We appear to be in the midst of an epidemic. No, not Covid-19 (which, for the time being at least, seems to continue to decline). I’m talking about hay fever.
Suddenly, my clinics and social media feeds are jam-packed with sufferers saying it’s worse than ever this year. Even my fellow Mail on Sunday columnist Piers Morgan is laid low with it, and seems unable to control his symptoms.
Although hay fever affects up to a third of Britons, anyone who doesn’t have it probably thinks it’s a mild ailment. But I’ve seen at first hand the misery this allergy to pollen causes.
And, in my experience, the reason it lays people so low is that many don’t know how to treat it properly. This is why hay fever can easily become a nightmare of breathing difficulties, wheezing and coughing, sneezing, eye problems and mucus.
We appear to be in the midst of an epidemic. No, not Covid-19 (which, for the time being at least, seems to continue to decline). I’m talking about hay fever (stock photo)
It’s particularly bad when combined with other conditions that affect breathing, such as asthma.
Over the past week the Met Office has been warning of surges in grass pollen, dubbed ‘pollen bombs’ (who thinks up these things?), reaching ‘very high risk’ levels.
They’ve been hitting the South and the Midlands in particular, where long, dry, hot spells are to blame, say experts.
And while you can’t control the weather, there are things you can do to sort yourself out – and now would be a really good time.
The lockdown, and all the anxiety it brought, may have also played a role. Studies have, over the years, shown that there is a relationship between hay fever and our mood: when we feel low, our symptoms can be worse.
Hay fever in younger people seems to go hand-in-hand with a more anxious personality type, research has shown. Trials of drugs to treat the condition also have a strong placebo effect – patients find their physical symptoms improve even when taking ‘dummy’ treatments.
All these things show that hay fever symptoms may well be linked to state of mind.
Over the past few weeks I’ve also seen a spike in people suffering from long-term conditions such as migraine and arthritis, both of which also have psychological components. It isn’t fully understood why, but it does give us a worthwhile avenue to explore in terms of treatment.
If patients are feeling really distressed, I often suggest trying one of the many mindfulness, meditation or cognitive behavioural therapy apps endorsed by the NHS.
Over the past week the Met Office has been warning of surges in grass pollen, dubbed ‘pollen bombs’ (who thinks up these things?), reaching ‘very high risk’ levels (stock photo)
There is a whole library of them on nhs.uk. I can’t guarantee they will instantly stop the symptoms, but it might help make things a lot more bearable.
Tackling hay fever symptoms does not start and end with antihistamine tablets – they are just one of a vast number of treatments, both medical and non-medical, that are worth trying.
If you were to check NHS medical guidelines for the treatment of hay fever, you’d find the first thing to try is not even a drug but nasal rinsing, which is cheap and easy.
Nasal rinses are squeezy bottles of ready-made saline that you stick up a nostril and squirt, making sure you’re over a sink, which reduces inflammation and congestion and rinses away pollen. They are available online and in pharmacies.
Hay fever in younger people seems to go hand-in-hand with a more anxious personality type, research has shown (stock photo)
It seems like a faff but actually it isn’t, once you get into a routine (do it in the morning and before bed). It could well be the only treatment you need. It’s also perfect for people who need to avoid medication, for example breastfeeding women.
Antihistamines are popular medications with few downsides, but nobody seems able to use them properly. Firstly, even non-drowsy antihistamines can make people feel tired or hung over and heavy, which is why so many stop taking them.
If this is happening to you, start taking them in the evening or try a different tablet, such as cetirizine, loratadine or acrivastine, which are available from the pharmacy.
Try them each separately for at least a week, and look out for the generic drugs rather than brand names as they are much cheaper and just as effective.
Antihistamines are usually labelled as once-a-day, but you can safely take them twice a day or even three times for better control – as long as drowsiness isn’t a problem.
In allergy clinics, patients are often given four times the typical doses with no adverse effects.
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If you really do think you’ve exhausted all these possibilities, GPs can prescribe a medicine called fexofenadine. Steroid nose sprays are also effective and, in fact, are often better than taking a tablet. These can be combined with an antihistamine tablet.
Patients who suffer eye symptoms also find these sprays are particularly good.
To use properly, you need to stick the nozzle just inside the nostril and aim for the outside wall of your nose – it’s easiest to do this if you hold the spray in the opposite hand to the side of the nose you’re sticking it in.
Spray once or twice and just breathe in gently – no sniffing. Then swap hands and repeat on the other side.
It can take up to two weeks for the effect to build up, so it is a good idea to start using them before the hay-fever season starts. And they have to be used every day, not just when you feel your symptoms. You can also get antihistamine nose spray from the pharmacy, for immediate relief.
Pollen avoidance is a genuine way of helping, alongside your other treatments. Most people don’t think it will work compared to the power of drugs. Wrong!
We are all trying to get out and exercise at the moment, but if you are a sufferer, don’t go for long walks in grassy open spaces – especially in the early morning and early evening when pollen levels are highest.
Likewise, after washing your clothes or bed linen, don’t be tempted to dry them outside in the lovely sunshine – they get covered in pollen.
And smearing a little petroleum jelly, or even lip balm, around the edge of each nostril traps pollen before it has a chance to get up your nose.
Hay-fever eye drops contain a medicine called sodium cromoglicate and can be bought from pharmacies. If you try this, I recommend using something called an eye-drop dispenser.
There are many versions, but they all basically sit over the eye and help direct the drops into the right place rather than all over the face.
Getting eye drops in is actually a real skill, and most people aren’t gaining the benefit as they’re simply not doing it properly.
Sorting out hay fever takes time and patience. Some of the ideas that seem the most time-consuming are actually the most effective – if you stick with it, you can find relief.