Hay fever is one of the most common reasons for people to attend their doctor in Spring and Summer, as pollen levels soar. Quite often by the time they come to their GP, hay fever sufferers have already tried numerous products from the pharmacy, from tablets to nasal sprays, but still have symptoms. And sometimes people just feel overwhelmed by all the different treatment options and don’t know where to start.

Can you prevent Hay Fever?

Reducing exposure to your known trigger(s) can help. Some suggestions for people with pollen allergies are:

• Staying indoors until after midday, particularly if the pollen count is high. The  pollen count  can be checked online. Windy weather and thunderstorms may also cause spikes in hayfever symptoms.
• Keep your windows closed at home during pollen season and in the car- remembering to use recirculated air conditioning when driving.
• Wearing glasses/sunglasses when outside
• Having a shower when you get home. Refreshing your eyes with simple saline/lubricant eye drops may also help.
• Avoid walking/camping in grassy areas, if grass pollen seems to be your trigger, and ideally let somebody else mow the lawn!
• Remove any weeds or plants outside your bedroom window that might trigger symptoms.

Lots of people use steroid nasal sprays to treat hay fever and allergic rhinitis. However, if their technique for using the nasal spray is incorrect, it can lead to poor results and uncontrolled symptoms, as the medication does not get delivered to the right place! Every manufacturer will include their own instructions, and it’s important to refer to these at the start. But here are some key points to remember, that apply to the pump type steroid nasal sprays that are commonly used to treat hay fever.

If you have further questions or concerns about how to use a nasal spray correctly, speak to your pharmacist or doctor.

You can read more about different types of nasal sprays for hay fever here. There is also more information on the various treatment options for hay fever here.

Further Patient Resources

Intranasal Spray Technique. nationalasthma.org.au

Article Resources

Sheth K. (2008). Evaluating the Safety of Intranasal Steroids in the Treatment of Allergic Rhinitis.

Benninger MS, Hadley JA, et al. (2004). Techniques of intranasal steroid use.

It’s that time of year again when the pollen count starts to climb, and hay fever sufferers begin to experience the dreaded, familiar symptoms of itchy eyes, runny nose, congestion and sneezing. For some people, it’s mild enough, but others get more severe symptoms that interfere badly with daily life. However, quite often, when doctors ask hay fever sufferers what treatment they’re using, it turns out they’ve been sticking to the same old antihistamine tablet for years, and are not aware of other helpful treatment options. Nasal sprays in particular can cause confusion- as there are so many types- some over the counter, some prescription-only. So what are differences between them and which is the best nasal spray for hay fever ?

Decongestant nasal sprays

Decongestant nasal sprays are available over the counter at the pharmacy. There are many types.  They make the blood vessels in your nasal passages constrict (shrink), and can quickly dry up a runny nose. However, they should only be used for 2 to 3 days at a time, as your nose can develop “rebound congestion” from them. They may also be unsuitable if you have high blood pressure or an eye condition called glaucoma.

Combination nasal sprays

There are also combination sprays that contain both steroids and antihistamine. They can be helpful, particularly if other over-the-counter options have not worked. Ask your doctor or pharmacist for more details.

Ipratropium nasal spray

This spray does not help itch and sneezing but it can treat a runny nose. It is also used to help symptoms of the common cold, in a similar way. It works by reducing mucus production.

How to choose the best nasal spray for hay fever?

• The usual advice from doctors is to find a steroid nasal spray that works for you and take it regularly for the full hay fever season, bearing in mind it can take a few weeks of daily use to see the results.
• You can get a steroid nasal spray without a prescription from your local chemist- the specific brand does not matter much (ask the pharmacist for advice if you’re unsure)
• Decongestant sprays are best avoided or used only occasionally for a day or two.
• You can also continue to take a daily antihistamine tablet, antihistamine nasal spray or eye drops, if helpful.
• If this approach is not controlling your symptoms properly, speak to your pharmacist about a combination spray, and other treatment options.
• You can also read more about using your nasal spray correctly here.
• Finally, it is always worth considering ways to reduce exposure to your pollen triggers.

Article Resources:

Chong L et al. (2016). Different types of intranasal steroids for chronic rhinosinusitis.

Passali D et al. (2016). Mometasone Furoate nasal spray: a systematic review

Cain R, Lal D. (2013). Update on the management of chronic rhinosinusitis

Deckx L et al. (2016). No nasal decongestants used alone relieve cold symptoms

Streaming nose, itchy watery eyes, irritated throat and a generally muzzy head- hay fever can be extremely uncomfortable. If it’s severe, it can be very hard to function- whether that’s working, socialising, or enjoying an afternoon in the sun.

Many people with mild hay fever can manage it themselves, with products from the pharmacy. But others struggle with symptoms and don’t really know what to do next. The good news is, there are often options people have not yet tried- and when they finally come to the doctor with their out-of-control symptoms, they’re surprised to hear about hay fever treatments they were unaware of.

Thunderstorm Asthma- learning from the past.

What Happened in Melbourne in November 2016?

9 people lost their lives, hundreds of people were hospitalised and thousands of people were affected by breathing problems due to thunderstorm asthma. Medical services were overwhelmed by an unexpected surge in sudden-onset attacks of severe wheezing and coughing, often in people who were undiagnosed as asthmatic.

Who was Affected?

For the most part, people who are known to be sensitive to grass pollen were affected – asthmatics and hay fever sufferers. But for many it was entirely unpredictable.

4. If you’re having trouble breathing and your reliever inhaler isn’t relieving your symptoms, call an ambulance. But don’t 100% rely on an ambulance being available if there’s a repeat of the thunderstorm asthma events of November 2016 – the 9 fatalities couldn’t get an ambulance in time.

5. If you have asthma or thunderstorm asthma, get an “Asthma Action Plan” from your GP. It’s all about planning.

6. A new warning  system for Thunderstorm Asthma has been launched in Victoria, in a bid to prevent serious illness and fatalities, as occurred in Melbourne in 2016.  If you have asthma or hay fever, it’s worth  getting the emergency app which is downloadable from Google Play or  the Apple App Store. Go to www.emergency.vic.gov.au/prepare to find out more. 

You can obtain prescription asthma inhalers from Qoctor, the Quick Online Doctor conveniently and cheaply.