What is hay fever?

Rhinitis is when the lining inside the nose and sinuses (mucous membranes) gets irritated and inflamed.  Common symptoms are stuffy, itchy or runny nose and sneezing.  It can also affect the eyes and throat with itchy, runny eyes and itchy throat.  Many things can cause rhinitis e.g. pollen, dust, mould, smoke and animal dander.

Allergic rhinitis happens when pollens, dust mites or other allergens in the air get into your nose and eyes and cause an allergic reaction.

Seasonal allergic rhinitis or hay fever happens to children who are allergic to pollens.  Pollens are released into the air by particular grasses or trees. Your child breathes these pollens in, and they irritate the lining of their eyes nose and sinuses. This type of hay fever is usually worse between late March and September especially when it is warm humid and windy.  This is when pollen count is at its highest.  Hay fever is quite common. 

  • grass pollen is the most common allergen (May to July)
  • tree pollen (February to June)
  • weed pollens (June to September)

Up to 50% of UK population report suffering from hay fever symptoms (Allergy UK). Your child has a greater chance of having hay fever if you, your child’s other parent or your other children have an allergy. Teenagers are more likely to get hay fever than younger children.

Perennial rhinitis happens all year round and is caused by other triggers. These could be dust mites in the house, animal fur or hair, and mould spores. If your child gets rhinitis all year round, they may be allergic to one of these triggers.

Infectious rhinitis – the common cold. Rhinitis is most often caused by viruses, the common cold (rhinovirus).  Most children will catch between 8-12 mild viral infections a year (about 1 cold a month).

Hay fever symptoms

Common symptoms of hay fever include:

  • clear runny nose and sniffing
  • blocked nose
  • mouth breathing
  • sneezing
  • itchy eyes, nose, roof of the mouth and back of the throat
  • red, sore and watery eyes.

Hay fever isn’t usually serious but if your child is very sensitive to pollens in the air, they can develop other symptoms like wheezing, hives and rashes, especially eczema.

Hay fever can also lead to poor-quality sleep, tiredness and poor concentration during the daytime.

Does your child need to see a doctor about hay fever?

You can get simple advice on medications by asking your pharmacist.

Please take your child to the GP if you’re worried about their hay fever symptoms, or the symptoms get in the way of your child’s daily life.

Tests for hay fever

Your GP might consider doing additional allergy testing or referring your child to a doctor who has experience in allergy. They may for more tests if the symptoms are impacting on your child significantly or it is not clear of the cause. These tests might change the hay fever treatment your child receives.

Hay fever treatment

There’s no cure for hay fever, so treatment aims to manage symptoms and avoid the causes.

Antihistamines syrups or tablets are usually divided into 2 main groups:

  1. Non-drowsy antihistamines (preferred) e.g. Cetirizine, loratadine and fexofenadine. These medications are less likely to make you feel sleepy.
  2. Antihistamines that make you feel sleepy e.g. chlorpheniramine (Piriton) and hydroxyzin.

Antihistamine eyedrops can be helpful for eye symptoms. Some of these can be purchased from a pharmacy and others are available on prescription e.g. optanolol (prescription) or sodium cromoglycate (over the counter)

Antihistamine also comes in several different forms including tablets, capsules, liquid syrups, creams, eye drops and nasal sprays. Please asked the pharmacist for advice if you’re unsure which medicine to try as not all antihistamines are suitable for everyone and only some are available over the counter.

Corticosteroid nose sprays are the best treatment for hay fever, especially for a blocked nose. Your child can use them safely throughout the pollen season for seasonal hay fever, or throughout the year for perennial rhinitis. E.g fluticasone (avamys). The mild steroid helps by reducing the inflammation in the nose.

Severe rhinitis caused by pollen or dust that won't go away, your doctor might consider sending your child to a specialist for immunotherapy. Immunotherapy is also known as desensitisation and aims to change the body's immune system and switch off the allergy. This will usually be done under the supervision of a doctor with experience in allergy and started at a hospital.

Allergen Avoidance

Prevention is a big part of hay fever treatment.

  • Try to avoid directly exposing your child to pollens during spring and early summer. For example, if your child is playing outside on warm and windy days, you can expect them to have worse symptoms.
  • Monitor pollen forecasts daily and stay indoors wherever possible when the count is high (generally on warmer, dry days). Rain washes pollen from the air so counts should be lower on cooler, wet days
  • On high pollen days, shower and wash their hair after arriving home and change their clothing
  • Avoid drying washing on a clothes-line outside when pollen counts are high
  • Apply an effective barrier around the edge of each nostril to trap or block pollens and other allergens and help prevent symptom

What not to do

  • do not cut grass or walk on grass
  • do not spend too much time outside during high pollen counts
  • do not keep fresh flowers in the house (if pollen allergic)
  • do not smoke or be around smoke – it makes your symptoms worse
  • do not dry clothes outside – they can catch pollen

Can children outgrow their hay fever?

Hay fever symptoms are more common in young people. At present, it is not possible to predict whose hay fever will get better and whose will remain. Some patients will also suffer from asthma and require inhalers.

Met Office pollen calendar for the UK

People with hay fever do not have allergies to all pollens. Pollen from different plants vary during the year. Tree pollen tends to be highest in spring, grass pollen is highest in summer and many weed pollens are highest in autumn:

  • tree pollen (e.g. hazel, yew, alder, elm, birch) counts highest in February and March
  • grass pollen counts highest in May to August.
  • Weed pollen (e.g. rape seed, nettle, mugwort) counts highest in May to September

Pollen forecast - Met Office produces pollen forecasts for 5 days ahead across the whole of the UK.

Other Useful resources:

Allergy UK Hay Fever | Allergy UK | National Charity

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