They are the all-too familiar symptoms for millions at this time of year – swollen, itchy eyes, a runny nose and a throat raw from sneezing.
As temperatures start to rise, it’s a sign that the hay fever season is in full swing. And experts say this year is set to be more miserable than most owing to record levels of pollen.
Hay fever symptoms normally appear when the pollen count exceeds 50, according to the Met Office
Forecasters predict today that virtually the entire country will experience very high pollen levels – and, they claim, conditions are perfect for a so-called ‘pollen bomb’. It will spell misery for the 13 million people – or one in four adults and one in ten children – who suffer from an allergy to pollen.
The NHS has already revealed that the number of people searching for advice on its website has more than doubled this past week.
Pollen levels are expected to be so bad for hay fever sufferers that the charity Asthma + Lung UK has issued an alert, warning those susceptible to severe symptoms to ‘avoid going outdoors as much as possible’.
So with all that in mind, what can you do to cope best? And is it possible to stave off the miserable hay fever symptoms in the first place? Our experts have the answers…
Why are so many people now getting hay fever?
Hay fever, also known as allergic rhinitis, is when the body’s natural defence cells overreact to pollen because they identify it as a threat. In response, they produce an antibody called immunoglobulin E to attack it. This, in turn, triggers the release of the chemical histamine into the bloodstream, which flushes pollen out from the body through itching and sneezing.
Britain’s hay fever season generally starts in late-March when tree pollen begins to spread. From mid-May to July is when grass pollen levels are highest, which is followed by a period of weed pollen until September.
The Met Office says hay fever symptoms normally appear when the pollen count – the number of pollen particles per cubic metre of air – exceeds 50. It’s considered ‘high’ when levels of grass pollen are between 50 and 150, and ‘very high’ above that level.
But for anyone with an allergy, warming temperatures are causing the British pollen season to become longer and more intense, Emma Rubach, at Asthma + Lung UK, says.
Many plants are remaining in their growing season for longer, she explains, which means more pollen circulating at higher levels for a greater portion of the year.
‘We’re seeing much more hay fever because of this,’ she adds.
And allergy expert Prof Adam Fox says: ‘While you don’t want to blame climate change for everything, there does genuinely seem to be an effect. Earlier in my career, you’d have a bad season and a not-so-bad season – now they all seem to be bad.’
A warm but mostly wet spring this year – which dampened down pollen – followed by a period of dry and hotter weather has also created the perfect conditions for more significant amounts to suddenly be released into the air – often described as a pollen bomb.
‘If it’s a warm day with a slight breeze, then you’re in trouble,’ says Prof Fox.
Do I really have to stay inside?
Not everyone with hay fever will need to. The advice from Asthma + Lung UK is directed at those most at risk from high pollen levels – namely, those with an extreme allergy to pollen who find it triggers their lung condition.
Ms Rubach says: ‘The advice is for people considered highly vulnerable because they’ve got a serious lung disease or they know high pollen affects them badly. When grass pollen levels are at their highest we see a spike in asthma attacks and, unfortunately, a spike in fatalities from asthma.
‘So if you are on high doses of steroids for asthma, and you also have a bad pollen allergy, you’re at risk when levels are this high as allergies and asthma are related.
‘We also have some evidence that it seems to affect people with chronic obstructive pulmonary disease (COPD) as well.’
Thankfully, these alerts don’t apply to most. Any changes to routines or behaviour should depend on how badly you’re affected by hay fever. ‘Warning signs to look out for include coughing, wheezing – particularly at night or in the early morning – and breathlessness,’ Ms Rubach adds. ‘If you feel your symptoms are worsening, seek urgent medical attention by calling your GP or ringing 111.
‘People with asthma should make sure they have their blue inhaler with them at all times, and to take their brown steroid inhaler every day as prescribed – that will keep inflammation in the airways under control.’
I’ve got all the symptoms – do I need to see my GP?
Antihistamine tablets can be taken in conjunction with nasal sprays, which narrow the blood vessels in the nose to ease congestion
No – there is a huge range of over-the-counter treatments available at any pharmacy.
The main ones are antihistamines – taken as a tablet, or in liquid form for children – which block the effects of the histamine released in response to pollen.
