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Hay fever (allergic rhinitis)

9-minute read

Key facts

  • Hay fever (allergic rhinitis) is an allergic response from your immune system that causes sneezing, runny nose and watery, itchy eyes.
  • Hay fever can be triggered by seasonal allergens like pollens and grass, or year-round triggers like dust mites, and animal fur.
  • See your doctor if your hay fever symptoms are ongoing and affect your day-to-day living.
  • Most people manage hay fever by avoiding allergens in their daily life, and with medications like antihistamines and nasal sprays.
  • Allergy testing can help to reveal potential triggers for hay fever, but should be considered alongside your history and symptoms.

What is hay fever?

Hay fever is the common name for seasonal allergic rhinitis. Hay fever describes a reaction that occurs when your nose or eyes come in contact with allergens to which you are sensitive, such as pollens, dust mites, moulds or animal dander. For some people, exposure to these allergens can trigger an immune response (your body’s natural defence system), which leads to swelling and inflammation in the inner lining of the nose (rhinitis).

Hay fever affects 1 in 5 people in Australia. Despite its name, it’s not caused by hay and doesn’t cause a fever.

What are the symptoms of hay fever?

Common symptoms of hay fever include:

  • an itchy, runny or blocked nose
  • itchy or watery eyes
  • frequent sneezing
  • needing to breathe from the mouth
  • always needing to clear your throat
  • always feeling like you have a head cold
  • snoring during sleep

Less common symptoms of hay fever may include:

You might only experience some of these symptoms, but still have hay fever or allergic rhinitis. Some of these symptoms can be caused by other diseases too.

CHECK YOUR SYMPTOMS — Use the hay fever and allergy Symptom Checker and find out if you need to seek medical help.

What causes hay fever?

Common allergens that may trigger hay fever symptoms include:

  • grass, weeds and tree pollens
  • dust mites and dust
  • animal fur or skin flakes
  • moulds and fungal spores
  • air pollutants
  • latex
  • breads and cereals
  • small animals

You may experience hay fever symptoms at certain times of the year (such as in spring or summer), depending on the allergens to which you are sensitive. Hay fever and other allergies can also be affected by your genes.

When should I see my doctor?

Most people are able to manage or relieve hay fever on their own. However, you should speak with your doctor about treatment options if your symptoms seem to be:

  • persistent, meaning that you experience symptoms at least 4 days in a week, for at least 4 weeks or more
  • moderate to severe, meaning that your symptoms affect your sleep and daily activities such as work, school, sport and leisure.

Your doctor can help you by asking you in detail about your symptoms, reviewing your home and work environment for possible triggers, and by assessing how intense your hay fever symptoms are and how much hay fever affects your day-to-day life. They can then organise further tests to investigate possible causes and help you find ways to manage or avoid hay fever in the future.

FIND A HEALTH SERVICE — The Service Finder can help you find doctors, pharmacies, hospitals and other health services.

How is hay fever diagnosed?

History

Your doctor can diagnose hay fever from a description of your symptoms and when they occur. They may also ask what medications you already take for hay fever — over-the-counter or prescribed — what triggers you have noticed in your work or home environment, and how hay fever affects your quality of life.

Physical exam

To rule out other causes of hay fever symptoms, your doctor may:

  • examine your face (especially your nose and eyes) for signs of hay fever
  • ask you to breathe through your nose
  • examine your nostrils with a special scope
  • examine your throat

Allergy testing

Allergy testing (for example, using a blood test or skin prick test) is the main way to learn whether your hay fever symptoms are caused by a particular allergen. You may be referred to a clinical immunologist or allergy clinic for this test.

A skin prick test involves:

  1. pricking the surface of your skin with a needle (usually on the forearm, upper arm or back);
  2. placing a droplet of a suspected allergen onto your skin;
  3. waiting to see if your immune system responds with a skin reaction.

Any allergy testing needs to be considered alongside your history and symptoms of hay fever. A positive test result doesn’t actually prove the allergen is causing your symptoms, only that your body is sensitive to the allergen.

