Hay fever is a common condition also known as Allergic rhinitis. It is an allergic condition that affects nose and eyes.
Symptoms:
- sneezing
- a runny or stuffy nose
- itchy ears, nose and throat
- red, itchy or watery eyes
- headahes
Postnasal drip, cough, irritability and fatigue are other common symptoms.
Risk factors for hay fever:
- Family history of atopy (i.e genetic susceptibility to develop allergic diseases)
- Male sex
- Birth during the pollen season
- First born status
- Early use of antibiotics
- Maternal smoking exposure in the first year of life
- Exposure to indoor allergens, such as dust mite allergen
When a patient is continually exposed to allergen, persistent nasal mucosal inflammation develops. In such patients, symptoms of rhinitis occur on exposure to lower doses of allergen and to nonspecific irritants. This results in continued and frequently more severe rhinitis symptoms with exposure to low allergen concentrations.
Allergic rhinitis requires a few years of allergen exposure to develop. It is uncommon in children under two years of age.
Allergic rhinitis occurs in association with allergic conjunctivitis, acute or chronic sinusitis, asthma and eczema.
Diagnosis of hay fever is done clinically based on signs and symptoms. Allergy skin testing confirms that the patient is sensitised to aeroallergens.
Management:
- Allergen avoidance
- Stay indoors as much as possible on windy days in spring and in wind gusts that come before storm
- Cover pillows, mattresses, box springs, comforters and furniture cushions with plastics to reduce dust mite exposure
- For those who are allergy to pets, it is recommended not to keep animals in the house
- Intranasal cortisone sprays such as Nasonex or Dymista contains low dose of steroids is effective treatment for hay fever
- Oral nonsedating antihistamines (2nd and 3rd generation) such as Telfast are good in controlling symptoms such as sneezing and itching but are not as effective as intranasal cortisone spray
- Immunotherapy- This involves referral to allergy specialist. Allergy specialist will do skin patch or prick testing to identify what allergen patient is allergy to. Once this is done, patient may be offered desensitition or oral immunotherapy
- For patients with severe hay fever not responding to all conventional treatment, there are biologic therapies such as Dupilumab, Mepolizumab or Omalizumab can be used. However, this biologic therapy has to be prescribed by specialist and not covered under PBS.