk of breathing in airborne pollen particles. 

The second type of hay fever is perennial hay fever, or perennial allergic rhinitis. Perennial hay fever can develop year-round and is caused by exposure to non-pollen allergens, such as hair or dander (tiny, shed particles of skin) from pets, dust mites or certain types of mold.

You may notice perennial hay fever symptoms after you spend time around a pet, or in a dusty or damp area. If your perennial hay fever is caused by mold, you may notice symptoms during rainy, humid weather.

Both forms of hay fever are allergic reactions that are caused by your immune system reacting to the presence of an allergen. 

If you have hay fever, your body will produce antibodies when it identifies an allergen, such as seasonal pollen or pet dander. Even though this substance might be harmless, your body will view it as harmful and target it via your immune system.

When you breathe in an allergen, your immune system will respond to it by releasing immune response compounds such as histamine. These cause the swelling, itching, blocked nose and other symptoms that characterize hay fever.

Not all people experience hay fever symptoms when they’re exposed to allergens. According to the American Academy of Allergy Asthma and Immunology, roughly 7.8 percent of people in the United States over the age of 18 have some form or allergic rhinitis, or hay fever.

Diagnosis of Hay Fever

If you think that you have hay fever, it’s best to talk to your healthcare provider. They can diagnose hay fever by performing a physical exam, talking to you about your medical history and, if necessary, performing an allergy test.

Several different tests are used to identify and diagnose allergies, including hay fever. To check if you have hay fever, your healthcare provider may recommend:

• A skin prick test. This test involves pricking your skin with a small quantity of allergens to check for an allergic reaction. Certain allergens may cause hives, indicating that your immune system is responding to their presence.

• A blood test. This test, called a RAST test, involves drawing your blood and checking it for antibodies that can signal an allergy. Hay fever is related to immunoglobulin E (IgE) antibodies, which your body may produce when it’s exposed to a substance that it believes is harmful.

These tests can help to accurately diagnose hay fever and, if positive, assist in identifying the allergens that trigger your hay fever symptoms.

It’s best not to rely on at-home allergy testing kits sold at drug stores to diagnose allergies such as hay fever. Although these kits are readily available, their results aren’t very accurate and can often produce false positives.

Hay Fever Treatment and Prevention

Hay fever can range in severity. If your symptoms are severe and impact your day-to-day life, your healthcare provider may recommend treating your hay fever by making changes to your lifestyle and using medication.

The most common medications used to treat hay fever are antihistamines, decongestants and nasal steroids.

Antihistamines

Antihistamines work by blocking the effects of histamine — a chemical that’s released by your body in response to allergic reactions.

Histamine is responsible for helping your immune system get rid of allergens. As your body ramps up histamine production, you may notice that your nose starts to become blocked or itchy, and that you sneeze or tear up more easily.

By blocking the effects of histamine, antihistamines help to control the symptoms of hay fever and make dealing with your allergies easier. 

Several different antihistamines are used to treat hay fever and other common allergies. Your healthcare provider may recommend a prescription antihistamine such as azelastine (a nasal spray sold as Astelin®) or olopatadine (Patanase®).

Over-the-counter antihistamines for treating hay fever include loratadine (Claritin®), fexofenadine (Allegra®) and cetirizine (Zyrtec®). If your hay fever affects your eyes, your healthcare provider may prescribe antihistamine eye drops such as ketotifen (Alaway®, Zaditor®) to control your symptoms.

Antihistamines can cause side effects, including drowsiness, dizziness and dry mouth. It’s best to discuss these with your healthcare provider before using any medication to treat hay fever. 

Decongestants

Decongestants work by relieving nasal congestion, meaning they’ll help to clear your nose and allow you to breathe easier if your nose becomes blocked or stuffy after you come into contact with pollen, pet hair or another allergen that triggers hay fever.

One of the most common decongestants is pseudoephedrine (Sudafed®).

As with other medications, decongestants can cause certain side effects. They can also become less effective over time and worsen hay fever symptoms if overused. To avoid side effects, it’s important to only use decongestants as recommended. 

Nasal Corticosteroids

Nasal corticosteroids help to reduce the inflammation that can develop in your nose if you have hay fever, controlling swelling and making it easier for you to breathe after you’re exposed to an allergen. 

Your healthcare provider may recommend using a nasal corticosteroid if you often develop nasal itching or a runny nose due to hay fever. 

Some nasal corticosteroids are available as over-the-counter medications, such as fluticasone (Flonase®) and triamcinolone (Nasacort®). Others, such as budesonide (Rhinocort®) and mometasone (Nasonex®), require a prescription.

In certain cases, your healthcare provider may prescribe a nasal spray that contains a corticosteroid and an antihistamine, such as Dymista®, which contains azelastine and fluticasone.

Like other medications, nasal corticosteroids can cause side effects that you’ll need to discuss with your healthcare provider before use. 