Taking too many allergy tests may sometimes cause confusion, and prompt unnecessary lifestyle changes to avoid every kind of allergen. Speak with your doctor about what the results of your allergy test mean, and whether you need to make changes to your lifestyle.

ASK YOUR DOCTOR — Preparing for an appointment? Use the Question Builder for general tips on what to ask your GP or specialist.

How is hay fever treated?

Hay fever can be treated in 3 main ways, depending on what the allergen is and how severe your symptoms are.

Minimise exposure to allergens

If you know which allergens trigger your hay fever, reducing your exposure to them may reduce symptoms.

If pollens are causing your hay fever, these tips may help:

  • Stay indoors until after midday, especially when the pollen count is high, it’s windy or after thunderstorms (you can check today’s pollen count here).
  • Wear sunglasses, carry tissues, shower when you arrive home, and rinse your eyes with water.
  • If your trigger is grass, avoid mowing, playing or walking in grassy areas, and don't go camping.
  • Keep windows closed at home and in the car, and use recirculating air conditioning in the car.
  • Avoid outdoor picnics during pollen season.
  • Try to plan holidays out of the pollen season, or holiday at the seaside.
  • If gardening at home, research which plants are less likely to trigger hay fever. Remove any weeds or vegetation outside your bedroom window that might trigger symptoms.

Nasal irrigation

For some people, saltwater nasal sprays or douches (a stream of water sprayed into the nose) will provide substantial relief from hay fever. These non-medicated approaches are safe and can often help relieve symptoms.

Medication

While medications can’t cure hay fever, they can reduce your symptoms effectively and their side effects are generally well tolerated. Ask your doctor or pharmacist about the following medications:

  • Intranasal corticosteroids: These effectively reduce inflammation in the lining of the nose caused by hay fever or other conditions. Like asthma preventer medications, corticosteroid nasal sprays need to be used regularly and carefully to be effective. Different brands are available, so ask your doctor which one is right for you.
  • Antihistamines: These manage symptoms of hay fever by blocking the action of histamine, which the body releases in response to exposure to an allergen. In this way, antihistamines reduce the symptoms of the allergic reaction. They are available as tablets, syrups, nasal sprays and eye drops to offer localised relief where you are experiencing hay fever symptoms. For example, use eye drops for itchy or watery eyes.
  • Combination medications: These contain an antihistamine and an intranasal corticosteroid. They offer the advantages of both medications.
  • Decongestant sprays: These unblock and dry the nose, but they should not be used for more than a few days. This is because they can cause problems such as 'rebound congestion', when your symptoms become worse after you stop using the decongestant.
  • Decongestant tablets: These also unblock and dry the nose but they can have stimulant side effects such as tremors, difficulty sleeping, anxiety or increased blood pressure. Speak with your pharmacist to see if decongestant tablets are suitable for you, especially if you have high blood pressure.

Immunotherapy

Allergen-specific immunotherapy, also known as ‘desensitisation’, is a therapy designed to reduce the intensity of the body’s reaction to an allergen. Immunotherapy works by gradually exposing someone to increasing doses of allergen extracts, either by injection or under the tongue. This is a long-term treatment option and should only be initiated by a medical specialist such as a clinical immunologist.

Are there complications of hay fever?

Complications of hay fever may include:

Hay fever may also trigger frequent ear infections, such as otitis media in children, and sinus infections (sinusitis) in adults.

Untreated hay fever may also increase the risk of developing asthma, or make asthma harder to control, so it’s especially important to treat your nasal symptoms if you have asthma. This is because asthma and hay fever are both associated with airway inflammation. About 4 in every 5 people with asthma also have hay fever.

Resources and support

For more information and support, try these resources:

  • Download the AirRater app to track your hay fever symptoms and monitor allergens in the environment.
  • Check the country’s pollen count at PollenForecast, or find the pollen count for your area.
  • Asthma Australia explains how hay fever can make asthma worse.

Other languages

Do you prefer other languages than English? The National Asthma Council has translated its Asthma & Allergy factsheets into Arabic, Chinese, Korean, Spanish and Vietnamese.

Learn more here about the development and quality assurance of healthdirect content.

Last reviewed: June 2020


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