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Hay fever (seasonal allergic rhinitis)

Hay fever is also known as seasonal allergic rhinitis. Symptoms include sneezing, a runny nose and itchy eyes. Around one in five people in the UK have an allergy such as hay fever. And these allergies are becoming even more common.

Hay fever is an allergic reaction to pollen from grasses, weeds or trees. The pollen is carried in the air, usually during the spring, summer and sometimes autumn. Pollen is a type of allergen – substances that can cause an allergic reaction.

If you have hay fever, your immune system mistakes these harmless substances as harmful intruders. When this happens, you will have an allergic reaction.

Hay fever, asthma, food allergies and eczema are related allergic conditions and you’re more likely to develop them if they run in your family. This is called atopy.


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  • Symptoms Symptoms of hay fever

    Symptoms of hay fever include:

    • sneezing
    • a blocked or runny nose (rhinorrhoea)
    • itchy eyes, nose, throat and roof of your mouth (palate)
    • red or watery eyes
    • postnasal drip (mucus dripping down your throat from the back of your nose) – this might make you cough
    • headache, caused by a stuffy nose
    • swollen eyelids – but this is less common

    These symptoms can make it difficult for you to concentrate or sleep well. In some people, pollen may also trigger asthma.

    If you have hay fever-like symptoms all year round, you may also be allergic to house dust mites, pet hair or moulds. This is called perennial allergic rhinitis.
  • Diagnosis Diagnosis of hay fever

    If you have hay fever, you will probably be familiar with your symptoms and may not need to see your GP. You can try and manage your symptoms with help from a pharmacist.

    If you do see your GP, they will usually be able to easily diagnose your hay fever, simply by asking about your symptoms. They may look inside your nose and examine your eyes. If your symptoms are difficult to control, your GP may arrange for you to have an allergy test. You’ll see an allergy specialist, who may do a skin-prick allergy test or blood tests. The blood test is to measure the level of immunoglobulin antibodies for a specific allergen in your blood.

  • Treatment Treatment and management of hay fever

    Self-help and prevention

    Here are ten ways to help reduce your hay fever symptoms.

    • Keep an eye on the pollen count. If you know it’s going to be high, you can take action before your symptoms get too bad or even start.
    • Stay indoors, and keep doors and windows closed.
    • Keep car windows closed when you’re driving.
    • Fit a car pollen filter.
    • Stay away from grassy areas, especially during the early morning and evening when the pollen count is highest.
    • Don’t mow lawns or rake leaves.
    • Wear wrap-around sunglasses to keep pollen out of your eyes.
    • Take a shower and wash your hair after going outside.
    • Don’t dry your washing outside. Pollen can get trapped in the fibres of your clothes and bed linen.
    • Apply a balm around the inside of your nostrils to reduce how much pollen gets into your nose – petroleum jelly works for some people.

    If it’s been raining, or is raining, the pollen count should be lower, so your symptoms will probably ease on these days. The pollen count is usually higher on warmer, dry days.


    A range of treatments are available to ease the symptoms of hay fever. You can buy most of these in shops and supermarkets. For others, you’ll need a prescription from your GP. Be sure to read the patient information leaflet that comes with your medicine. If you have any questions, ask your pharmacist or GP for advice. Be aware that some hay fever treatments aren’t suitable if you’re pregnant or breastfeeding.

    Antihistamine tablets

    If your hay fever is mild, you might find that antihistamine tablets are all you need to ease your symptoms. These include cetirizine and loratadine. Antihistamines usually reduce sneezing and a runny nose, but may not help as much with a blocked nose.

    Some antihistamines can make you feel drowsy. Even those labelled ‘non-drowsy’ can still make some people feel tired, so don’t drive or operate heavy machinery if you get this side-effect. Always read the patient information leaflet that comes with your medicine. If you’re unsure about anything, ask your pharmacist.

