Find out more about how to diagnose and get relief from this common condition that can make you feel awful, seasonally and year-round.
Hay fever, also called allergic rhinitis, causes cold-like symptoms. These may include a runny nose, itchy eyes, congestion, sneezing and sinus pressure. But unlike a cold, hay fever isn't caused by a virus. Hay fever is caused by an allergic response to a harmless outdoor or indoor substance the body identifies as harmful (allergen).
Common allergens that can trigger hay fever symptoms include pollen and dust mites. Tiny flecks of skin shed by cats, dogs, and other animals with fur or feathers (pet dander) also can be allergens.
Besides making you miserable, hay fever can affect how well you perform at work or school and can generally interfere with your life. But you don't have to put up with annoying symptoms. You can learn to avoid triggers and find the right treatment.
Hay fever symptoms can include:
Your hay fever signs and symptoms may occur year-round or may start or worsen at a particular time of year (seasonal).
Hay fever triggers include:
Symptoms can be similar, so it can be difficult to tell which one you have.
|Hay fever||Runny nose with thin, watery discharge; no fever||Immediately after exposure to allergens||As long as you're exposed to allergens|
|Common cold||Runny nose with watery or thick yellow discharge; body aches; low-grade fever||1 to 3 days after exposure to a cold virus||3 to 7 days|
See your health care provider if:
Many people — especially children — get used to hay fever symptoms, so they might not seek treatment until the symptoms become severe. But getting the right treatment might offer relief.
When you have hay fever, your immune system identifies a harmless airborne substance as being harmful. This substance is called an allergen. Your immune system is how your body protects itself, so it produces immunoglobulin E (IgE) antibodies to protect against this allergen. The next time you come in contact with the allergen, these antibodies signal your immune system to release chemicals such as histamine into your bloodstream. This causes a reaction that leads to the symptoms of hay fever.
The following can increase your risk of developing hay fever:
Problems that may go along with hay fever include:
There's no way to avoid getting hay fever. If you have hay fever, the best thing to do is to lessen your exposure to the allergens that cause your symptoms. Take allergy medications before you're exposed to allergens, as directed by your health care provider.
To diagnose hay fever, your health care provider typically does a physical exam and talks about your health, symptoms and possible triggers. Your provider may recommend one or both of these tests:
A small area of swelling with surrounding redness (arrow) is typical of a positive skin prick test for allergy.
Once you know what you're allergic to, you and your health care provider can develop a treatment plan to reduce or get rid of your hay fever symptoms.
It's best to limit your exposure to substances that cause your hay fever. If your hay fever isn't too severe, medications you can buy without a prescription may be enough to relieve symptoms. For worse symptoms, you may need prescription medications.
Many people get the best relief from a combination of allergy medications. You might need to try a few different options before you find what works best.
If your child has hay fever, talk with your child's health care provider about treatment. Not all medications are approved for use in children. Read labels carefully.
Treatments for hay fever may include medications, immunotherapy and nasal saline rinses.
These nasal sprays help prevent and treat the nasal stuffiness (congestion) and the itchy, runny nose caused by hay fever. For many people, nasal sprays are the most effective hay fever medications, and they're often the first type of medication recommended.
Nasal corticosteroids are a safe, long-term treatment for most people. Side effects can include an unpleasant smell or taste and nose irritation. Steroid side effects from a nasal spray are rare.
Antihistamines work by blocking a symptom-causing chemical (histamine) released by your immune system during an allergic reaction. Antihistamines can help with itching, sneezing and a runny nose but have less of an effect on congestion. These preparations are usually given as pills (orally). However, there are also antihistamine nasal sprays that can relieve nasal symptoms. Antihistamine eye drops can help relieve eye itchiness and irritation.
Common side effects of antihistamines are dry mouth, nose and eyes. Some oral antihistamines may make you sleepy. Other side effects of oral antihistamines can include restlessness, headaches, changes in appetite, trouble sleeping, and problems with blood pressure and urinating. Talk to your health care provider before taking antihistamines, especially if you're pregnant or breastfeeding, or have glaucoma or an enlarged prostate.
Decongestants reduce nasal stuffiness and pressure from swelling. Because they do not relieve other symptoms of hay fever, they're sometimes combined with other medications such as antihistamines.
Decongestants are available as liquids, tablets and nasal sprays. They are also available with and without a prescription.
Oral decongestants can cause a number of side effects, including increased blood pressure, insomnia, irritability and headache. Decongestants may cause problems urinating if you have an enlarged prostate. Check with your health care provider before taking decongestants if you have high blood pressure or heart disease or if you're pregnant.
Don't use a decongestant nasal spray for more than 2 to 3 days at a time because it can worsen symptoms when used continuously (rebound swelling).
Cromolyn sodium can help relieve hay fever symptoms by preventing the release of histamine. This medication is most effective if you start using it before you have symptoms. Cromolyn sodium is available as a nonprescription nasal spray that must be used several times a day. It's also available in eye drop form with a prescription. Cromolyn sodium doesn't have serious side effects.
