Patient care in hayfever season

Almost one in four people in the UK suffers from hay fever (allergic rhinitis) and the numbers are rising. This common chronic condition is an inflammation of the inside part of the nose caused by pollen (allergen) produced by plants in susceptible individuals. Symptomatology includes: sneezing and coughing; a runny or blocked nose; itchy, red or watery eyes; an itchy throat, mouth, nose and ears; pain around your temples and forehead; headache; earache and feeling tired. Stress levels may increase in those with severe symptoms. People with asthma can experience additional complications.

Some patients only get hay fever around spring and summer; this is called seasonal allergic rhinitis.

It is key that antihistamines and other hay fever drugs are reviewed and stopped if not required, especially during winter.

Treatment for hay fever includes:

• Antihistamines: newer antihistamines like loratadine, cetirizine or fexofenadine are usually preferred over older drugs, e.g. promethazine or chlorphenamine; since they penetrate the blood barrier only to a slight extent, causing less sedation.
• Steroid nasal sprays (beclomethasone, fluticasone, etc.): corticosteroids anti-inflammatory properties help to decongest the nose and improve other symptoms, like itching or sneezing. Maximum effect is usually achieved after two weeks of treatment.
• Sodium cromoglicate eye drops: for allergic conjunctivitis.
• Allergen immunotherapy (grass or tree pollen extract): for severe cases: small quantities of the allergen are administered to the patient over years to reduce hay fever symptoms in patients who failed to respond to conventional therapy.

General basic measures to avoid exposure to pollen include: closing windows and doors at home, staying indoors when pollen count is high, wearing sun glasses and applying small amounts of vaseline around the nostrils is also recommended.