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About Hayfever


Hayfever: the treatment


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What is the point of treating hayfever?

The objective should be to let you lead a normal life. For this it is not necessary to remove every last symptom, but just to make the symptoms mild enough so that they do not interfere with your life.

Your treatment should depend on:

  • How bad your hayfever is.
    Bad hayfever may need three or more treatments at once. Mild hayfever needs only an antihistamine or perhaps a nasal spray. Very mild hayfever may need no treatment, depending on how well you need to be to do your tasks.

  • What your most troublesome symptoms are.
    A nasal spray if your nose is the main problem, an antihistamine plus eye drops if your eyes bear the brunt.

  • What your needs are; how effective the treatment needs to be to let you do what you need to do.
    For example, if you are an actress on television you may need more treatment to be able to do your job well than if your job is not in the public eye. If you are taking exams, or having a job interview, you will also need the very best treatment.

Starting treatment early can keep your hayfever mild.

One of the nasty things about hayfever is that the hayfever itself makes your nose inflamed and sensitive. So as the season goes on you may get worse trouble from the same amount of pollen. Some treatments prevent this from happening, for example the nose sprays which have steroids in them. So starting your treatment just before you expect your hayfever season to start, can mean you need less treatment to get a good result.

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What treatments are there for hayfever?

There are many treatments, but just a few kinds are the most important ones. Here is a list.

  • Avoiding pollen
    There may be some useful things you could do, from closing windows to going abroad, or even wearing special spectacles.

  • Antihistamine tablets, capsules, or liquid medicines
    The simplest treatment. These help all the symptoms of hayfever, and the latest ones have excellent safety. But they may not treat all your symptoms well enough on their own.

  • 'Antiallergic' nasal sprays or eye drops
    A confusing name, as the other medicines in the list also act against allergy.
    Two of these medicines, cromoglycate (Rynacrom ® & Vividrin ® nasal sprays, also other names) and nedocromil (Tilarin ® nasal spray, Rapitil ® eye drops), are similar to each other, work, and have very good safety.
    A third medicine, lodoxamide (Alomide ® ) is an alternative which serves the same purpose.
    Like the antihistamine sprays and drops they are used especially when people do not want to use steroid sprays or drops. As eye drops they are important because steroid eye drops do cause serious side effects.

  • Antihistamines, sprays or drops for your nose or eyes
    Work about as well as the antiallergic drugs. Like them, they only help in the nose or eyes, where they are applied.

  • Steroid sprays or drops
    Very effective and safe for the nose only. Steroid eye drops are very effective but can have serious side effects.

  • Decongestant sprays
    Can help a lot over a short period of up to a few days, but cause worse trouble than you started with if you use them for longer.

  • Decongestant tablets
    They definitely help blockage of the nose, but have side effects especially in people with high blood pressure or a number of other medical conditions. At least one of them, phenylpropanolamine, seems to carry a small risk of causing a stroke due to bleeding in the brain, at least when people take it as a slimming drug (definitely not recommended by us). Some antihistamine tablets or capsules have a decongestant in them.

  • Steroid tablets or injections
    Work very well but have side effects. Should be used only for short periods when all else fails and it is really important to suppress symptoms, e.g. for exams, weddings, interviews.

  • Desensitising injections
    Widely used throughout the world but hardly used in Britain, these can help hayfever when the best you can achieve with other treatments is not good enough.

What a lot of treatments! Should I use them all?

No! At least not unless your hayfever is truly terrible, and probably not then either. If your hayfever is as bad as that you had better see a recognised allergy specialist.

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The treatments in more detail

The following is based on treatments available in Britain.

  • Avoiding pollen

    You may be able to help the problem by avoiding the cause. For example:

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    Treatment: summing up

    Surely, with all these options, you and your doctor should be able to find something which will keep you in reasonable shape. Have a good summer.

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    If you spot mistakes or have questions, please e-mail me .
    This page is maintained by Martin Stern
    Updates : 3 Dec 1998 (Caution against use of decongestant spray for diving. More cautious advice for these in air travel.). 20 Jan 2000 (deleted Airshield spectacles). 2 Aug 2000 antihistamines revised. 30 Nov, 6 & 15 Dec 2000 strokes from decongestant. 15 Dec 2000 antihistamines OTC (table). 25 Jan 2001 pregnancy, other minor changes. 9 May 2001 desloratadine & minor changes. 5 Mar 2003 pregnancy.

    Copyright © 1997, 2000, 2001, 2003 Martin Stern