‘Piriton, Benadryl and Clarityn all have different active ingredients,’ explains Dr Dean Eggitt, a GP based in South Yorkshire. ‘Everyone will react to them differently, too. You won’t know how until you try them, so shop around until you find one that works best for you.’
You can also save money by buying generic versions of the same drugs, Dr Eggitt advises. ‘Once you’ve found an antihistamine that works, ask the pharmacist for an identical product to the branded one – it will be much cheaper.’
These can also be taken in conjunction with corticosteroid nasal sprays, such as Beconase or Pirinase, which work as vasoconstrictors – narrowing the blood vessels in the nose to ease congestion.
‘Our nurses say the nasal sprays are the best thing you can take, and if you start using them before the season starts they’re even more effective,’ adds Ms Rubach.
‘But you have to use them properly – and most people don’t.
‘A general rule is to tip your nose downwards to your toes, and to insert the nozzle into your nostril sideways before spraying.’
But for some, these solutions aren’t enough. As a result of their pollen allergy, they will experience wheezing or asthma attacks, and may need to use an inhaler.
‘Stronger antihistamines can be given on prescription if you need them,’ Dr Clare Gerada, former president of the Royal College of GPs, explains.
My eyes are still really itchy – what can I do?
Red, itchy, swollen eyes can be infuriating – but don’t be tempted to rub them.
‘It’s the worst thing you can do,’ Dr Gerada says. ‘It’ll only make it worse and you could be transferring more pollen into your eyes.’
Instead, buy eye drops containing an antihistamine called sodium cromoglicate, which will reduce inflammation and itching.
Otherwise, wear wraparound sunglasses to prevent pollen from getting into your eyes and regularly splash them with cold water. A damp, cold cloth pressed against your eyes may also help.
Is there any medicine-free advice to offer?
Yes. Saltwater nasal sprays and rubbing your nostrils with Vaseline can be ‘genuinely effective’, says Prof Fox.
‘Some sprays, such as Sterimar, essentially rinse out pollen from your nose,’ he says. ‘And rubbing anything sticky around your nostrils, such as a petroleum jelly, acts as a pollen trap and makes it harder for it to get up there.’
He also recommends avoiding going out first thing in the morning and last thing in the evening, when levels are highest – due to the low density of the pollen grains. And washing your hands regularly can help to prevent the transfer of pollen if you touch your face.
‘Having a shower and washing your hair when you come home can make a big difference,’ Prof Fox adds. ‘Any pollen on you will transfer to your pillow and into your nostrils overnight, making you congested and your sleep less comfortable.’
Asthma + Lung UK also recommends hanging washing inside to avoid bringing pollen into the house, as well as keeping windows and doors closed when possible. Vacuuming and wiping surfaces down regularly with a damp cloth will make sure pollen doesn’t hang around, too.
What can I do to get pollen out of my house?
There are products on offer which claim to remove allergens, including pollen, from the air inside your home. They suck up air through a HEPA (high-efficiency particulate air) filter and then pass it through a UV light, which helps to eliminate bacteria and viruses.
But the challenge, as Dr Eggitt points out, is that the pollen returns as soon as you open a door or window.
‘The air filters need to be of a large, industrial size before they have any effect,’ he claims. ‘The placebo effect can be useful for about 30 per cent of sufferers – so if you think it might help, go ahead.’ But Prof Fox doesn’t recommend them due to a lack of clinical evidence that they make a difference.
If you do opt for one, however, choose a product which has the Allergy UK seal of approval.
Are there areas to avoid when pollen is extreme?
Green meadows or forests might seem like no-go areas for hay fever sufferers.
However, those living in polluted cities can suffer more severely with hay fever due to a phenomenon called grey fever, Ms Rubach says.
‘Particles from pollution, such as diesel fumes, bind with pollen in the air, keeping it hanging around for longer,’ she explains.
Pollution also increases the body’s inflammatory response – and if your airways are already irritated, even tiny amounts of pollen can trigger hay fever and asthma symptoms.
Prof Fox’s advice? The coast. ‘The best place to be on high- pollen days is by the seaside, where there’s a decent wind, less pollution and less pollen.’
There’s a jab to stop allergies – should I get it?
For most people, the answer is no. Triamcinolone acetonide, sold as Kenalog, is a steroid injection which used to be licensed in the UK as a long-term treatment for hay fever. But it was withdrawn for this purpose ten years ago as its side effects outweighed the benefits.