    Nasal sprays

    If you have persistent or more severe symptoms, a steroid nasal spray, such as beclometasone or fluticasone, may be a good option for you. These are available as over-the-counter medicines from a pharmacy. They can improve and prevent all nasal symptoms, such as sneezing and a blocked nose.

    However, a steroid spray may take some time before it starts to work. Use it at least two weeks before your symptoms usually start and then every day during the hay fever season. Make sure you take the lowest dose that works for you. You may have some mild side-effects, such as irritation in your nose or nosebleeds. If your hay fever is mild, try an antihistamine nasal spray, such as azelastine. There are also sprays available on prescription that contain both steroid and antihistamine if your symptoms are more severe.

    Eye drops

    If you have itchy or sore eyes, you can use eye drops. Sodium cromoglicate drops usually work well and are available without a prescription from your local pharmacy. Lodoxamide, nedocromil and antihistamine drops are other options if sodium cromoglicate doesn’t help.

    Steroid tablets

    Steroid tablets are rarely prescribed for hay fever, unless you have very severe symptoms. If you’re prescribed them by your GP, it will only be a short course of treatment.


    If all other treatments don’t work, your GP may refer you to see an allergy specialist, who may offer you immunotherapy. This is sometimes called desensitisation.

    Immunotherapy involves having doses of the pollen you’re allergic to over a period of three years. It helps ‘reset’ your immune system, so it no longer thinks the specific allergen you’re allergic to is a threat. It’s available either as injections, or as drops or a tablet which dissolves under your tongue (sublingual therapy).

    Immunotherapy is expensive and time-consuming so you will only be considered for this type of treatment if your hay fever symptoms are very severe.

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  • Causes Causes of hay fever

    If you have hay fever, your body produces a type of antibody called immunoglobulin E (IgE) when you come into contact with pollen. Antibodies are only usually released to fight harmful intruders, such as viruses. But with hay fever, your body believes that the harmless pollen is actually harmful. IgE triggers the release of certain substances from cells in your nose, throat and eyes. One of these substances is histamine, which sets off the symptoms of hay fever.

    You may be allergic to one or more types of pollen – this will determine when your symptoms are most severe. Some possible causes include:

    • grass pollen
    • tree pollen
    • weeds, such as nettles, dock and mugwort
    • fungal spores

    More than nine out of 10 people in the UK who have hay fever are allergic to grass pollen. Different trees produce pollen at different times of the year. One in four people in the UK with hay fever are allergic to birch tree pollen.

    Allergen Time of year when
    symptoms are worst
    Tree pollen Spring
    Grass pollen     
    End of spring and beginning of summer
    Early spring to late autumn

    The time and length of the pollen season can be different depending on where you live. It usually starts earlier in the year and lasts longer in Southern and Central UK.

  • The pollen count The pollen count

    The pollen count is the average number of pollen grains in one cubic metre of air over 24 hours. There are pollen counts for grass, tree and weed pollen, and fungal spores.

    The pollen count is classed as low, moderate, high or very high.

    • Low is less than 30 (pollen grains per cubic metre of air).
    • Moderate is 30 to 49.
    • High is 50 to 149.
    • Very high is 150 or more.

    Keeping an eye on the pollen count can help you manage your hay fever symptoms. If you know it’s going to be high, you can take medicines and try self-help measures. See our Treatment section for more information. The weather can affect the pollen count too – it’s generally higher on dry, sunny days and lower on rainy days.

  • Do complementary therapies work? Do complementary therapies work for treating hay fever?


    Experts aren’t yet sure. Some people find complementary therapies for hay fever helpful. However, scientific research that’s been done hasn’t yet proven one way or another how well they work. This is because the results have been mixed.

    More information

    Complementary therapies can be used alongside conventional medicines, such as those you get in a pharmacy or prescribed by your GP. They include acupuncture, homeopathy and herbal medicines. Some practitioners claim that these complementary therapies can relieve your hay fever symptoms or even prevent them. Some studies have shown promise. For example, acupuncture has helped improve hay fever symptoms in some people. However, there isn’t a large enough amount of evidence to recommend these treatments and more research is needed

    Some people find that complementary therapies work for them. However, they can sometimes affect how other medicines work or cause side-effects. Do your research and if you’re unsure, contact your GP for some advice before trying anything new.

