Hay Fever

Allergic rhinitis (hay fever) is an allergic reaction to tiny particles in the air called allergens. When you breathe in allergens through your nose or mouth, your body reacts by releasing a natural chemical called histamine. Several indoor and outdoor allergens cause hay fever. Common causes include dust mites, mold, pet dander and pollen from trees and plants.

Other names #

• Allergic Rhinitis

Causes #

• Allergens are harmless to most people. But if you have hay fever, your immune system thinks the allergen is intruding.
• The immune system tries to protect your body by releasing natural chemicals into your bloodstream.
• The main chemical is called histamine.
• It causes mucous membranes in the nose, eyes and throat to become inflamed and itchy as they work to eject the allergen.

Seasonal and perennial allergies can result from many allergens, including:

• Dust mites that live in carpets, drapes, bedding and furniture.

• Pollen from trees, grass and weeds.

• Pet dander (tiny flakes of dead skin).

• Mold spores.

• Cockroaches, including their saliva and waste.

• Food allergies can also cause inflammation in the nose and throat. If you think you’re having an allergic reaction to something you ate, get medical help right away. Food allergies can be life-threatening.

Symptoms #

Symptoms of hay fever include:

• Nasal stuffiness (congestion), sneezing and runny nose.

• Itchy nose, throat and eyes.

• Headaches, sinus pain and dark circles under the eyes.

• Increased mucus in the nose and throat.

• Fatigue and malaise (general feeling of discomfort).

• Sore throat from mucus dripping down the throat (postnasal drip).

• Wheezing, coughing and trouble breathing.

Diagnosis #

• Your healthcare provider will examine you, ask about your symptoms and evaluate you for other conditions, such as a cold or asthma.

• To measure your antibodies to specific allergens, your provider may take a blood sample and send it to a lab for testing.

• This blood test is called an immunoglobulin E (IgE) test. It can detect all types of allergies, including food allergies.

• Your provider may recommend a skin prick test to determine what allergens are causing your symptoms.

• This common test is painless and accurate, though it may be a little uncomfortable. Your provider places a small sample of different allergens on your skin (usually on your forearm or back) and scratches or pricks the skin with a needle. Scratching the skin allows the allergen to get under the surface.

Treatment #

• Antihistamines: Antihistamine medications are available with a prescription or over the counter. They work by blocking the histamine that your body releases during an allergic response. Antihistamines come as pills, liquids, eye drops, nasal sprays and inhalers. They include:

• Loratadine

• Cetirizine

• Fexofenadine

• Levocetirizine

Antihistamines can cause drowsiness. Avoid alcohol when taking antihistamines, especially if you’re going to drive.

• Decongestants: These medications relieve congestion in the nose and sinuses. You can take decongestants by mouth (in pill or liquid form) or use a nasal spray. They include:

• Afrinnasal spray.

• Phenylephrine nasal spray.

• Pseudoephedrine.

Decongestants can increase blood pressure and cause headaches, trouble sleeping and irritability. Nasal decongestants can be addictive if used longer than five days. Be sure to talk to your provider before taking them.

• Corticosteroid nasal sprays: These sprays and inhalers reduce inflammation and relieve symptoms of hay fever. The most common nasal sprays are Flonase, Nasacort and Rhinocort. Side effects include headaches, nasal irritation, nosebleeds and cough.

• Leukotriene inhibitors: During an allergic reaction, the body releases leukotriene, histamines and other chemicals that cause inflammation and hay fever symptoms. Available only with a prescription, these pills block leukotriene. The most common leukotriene inhibitor is montelukast (Singulair). Some people experience changes in mood, vivid dreams, involuntary muscle movements and skin rash when taking this medication.

• Immunotherapy: This treatment works by helping your body learn to tolerate allergens. Your provider gives you a series of injections (allergy shots) with a small amount of the allergen. Every time you get a shot, your provider increases the amount of the allergen. Over time, your immune system develops immunity to the allergen and stops launching a reaction to it.