Please note: This information was current at the time of publication but now may be out of date. This handout provides a general overview and may not apply to everyone. 

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Am Fam Physician. 2011;83(4):477-478

What is hay fever?

Hay fever, also known as seasonal allergic rhinitis (say: rine-EYE-tis), is a reaction to pollen. Sometimes symptoms are caused by molds or flakes of animal skin from pets. If pollen is the cause, you will feel worse when pollen levels are high.

What causes hay fever?

Allergens cause your body to respond with an allergic reaction. When you are exposed to something you are allergic to, your body releases chemicals. One of theses chemicals is histamine, which is your body's defense against the allergen. The release of histamine causes swelling, itching, sneezing, runny nose, and watery eyes.

If you are allergic to pollen, you will notice that your symptoms are worse on hot, dry days when wind carries the pollen. On rainy days, pollen often is washed to the ground, which means you are less likely to breathe it.

What are the symptoms of hay fever?

They vary depending on how bad your allergies are. Symptoms can include:

  • Sneezing

  • Coughing

  • Itching (mostly eyes, nose, mouth, throat, and skin)

  • Runny nose

  • Stuffy nose

  • Headache

  • Sore throat

  • Watery, red, or swollen eyes

  • Dark circles under your eyes

  • Trouble smelling

How does hay fever differ from a cold or the flu?

Hay fever lasts longer than a cold or the flu—up to several weeks—and does not cause fever. With hay fever, the fluid from your nose is thin, watery, and clear. With a cold or the flu, the fluid tends to be thicker. Itching (mostly eyes, nose, mouth, throat, and skin) is common with hay fever but not with a cold or the flu. Sneezing happens more with hay fever.

When should I see a doctor?

If your symptoms bother you, see your doctor. He or she will probably do a physical exam and ask you questions about your symptoms. Keeping a record of your symptoms over time can help your doctor figure out what triggers your allergies.

How is hay fever treated?

Your doctor will help you decide what medicine is best for you depending on your symptoms, age, and overall health.

You can get some treatments over the counter. Antihistamines can help reduce sneezing, runny nose, and itchiness. They're more useful if you use them before you're exposed to allergens. Some come in pills (some brand names: Zyrtec, Dayhist, Claritin) and some are nose sprays. These medicines can cause sleepiness and dry mouth.

Decongestants can help relieve stuffy nose. They come in pills, nose sprays, and nose drops (some brand names: Sudafed, Afrin, Sinex). They work best when used for about three days. They can raise your blood pressure, so check with your doctor to make sure it's safe for you to use them.

If over-the-counter medicines are not helping, your doctor may prescribe other treatments, such as nasal steroid sprays (two brand names: Flonase, Nasacort), eye drops, or allergy shots.

How can I avoid getting hay fever?

The best way to cope with hay fever is to avoid the allergens that cause it. Washing out your nose regularly with a salt water solution can clear out the allergens. You can make your own with one cup of water and a third of a teaspoon of salt, or you can buy a kit. Shower or bathe before bedtime to wash pollen and other allergens off your hair and skin. Stay inside, especially on dry, windy days. Keep windows and doors shut, and use an air conditioner at home and in your car.

Where can I get more information?

Your doctor

American Academy of Family Physicians

American Academy of Allergy, Asthma, and Immunology

Revolution Health Allergy Community

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