  • Do supermarket own-brand antihistamines work? Do supermarket own-brand antihistamines work?


    Yes, supermarket own-brand products contain the same active ingredients as branded antihistamines, so they work in exactly the same way.

    More information

    Most branded antihistamines are available as non-branded products. These are known as ‘generics’. Exactly the same ingredients are available, in the same dose, in unbranded products or pharmacy or supermarket own-brands. They can be up to 90 percent cheaper than the original branded version.

    Generic medicines sold in the UK have to meet the same quality and safety standards as the branded equivalent. Therefore, the active ingredient of the generic product will be chemically the same and have the same effect in your body as the branded one.

    There is no need to pay more for an advertised or more smartly-packaged product. Always read the patient information leaflet that comes with your medicine and if you have questions, ask your pharmacist for advice.

  • Will I have hay fever abroad? Will I have hay fever abroad?


    You might do. It depends on which country you visit and at what time of year you go.

    More information

    The hay fever season happens at different times in different countries. This depends on the climate and type of plants and trees that grow there. If you get severe hay fever, it’s best to go on holiday somewhere where the pollen count is low all year round. Alternatively, you could visit places that aren’t in their peak pollen season.

    There is generally less pollen in coastal areas. So, if you visit the seaside, your hay fever symptoms shouldn’t be as severe. This is because the sea breeze blows pollen inland and brings fresh air with it.

    One thing to remember is that there are different pollen types abroad that might trigger hay fever symptoms, such as olive pollen or ragweed. Also, some years, seasons can come earlier or later, or unexpected weather can produce pollen when you might not expect it.

    The best advice is to check the pollen count before you travel and take medicines with you. The National Pollen and Aerobiology Unit has a list of low pollen destinations month by month, which is worth checking before booking a holiday.

  • Resources Resources

    Further information


    • Hay fever and allergic rhinitis. Allergy UK., published March 2015
    • Allergic rhinitis. NICE Clinical Knowledge Summaries., published June 2015
    • Why is allergy increasing? Allergy UK., published November 2013
    • Rhinitis (hay fever). American Academy of Allergy, Asthma and Immunology., accessed 2 July 2015
    • Eczema (atopic eczema). British Skin Foundation., accessed 2 July 2015
    • Atopy. American Academy of Allergy, Asthma and Immunology., accessed 2 July 2015
    • Allergic rhinitis. Medscape., published February 2015
    • Post-nasal drip. American Academy of Otolaryngology–Head and Neck Surgery., accessed 2 July 2015
    • Allergic rhinitis. BMJ Best Practice., published December 2014
    • Allergic conjunctivitis. PatientPlus., published February 2014
    • Hay fever. BMJ Best Practice., published September 2014
    • Immunotherapy. Allergy UK., published June 2013
    • Allergic rhinitis. PatientPlus., published August 2012
    • What is causing your allergy? Allergy UK., published June 2013
    • Allergenic pollen types. National Pollen and Aerobiology Research Unit., published May 2014
    • Grass. National Pollen and Aerobiology Research Unit., published June 2012
    • Birch. National Pollen and Aerobiology Research Unit., published June 2012
    • Frequently asked questions. National Pollen and Aerobiology Research Unit., published May 2014
    • Recording the pollen count. National Pollen and Aerobiology Research Unit., published May 2014
    • Complementary and alternative medicine. Patient Plus., published April 2012
    • Kern J, Bielory L. Complementary and alternative therapy (CAM) in the treatment of allergic rhinitis. Curr Allergy Asthma Rep 2014; 14(12):479. doi:10.1007/s11882-014-0479-8
    • About generics. British Generics Manufacturers Association., accessed 9 July 2015
    • Low pollen holiday destinations. National Pollen and Aerobiology Research Unit., published May 2014


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