Montelukast (Singulair) is a prescription tablet taken to block the action of leukotrienes. Leukotrienes are immune system chemicals that cause allergy symptoms, such as irritation in the nose and making too much mucus. It's especially effective in treating allergy-induced asthma. It's often used when nasal sprays can't be tolerated or for mild asthma.
Montelukast can cause headaches. In rare cases, it has been linked to psychological reactions such as insomnia, anxiety, depression and suicidal thinking. Get medical advice right away for any unusual psychological reaction.
Available in a prescription nasal spray, ipratropium helps relieve severe runny nose by preventing the glands in the nose from making too much mucus. It's not effective for treating congestion, itching or sneezing.
Mild side effects include dry nose, nosebleeds, dry and irritated eyes, and sore throat. Rarely, the medication can cause more-severe side effects, such as blurred vision, dizziness and trouble urinating. This drug is not recommended if you have glaucoma or an enlarged prostate.
Corticosteroid pills such as prednisone sometimes are used to relieve severe allergy symptoms. Because the long-term use of corticosteroids can cause serious side effects such as cataracts, osteoporosis and muscle weakness, they're usually prescribed for only short periods of time.
Also called immunotherapy or desensitization therapy, allergy shots change the way the immune system reacts to allergens. If medications don't relieve your hay fever symptoms or cause too many side effects, your health care provider may recommend allergy shots. Over 3 to 5 years, you'll get regular shots (injections) containing tiny amounts of allergens. The goal is to get your body used to the allergens that cause your symptoms and decrease your need for medications.
Immunotherapy might be especially effective if you're allergic to animal dander, dust mites or pollen produced by trees, grass or weeds. In children, immunotherapy may help prevent asthma.
Rather than getting shots, you take tiny amounts of allergen in pill form that dissolves in your mouth. Pills are usually taken daily. Sublingual allergy tablets don't work for all allergens but can be helpful for grass and ragweed pollens and dust mites.
Saline nasal sprays can moisten dry nasal passages and thin nasal mucus. You don't need a prescription and you can use them as often as needed.
Rinsing your nasal passages with saline (nasal irrigation) is a quick and effective way to relieve nasal congestion. Rinsing flushes out mucus and allergens from your nose. Saline irrigation is a water-based solution that contains a tiny amount of salt (sodium) and other ingredients.
Saline irrigation solutions can be purchased ready-made or as kits to add to water. You can also use a homemade solution. Look for a squeeze bottle or a neti pot — a small container with a spout designed for nose rinsing — at your pharmacy or health food store.
To make up the saline irrigation solution, do not use tap water, as it can contain organisms that could cause infection. Use water that's distilled or sterile. You can also use water that was boiled and cooled. Another option is using water that has been filtered using a filter with an absolute pore size of 1 micron or smaller.
To prevent infections, wash the bottle or pot with hot soapy water and rinse it after every use and leave it open to air-dry. Do not share a container with other people.
It's not possible to avoid allergens completely, but you can reduce your symptoms by limiting your exposure to these substances. If you know what you're allergic to, you can avoid your triggers. Consider some of these tips.
Pollen and mold spores are fine dustlike particles that plants use in fertilization. They float in the wind and can get into your nose and eyes.
Dust mites are tiny, insect-like pests that are common in dust. They live in bedding, carpets, upholstery and stuffed animals. Dust mites prefer warm, humid spaces.
Cockroaches leave tiny droppings that can become airborne. Getting rid of the insects gets rid of their droppings.
Pet dander is tiny flecks of skin shed by cats, dogs, and other animals with fur or feathers. Pet urine and saliva may also contain allergens.
While there isn't much evidence about how well alternative treatments work, people sometimes try them for hay fever. Examples include:
Herbal remedies and supplements. Extracts of the shrub butterbur may help prevent seasonal allergy symptoms. If you try butterbur, be sure to use a product that's labeled PA-free, which indicates that it's had potentially toxic substances removed.
There's some limited evidence that spirulina and Tinospora cordifolia also may be effective. Though their benefits are unclear, other herbal remedies for seasonal allergies include capsicum, honey, vitamin C and fish oil.
Herbal remedies and supplements are not evaluated by the U.S. Food and Drug Administration the way medications are. Discuss these products with your health care provider before using them.
You're likely to start by seeing your primary care provider. However, in some cases when you call to set up an appointment, you may be referred to an allergist or other specialist.
Take a family member or friend along, if possible. Someone who accompanies you can help you remember information.
Here's some information to help you prepare for your appointment. Before your appointment, make a list of:
For hay fever, questions to ask include:
Don't hesitate to ask other questions during your appointment.
Your health care provider is likely to ask you a number of questions, including:
While waiting for your appointment, remedies available without a prescription may help ease hay fever symptoms. They include pills, liquids, nasal sprays and eye drops. Also, try to reduce your exposure to possible triggers, if possible.