Hay fever is back but a new treatment could be life-changing

It's hay fever season, which means months of cold-like symptoms for people sensitive to pollen. But by taking preventative steps and medication, it's possible to keep the allergy under control  

Symptoms such as watery eyes, runny nose, sneezing, and itchy throat and ears can make you feel as if you constantly have a cold and a stuffy head. Picture: iStock

On the Beating Breathlessness WhatsApp service, people talk about how miserable they are with hay fever.

Symptoms such as watery eyes, runny nose, sneezing, and itchy throat and ears can make you feel as if you constantly have a cold and a stuffy head, says respiratory nurse specialist Ruth Morrow who runs the Asthma Society of Ireland’s WhatsApp messaging service. “It’s very disruptive to life.”

Hay fever, or seasonal allergic rhinitis as it’s also called, starts in March when tree pollens become problematic, grass pollen makes itself felt from around late April, while nettle pollen is strong in June and July.

“Pollen tends to decrease from August on,” says Morrow, who confirms that one in five people suffer from hay fever alone, while 85% of asthma sufferers also get hay fever.

“If hay fever isn’t managed properly, it will cause asthma to get worse,” she warns.

Dr Dermot Nolan, a GP with a special interest in asthma and allergies (he runs a clinic in Tramore), says people get confused about hay fever. “It’s not caused by hay and it’s not a fever. People can think it’s a very trivial illness. For some it’s not — it has a major impact on their lives. It has a real impact, for example, on Leaving Cert students during exams.”

British research, which took into account that critical examinations for young people are often held in summer during peak grass pollen season, showed the adverse impact of hay fever on grades. Analysing more than 1,800 15- to 17-year-olds, it found an association between current symptomatic allergic rhinitis and significantly increased risk of unexpectedly dropping a grade in summer examinations. Thirty-six percent dropped one or more grades in any of three core subjects (maths, English, science).

The first line of defence in dealing with hay fever is avoidance. Morrow has the following recommendations:

• Keep windows closed at night time or when pollen count is high;
• Monitor the pollen tracker and minimise time spent outdoors when the pollen count is high;
• Apply petroleum jelly (Vaseline) around nostrils to trap pollen when outdoors;
• Wear wraparound sunglasses to minimise levels of pollen irritating your eyes. Splash eyes with cold water to help flush out pollen and to soothe/cool your eyes;
• Shower, wash your hair and, change your clothes if you’ve been outdoors for an extended period;
• Exercise in the morning rather than the evening when there are higher rates of pollen falling;
• Avoid drying clothes outdoors. Shake clothes outside before bringing them in — particularly bedclothes;
• Minimise contact with pets that have been outdoors and are likely to carry pollen.

People should also talk to their doctor or pharmacist about taking medication to prevent or reduce symptoms. Over-the-counter treatments, eg, antihistamines and nasal steroids, are effective for many. “These work really well but you have to start these treatments three to four weeks before symptoms kick in. And make sure your technique is right when using nasal sprays,” advises Nolan.

The newest strategy in the hay fever-fighting arsenal is sublingual immunotherapy (SLIT). “Up to now, it could only be used for grass pollen. In the last six months or so, it has been launched for dust mite allergy and some tree pollens too,” explains Nolan, who says the therapy has been used much more widely in mainland Europe but it’s getting more popular now in Ireland.

SLIT involves a dissolvable tablet placed under the tongue. This is taken over a three-year period, either daily during the allergy season or once a day for the entire three-year period. “I have patients where this has literally changed their lives. Their quality of life has improved dramatically and they’re off all [hay fever] meds. Within three years, many have been cured of hay fever,” says Nolan, adding the first dose is given under supervision in the clinic so as to check for side-effects — after that, it can be done at home.

James Clegg. Picture: Videoworks

James Clegg, a 23-year-old based in Malahide, works in the TV and film industry and started SLIT treatment in summer 2021. Diagnosed with asthma at age four, hay fever has always been a potential trigger for his asthma.

“With hay fever, I’d get a stuffy or runny nose. I’d start sneezing. Having asthma, it was always a bit more hassle for me. If I was out and about and had forgotten to take my inhaler even one morning, hay fever could complicate things.”

By last summer, James had been on SLIT for a year. “I saw a noticeable improvement in the hay fever. I was breathing a lot clearer and having less of those allergic symptoms. It’s a definite enhancement to my life.”

Nolan confirms SLIT is available from a GP but many GPs prefer to refer the patient for expert opinion, either from a GP with a special interest or in a hospital-based allergy clinic. He explains the house dust mite therapy is available only on a private basis, but the grass treatment is free to medical card patients.

It’s worth noting that hay fever can develop at any stage in a person’s life. “I’ve come across a 90-year-old who got it — she’d never before had hay fever,” says Morrow. Both she and Nolan have a sense that growing numbers of people are becoming susceptible to pollen. “People locked down during covid. They had little exposure to pollens. They’re back out now and getting exposed again, so I think rates will go up this year,” says Nolan.

Morrow urges people to keep an alert eye on the pollen count via a pollen tracker. “Pollen goes up and down all the time, and it can also depend on where you live. It tends not to be a big problem if you live near the coast, but go 20 miles inland and it can get high again. It tends to be worse near woodland.”

• Find the pollen tracker on exa.mn/PollenTracker
• Asthma Awareness Week takes place from May 1-7. To celebrate the 50th anniversary of Asthma Society of Ireland, a virtual information conference on the topic of ‘Asthma Care for All’ will be held. It’s open to people living with asthma, their caregivers and the public. 
• Register in advance at www.asthma.ie/home. Asthma Adviceline is on 1800 44 54 64; Beating Breathlessness WhatsApp service is on 086-0590132.