Other Medications 

Although less common than antihistamines, decongestants and nasal corticosteroids, several other medications are also used to treat hay fever symptoms:

• Allergen immunotherapy. This form of therapy involves injections of small amounts of allergens. Over the long term, your body responds to the allergen, increasing your level of tolerance or immunity and helping you to manage your hay fever symptoms.
  
  Allergy shots are effective at decreasing the symptoms of many allergies, and can help to stop hay fever from worsening or developing into asthma. However, they can cause certain side effects and may not be the best option for everyone.

• Allergy tablets. An alternative to allergen injections, allergy tablets can be used to treat some allergies, including allergies to grass pollens, house dust mites and plants such as ragweed. Like allergen injections, they’re a form of immunotherapy. 

Depending on the severity of your hay fever and your response to treatments, your healthcare provider may prescribe one or several medications. Use your medication as prescribed by your healthcare provider. If you don’t notice any improvements, talk to them before making any changes. 

Your healthcare provider may recommend that you start taking your hay fever medication before the start of allergy season. This may help to prevent or limit the release of histamine and other chemicals that contribute to hay fever symptoms, making your symptoms easier to deal with.

Home Remedies and Lifestyle Changes

Most home remedies aren’t effective at stopping the symptoms of hay fever. However, there are several things that you can do to reduce the severity of your symptoms:

• Rinse your sinuses using sterile saline. This can help to relieve nasal congestion and make breathing easier. You can buy sterile saline nasal sprays and mists from your local drug store, or use a squeeze bottle with distilled, sterile saline solution.

• Use a humidifier. Humid air can help to ease the symptoms of certain allergies. It’s best to set your humidifier’s humidity level to 30 percent to 50 percent and use filtered water to avoid spreading unwanted microorganisms into your home’s air.

• Avoid using a ceiling fan. Ceiling fans can drive dust around your room, especially if they’re not kept clean. This could worsen your allergies and make it harder to enjoy a proper night’s sleep. 

Prevention

Hay fever isn’t contagious, meaning you don’t need to worry about spreading it to your friends, family or partner. You can also use the following prevention tactics to reduce your exposure to allergens and more effectively manage hay fever during allergy season: 

• Limit outdoor activities during allergy season. If you’re allergic to pollen, it’s best to avoid spending too much time outdoors, especially in areas with lots of plant life, when pollen levels are at their highest.
  
  You can find local pollen information on the AAAAI's National Allergy Bureau™ website, which tracks seasonal pollen levels in metropolitan areas across the United States and several other countries.

• Be careful on hot, windy days. Windy weather can spread pollen around, making you more at risk of coming into contact with an allergen. Be especially careful if you need to go out during the morning, as this is when pollen levels are often at their highest.

• Consider wearing a mask outdoors. A simple disposable face mask can help to keep pollen and other allergens away from your nose and mouth while you’re out and about, potentially reducing your risk of experiencing an allergic reaction.
  
  Wearing a mask can be particularly helpful if you need to mow the lawn, rake leaves or do other yard work that requires you to spend time outdoors.

• Just got home? Take a shower to wash away pollen. Pollen can collect on your skin, clothes and shoes after spending time outside. Take a shower and wash your clothes to get rid of any excess pollen before it has a chance to spread throughout your home.

• Use air filters at home. If you’re concerned about air quality and allergens inside your home, use a high-efficiency particulate air (HEPA) filter and be sure to clean your HVAC system regularly to prevent dust from collecting inside vents and air ducts.

• During pollen season, switch on the AC and close the windows. This helps to stop pollen from entering into your home. To avoid pollen while you’re driving, push the air recirculation button inside your car to block outside air from entering.

• Avoid hanging laundry outside. During allergy season, pollen can collect on towels, sheets and other laundry. Try hanging large items inside or use your dryer for clothes and bedding that’s large enough to attract significant amounts of pollen.

• Control your home’s humidity level. Humidity can contribute to the growth of mold and unwanted pests such as cockroaches or dust mites.
  
  Control your home’s humidity level to prevent the growth of allergens. According to the EPA, your home’s indoor relative humidity (RH) level should be in the 30 percent to 50 percent range to prevent mold growth and discourage pests.

• Consider using allergy-proof covers on your mattress, bed base and pillows. If you’re allergic to dust mites, this may help to limit your exposure and prevent you from experiencing hay fever symptoms.

• Vacuum and spray regularly. Clean up using a vacuum cleaner with a HEPA or small particle filter and spray your home using insecticide that’s designed specifically for dust mites.

• Keep pets outside your home. Pet hair and dander can collect on carpets, making it best to keep pets outside your home if you’re allergic. If you have a dog, bathe it twice every week to prevent excess hair and dander shedding. 

Talk to a Healthcare Provider About Hay Fever

If you think you have hay fever, talking to a healthcare provider can help you learn more about your allergens and the treatment options that are available to you.

Consult with a licensed healthcare provider now to discuss your symptoms and learn more about what you can do to treat and manage hay fever. 

If appropriate, the provider can write you a prescription on the spot and send it directly to a local pharmacy of your choice, allowing you to get the relief you need fast, all without having to go to an office.