It works by suppressing the immune system and dampening down the allergic reaction to pollen, and was popular as the effects from a single jab could last for several months.
But, like any steroid, it had side effects – it was found to leave people vulnerable to other infections as well as increase the risk of an irregular heartbeat, depression and high blood pressure.
Prof Fox says: ‘There’s no doubt it’s effective.
‘But it’s an enormous whack of steroids that has potentially long-term consequences.’
In recent years the NHS has begun offering a new treatment for severe hay fever sufferers called immunotherapy.
This involves dosing patients with a small amount of pollen as a jab or pill over several months to build-up the body’s immunity. This is done in the months leading up to the pollen season.
But charities have complained the waiting list for this service is so long that some patients are waiting years to start on it (see panel above).
Kenalog is still being offered by private clinics.
But as a prescription-only medicine, advertising it is illegal, and the Medicines and Healthcare Products Regulatory Agency (MHRA) has recently clamped down on clinics which flout the law on social media.
Dr Eggitt says that for some people with hay fever symptoms so extreme that it stops them living their lives normally, it ‘might be worth the risks’.
But he warned: ‘For most people, I wouldn’t view it as a quick fix to get a happy summer.’
I’ve bought local honey – shouldn’t that work?
There is a theory that consuming honey made from local pollen helps develop a tolerance to it, but there is no robust evidence to back this up
Sadly not – there is no robust evidence that honey made from local bees helps with hay fever symptoms.
One large, double-blinded study from the US – in which researchers nor participants knew which sample was which – saw people taking either local honey, nationally produced honey or honey-flavoured corn syrup. No difference between their hay fever symptoms was found.
The theory is that consuming honey made from local pollen helps develop a tolerance to it, dampening down the body’s immune response.
But honey is made from flower pollen – not the grass or tree pollen which typically causes hay fever.
Another idea is that taking probiotics – supplements or foods which can improve the levels of ‘good’ bacteria in the body – in products such as yogurts, fermented vegetables and sour cream could improve the balance of bacteria in the nose, lessening the symptoms of hay fever.
However, as Prof Fox explains: ‘There are no useful clinical trials to say probiotics can help your hay fever.’
Patients like Hannah are waiting YEARS for NHS therapy to end severe hay fever misery
MailOnline’s UK showbusiness reporter Hannah McDonald says for weeks in summer she has to stay indoors with windows closed
The lives of some patients with severe hay fever are being put at risk because they are waiting years for vital NHS treatment, says a charity.
Most people with pollen allergies can combat symptoms with over-the-counter tablets and nasal sprays but some have such a bad reaction to hay fever it is difficult for them to even breathe.
In recent years the NHS has begun offering an effective treatment for severe sufferers called immunotherapy.
Patients are given a small amount of pollen in an injection or tablet over several months to boost the body’s immunity before a pollen season. But the charity Allergy UK says a lack of specialist hay fever clinics means that, although 13 million people in the UK have the condition, only 1,000 a year get immunotherapy to treat it.
Experts say that nine in ten people with hay fever also have asthma – raising the risk of breathing difficulties. ‘A pollen allergy can induce asthma attacks which carry very serious risks and can even be fatal,’ says Amena Warner, head of clinical services at Allergy UK.
‘However, access to treatments such as immunotherapy is hindered by long waiting lists and a postcode lottery of care which means that some people who would benefit from immunotherapy may not be able to access it. This must change.’
One patient waiting for immunotherapy is Hannah McDonald, 27, from Aberdeen, whose hay fever is so severe that, for several weeks during the summer, she cannot breathe through her nose.
Hannah, who is MailOnline’s UK showbusiness reporter, says she has struggled with the allergy all her life. ‘I’ve tried everything from the pills to the sprays and even air purifiers but nothing works,’ she says. ‘Every year, my nasal passages swell up making it difficult to breathe. Last summer, it got so bad I was wheezing.’
Last month, after reading about immunotherapy, Hannah asked her GP for a referral to a specialist clinic to receive the treatment. However because of the long waiting list, she has still not been given an appointment.
‘God knows how long I’ll wait,’ she says. ‘I called up last week and was told they didn’t have an update.
‘I dread June and July. While everyone goes to the park, I have to stay indoors with the windows closed.’