Managing Hay Fever and Seasonal Allergies

Knowing which affects you helps, because it determines when to start treatment.

Timing matters more than most people realise

Antihistamines and particularly steroid nasal sprays work better when started before the season rather than after symptoms establish.

Nasal steroid sprays take several days to reach full effect and are frequently abandoned by people who expect immediate relief. Starting one to two weeks before your usual season and continuing throughout is the approach with the best evidence.

Treatment options

Non-sedating oral antihistamines are effective for sneezing, itching and eye symptoms and are available over the counter. Older sedating types cause drowsiness and impair driving.

Intranasal corticosteroid sprays are the most effective single treatment for nasal congestion and are generally recommended first-line for moderate to severe symptoms.

Antihistamine eye drops address eye symptoms more directly than oral treatment.

Nasal saline irrigation removes pollen from the nasal passages and is inexpensive and safe.

Combination approaches are frequently needed, and using a spray correctly matters — aiming outward toward the ear rather than up at the septum improves effect and reduces irritation.

Reducing exposure

Pollen counts are typically highest in the early morning and evening, which affects when to ventilate the house and exercise outdoors.

Keep windows closed at peak times and use recirculation in the car with a cabin filter in good condition.

Shower and change clothes after being outdoors, since pollen adheres to hair and fabric and is then carried to bed.

Dry laundry indoors during high pollen periods rather than on a line.

Wraparound sunglasses reduce eye exposure measurably.

When to seek further help

Symptoms not controlled by over-the-counter treatment used correctly and consistently.

Symptoms affecting sleep, work or school performance, which is common and underestimated.

Wheeze or breathlessness, since allergic rhinitis and asthma frequently coexist and uncontrolled rhinitis worsens asthma control.

Year-round symptoms, which suggest a perennial allergen such as house dust mite or animal dander rather than pollen, and a different management approach.

Immunotherapy

For severe symptoms not controlled by medication, allergen immunotherapy — given as tablets under the tongue or as injections — can substantially reduce sensitivity over time.

It requires a confirmed diagnosis, a course lasting around three years, and specialist supervision. For the right patients the benefit persists after treatment ends.