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Hay Fever: What It Is and What to do About It

Hay fever is an inherited allergy that affects one in five persons in the United States. It is typically caused by an allergy to various airborne allergens, such as pollens from trees, grasses or weeds. The usual symptoms of hay fever are sneezing, runny nose, nasal congestion, postnasal drainage, itching of the nose and red, itchy eyes. Other symptoms may include itching and congestion of the ears, or itching of the throat and neck, face or back. For many people the symptoms are seasonal, lasting only several months.

The allergic reaction of hay-fever sufferers is caused by a natural protein called immunoglobulin-E (IgE) antibody. When IgE combines with pollen in the nose, the resulting reaction produces the symptoms we cal1 hay fever.


Many hay-fever patients may be unaware of the indoor allergens to which they are allergic. These include the house dust mite, mold and animal dander, all of which may contribute to year-round symptoms. Board-certified allergists who treat persons with hay fever take an extensive allergy patient history and identify the various symptoms and their seasonal patterns. Often, the history alone may make the diagnosis. Specific identification of the allergen can be done by either allergy skin testing or, less often, by blood testing. Skin tests and blood tests can be performed by board-certified allergy specialists.


The most effective allergy treatment is total avoidance, but sometimes this is impractical. If attempts at avoidance fail, the next step is treatment with medications. The drugs of choice include oral antihistamines and antiallergic nasal sprays.


Many antihistamines and antihistamine/decongestant combination drugs are available over-the-counter. These may cause drowsiness and often are not well tolerated. If this happens, prescription antihistamines should be obtained from a physician. Several newer nonsedating antihistamines, such as Seldane and Hismanal, may give relief of symptoms without drowsiness. Combination prescription antihistamine/decongestants are used in many cases, especially if nasal congestion is a major symptom.

Antiallergy Nasal Sprays

Synthetic steroid sprays may reduce the severity of the allergic reaction. When similar medication is given by mouth or injection side effects may occur. Cromolyn nasal spray may help prevent allergic reactions when taken before the allergen is inhaled. Both anti­allergic nasal sprays are very effective and have minimal side effects. These sprays take a few days to become effective and must be used on a regular basis during the allergy season.

Immunotherapy (Allergy Shots)

For selected patients, regular injections of allergens may relieve symptoms. These injections, given over a period of months, usually provide relief within the first year. Immunotherapy reduces the reaction to pollens. This usually results in decreased symptoms and less need for allergy medications.

The Problem of Undertreatment

Nasal allergies may be underestimated by many patients, since the symptoms are not usually disabling. Often patients believe these symptoms are part of their “normal” condition. This leads to under-treatment. More severe symptoms may include marked fatigue during the allergy season, difficulty sleeping because of nasal congestion and post­nasal drainage, poor appetite, headaches and an increase in ear or sinus infections.

Many people are unaware of the effective prescription medications available. These are superior to the over-the-counter medications, which are frequently sedating and may result in poor concentration and decreased work or school performance. With the new weapons available, there’s no need to put up with hay fever any longer.

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