Seasonal allergic rhinitis

Overview

Seasonal allergic rhinitis, also known as hay fever, is an allergic reaction to pollen from trees, grasses, or weeds. When you breathe in pollen, your immune system mistakenly sees it as a threat and releases histamine, causing sneezing, a runny or blocked nose, and itchy eyes. Symptoms only happen at certain times of the year, depending on which pollen you are allergic to.

Yes, it is one of the most common allergic conditions, particularly during spring and summer.

It can affect people of any age, but it often starts in childhood or early adulthood. It is equally common in males and females.

Symptoms

Common symptoms

• Sneezing, especially after waking up or going outdoors.
• Runny or blocked nose (stuffy nose).
• Itchy, red, or watery eyes (allergic conjunctivitis).
• Itchy throat, nose, or ears.
• Coughing or clearing your throat often.
• Feeling tired or having trouble sleeping.

Symptoms in children

• Frequent nose rubbing (called the 'allergic salute').
• Dark circles under the eyes (allergic shiners).
• Irritability or trouble concentrating in school.
• Snoring or breathing through the mouth.

Symptoms in older adults

• Symptoms may be mistaken for a cold or sinus infection.
• Dry eyes or gritty feeling in the eyes.
• Worsening of asthma or COPD symptoms.
• Difficulty sleeping due to nasal congestion.

Causes

Main causes

• Pollen from trees (such as birch, oak, or plane) – usually in spring.
• Pollen from grasses – usually in late spring and summer.
• Pollen from weeds (such as ragweed or nettle) – usually in late summer and autumn.

Risk factors

• Having a family history of allergies, asthma, or eczema.
• Having asthma or eczema yourself.
• Living in an area with high pollen counts, such as countryside or gardens.
• Being exposed to air pollution, which can make you more sensitive to pollen.

When to see a doctor

See a doctor urgently if:

• If you have any of the emergency symptoms listed above (difficulty breathing, swelling, etc.).
• If your symptoms are very severe and do not respond to pharmacy treatments.

Book a routine appointment if:

• If your symptoms last longer than a few weeks or keep coming back each season.
• If they interfere with your sleep, daily activities, or school/work performance.
• If over-the-counter treatments (such as antihistamines or nasal sprays) do not help.

Diagnosis

Your doctor will ask about your symptoms, when they happen, and if you have any other allergies. Usually, a clear story of symptoms during pollen season is enough to diagnose.

Tests that may be done

• Skin prick test – small drops of allergen extracts are placed on your arm and pricked into the skin. If you react, a small red bump appears.
• Blood test (specific IgE test) – checks your blood for antibodies against certain pollens.

What to expect at your appointment

Your doctor may refer you to an allergy clinic for testing. The tests are simple, and you can usually get results the same day (skin test) or within a week (blood test). They help identify exactly which pollen triggers your symptoms.

Treatment

Treatment focuses on relieving allergy symptoms and preventing them. It usually starts with avoiding pollen as much as possible, then using medicines if needed. For persistent cases, immunotherapy (allergy shots or tablets) may help build tolerance.

Self-care at home

• Check daily pollen forecasts and stay indoors when counts are high.
• Keep windows and doors closed during high pollen days, especially in the morning and early evening.
• Wear wraparound sunglasses to protect your eyes from pollen.
• Shower and change your clothes after being outdoors to remove pollen.
• Use a vacuum cleaner with a HEPA filter and keep surfaces clean.
• Avoid drying clothes outside on high pollen days.

Medical treatments

Over-the-counter antihistamines (tablets, nasal sprays, or eye drops) can reduce sneezing, itching, and runny nose. Steroid nasal sprays help reduce inflammation in the nose and are often used daily during the season. If these are not enough, your doctor may recommend a combination of medications or prescribe a stronger treatment. Immunotherapy (allergen desensitisation) is a long-term option that can reduce your sensitivity to pollen. You should always speak to your pharmacist or doctor before starting any new treatment.

When is surgery considered?

Surgery is rarely needed for hay fever. It may be considered if you have complications such as nasal polyps (small growths in the nose) or a severely blocked nose that does not improve with medication.

Living with this condition

Living with hay fever means planning around pollen seasons. You may need to limit time outdoors during peak times and keep a diary of your symptoms to find patterns. Many people find that with good management, they can still enjoy most activities.

Lifestyle tips

• Avoid exercising outdoors when pollen counts are high – early morning or after rain is better.
• Use air conditioning in your car and home instead of opening windows.
• Wash your hair before bed to avoid bringing pollen into your pillow.
• Consider using a saline nasal rinse to flush out pollen from your nose.

Diet and exercise

There is no special diet for hay fever, but eating a balanced diet with plenty of fruits and vegetables supports your immune system. Some people find that avoiding foods that cross-react with pollen (like apples, celery, or melon) helps if they have oral allergy syndrome. Exercise is good for you – try to do it indoors when pollen is high.

Mental health and emotional wellbeing

Hay fever can be frustrating and affect your sleep, concentration, and mood. Some people feel anxious or low when symptoms are bad. It is important to talk to your doctor if it is affecting your quality of life – they can help you find better ways to manage it.

Prevention

You cannot prevent hay fever completely, but you can reduce your exposure to pollen to prevent or reduce symptoms. Following the self-care tips above can make a big difference.

Complications

If left untreated

• Sinusitis (inflammation of the sinuses, causing facial pain and pressure).
• Ear infections or glue ear (fluid behind the eardrum).
• Sleep problems, which can affect school, work, and mood.
• Worsening of asthma symptoms if you have asthma.
• Nasal polyps (small, harmless growths inside the nose that can block it).

Long-term outlook

For most people, hay fever can be managed well with the right combination of avoidance and treatment. Symptoms often improve as you get older, and many people find their hay fever becomes milder over time. Even if it persists, there are effective treatments to help you stay comfortable.

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