What are the commonly used treatments for hay fever?

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The commonly used treatment options for hay fever are: antihistamine nose sprays, antihistamine tablets, steroid nose sprays, and eye drops. If your hay fever symptoms are not controlled on the medication that you are taking after 2-4 weeks, you should discuss this with your doctor. You may need to try a different treatment or add in another treatment.

If you are taking hay fever medication regularly and your hay fever is well controlled on your current treatment, you should continue this treatment until the end of the pollen season.

Antihistamine nose spray

A dose from an antihistamine nose spray can rapidly ease itching, sneezing and watering (within 15 minutes or so). It may not be so good at easing congestion. Antihistamines work by blocking the action of histamine. This is one of the chemicals involved in allergy reactions. A spray can be used 'as-required' if you have mild symptoms. It can also be taken regularly to keep symptoms away.

Antihistamine tablets (or liquid medicines)

Antihistamines taken by mouth (tablets or liquids) are an alternative. They ease most of the symptoms but may not be so good at relieving nasal congestion (blocked nose). Antihistamines taken by mouth are good if you have eye symptoms as well as nose symptoms. They are also usually given to small children instead of a nasal spray. A dose usually works within an hour. Therefore, one can be taken 'as required' if symptoms are mild, or come and go. One can also be taken regularly if symptoms occur each day.

There are several brands of antihistamines that you can buy at pharmacies or get on prescription. Older brands such as chlorphenamine work well, but make some people drowsy, so they should not be taken if you are driving or operating machinery. There are several newer ones that cause less drowsiness. Ask your pharmacist for advice.

If you are pregnant or breastfeeding, it is advised to try to avoid antihistamines if possible. Treatment with a steroid nose spray is usually tried first (see below). An antihistamine may sometimes be used if your symptoms are not controlled. Discuss with your doctor or pharmacist if you are pregnant or breastfeeding and have hay fever.

Steroid nose sprays and drops

A steroid nose spray usually works well to clear all the nose symptoms (itch, sneezing, watering and congestion). It works by reducing inflammation in the nose. A steroid nose spray also tends to ease eye symptoms. It is not clear how it helps the eye symptoms - but it does! Steroid nose drops are also sometimes used.

It takes several days for a steroid spray to build up to its full effect. Therefore, you will not have an immediate relief of symptoms when you first start it. In some people it can take up to three weeks or longer to be fully effective. So do persevere. (It is best to start taking it a few weeks before the hay fever season is likely to begin if you know that you have hay fever.)

A steroid nose spray tends to be the most effective treatment when symptoms are more severe. It can also be used in addition to antihistamines if symptoms are not fully controlled by either alone.

You need to take it each day over the hay fever season to keep symptoms away. However, once symptoms have gone, the dose of a steroid spray can often be reduced to a low 'maintenance' dose each day to keep symptoms away. There are several brands which you can buy at pharmacies, or get on prescription. Side-effects or problems with steroid nose sprays are rare (read the packet leaflet for details).

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