Every spring and summer, millions of people across the UK find themselves wondering the same thing: is this hay fever, or am I coming down with something? A runny nose, sneezing, a scratchy throat, and general fatigue can all be caused by hay fever, a common cold, influenza, or COVID-19 — and telling them apart is not always straightforward.
This guide walks through the distinguishing features of each condition, explains why certain symptoms overlap, and gives you a clear framework for working out what you are most likely dealing with.
What Is Hay Fever?
Hay fever — also known as seasonal allergic rhinitis — is an allergic response triggered by airborne pollen. When pollen particles come into contact with the lining of the nose, eyes, and throat in a sensitised individual, the immune system releases histamine and other inflammatory chemicals, producing the characteristic symptoms.
It is one of the most common chronic conditions in the UK, affecting an estimated 10–30% of adults and up to 40% of children. Despite its name, hay fever causes no actual fever. This is one of its most clinically useful distinguishing features.
Around one in five people develop hay fever for the first time as an adult. If you have never had it before and develop nasal or eye symptoms during pollen season, do not assume it must be a virus — new-onset hay fever in adults is common.
UK Pollen Calendar 2026
The timing of your symptoms is one of the most useful clues. Hay fever follows the UK pollen season — if your symptoms reliably appear each year at the same time and coincide with high pollen counts, hay fever is the most likely explanation.
Grass pollen is the most common trigger and accounts for the majority of UK hay fever cases. The grass pollen season runs from May to August, with peak counts typically occurring in June and July. Check live pollen forecasts on the Met Office website.
Full Symptoms Comparison
The table below compares symptoms across all four conditions. Use it as a quick-reference guide — but remember that symptoms vary between individuals and can overlap.
| Symptom | 🌿 Hay Fever | 🤧 Cold | 🤒 Flu | 🦠 COVID-19 |
|---|---|---|---|---|
| Sneezing | ✓ Common | ✓ Common | Sometimes | Sometimes |
| Runny / blocked nose | ✓ Very common | ✓ Very common | Sometimes | Sometimes |
| Itchy eyes | ✓ Common | ✕ Rare | ✕ Rare | ✕ Rare |
| Itchy nose / throat | ✓ Common | ✕ Rare | ✕ Rare | ✕ Rare |
| Watery eyes | ✓ Common | Occasionally | ✕ Rare | ✕ Rare |
| Raised temperature / fever | ✕ Never | Mild, occasionally | ✓ Very common | ✓ Common |
| Muscle aches / fatigue | ✕ No | Mild | ✓ Severe | ✓ Common |
| Sore throat | Sometimes | ✓ Common | ✓ Common | ✓ Common |
| Cough | Rare / mild | ✓ Common | ✓ Common | ✓ Common |
| Loss of smell (anosmia) | Partial (congestion) | Partial (congestion) | Sometimes | ✓ Can be sudden/complete |
| Headache | Sinus pressure | Mild | ✓ Common | ✓ Common |
| Breathlessness | If asthma present | ✕ Rare | Occasionally | ✓ Can occur |
| Symptom onset | Immediate (minutes) | Gradual (1–3 days) | Sudden (hours) | Gradual (2–14 days) |
| Duration | Weeks–months (seasonal) | 7–10 days | 1–2 weeks | Variable (days–weeks) |
| Improves indoors / away from pollen | ✓ Usually yes | ✕ No | ✕ No | ✕ No |
| Responds to antihistamines | ✓ Yes | ✕ No | ✕ No | ✕ No |
The Four Key Differences to Remember
If you remember nothing else from this article, remember these four distinguishing features:
Itchy eyes, nose, and throat are almost exclusively a sign of hay fever. Viral infections rarely cause significant itching.
Hay fever never causes a raised temperature. A fever above 37.8°C points firmly toward a viral infection.
Hay fever starts within minutes of pollen exposure. Colds and COVID-19 develop gradually over one to three days.
Do symptoms improve when you are indoors or on low-pollen days? If yes, hay fever is more likely. Viral symptoms persist regardless.
Hay Fever vs the Common Cold
These two conditions are the most commonly confused, and with good reason — both cause a runny nose, sneezing, and congestion. The key differences come down to itching, timing, and duration.
A cold is caused by a virus (most commonly a rhinovirus) and typically takes one to three days to develop fully. It usually resolves within seven to ten days. Hay fever, by contrast, can persist for weeks or even months throughout the pollen season.
Take a non-drowsy antihistamine such as cetirizine or loratadine and note whether your symptoms improve within an hour or two. If they do, hay fever is highly likely. Antihistamines have no effect on viral symptoms.
Cold symptoms also typically include a sore throat from the outset — hay fever can cause throat irritation due to post-nasal drip, but a genuinely painful or swollen throat is more characteristic of a viral infection. Coloured nasal discharge (yellow or green) after several days suggests a cold or secondary infection rather than hay fever, which produces clear, watery mucus.
Hay Fever vs Influenza
Influenza (flu) is generally easier to distinguish from hay fever than a cold is. The hallmarks of flu are systemic — fever, muscle aches, significant fatigue, and a sudden onset that can leave you bedbound. Hay fever, even at its most severe, does not cause this degree of systemic illness.
A useful clinical shorthand: if you felt well at breakfast and genuinely unwell by lunchtime, flu is more likely than hay fever. Hay fever does not cause sudden-onset systemic illness — it builds gradually with pollen exposure.
It is worth noting that hay fever can worsen asthma symptoms, including breathlessness and wheezing. If you have both hay fever and asthma and experience chest tightness during pollen season, this is more likely to be asthma triggered by pollen than influenza — particularly if you have no fever or muscle aches.
Hay Fever vs COVID-19
COVID-19 continues to circulate in the UK as an endemic respiratory virus, and its symptoms can overlap with both hay fever and other respiratory illnesses. The key differentiators are the same as for flu: fever, systemic fatigue, and muscle aches are not features of hay fever.
One specific symptom worth noting is anosmia — a sudden and complete loss of smell. While hay fever and colds can reduce the sense of smell through nasal congestion, a sudden complete loss of smell is more characteristic of COVID-19 infection with certain variants. If you experience this, particularly alongside a fever or significant fatigue, current NHS guidance recommends treating this as a potential viral infection and avoiding contact with vulnerable individuals.
Lateral flow tests for COVID-19 remain available. If you are unsure whether your symptoms represent hay fever or COVID-19 — particularly if you are in contact with immunocompromised individuals — a rapid test is a sensible and straightforward step. COVID-19 test kits are available from Access Doctor.
Can you have hay fever and COVID-19 simultaneously?
Yes. Both conditions can occur at the same time. If you have your usual seasonal hay fever symptoms but also develop a fever, significant fatigue, or symptoms that are clearly worsening over days rather than fluctuating with pollen exposure, a concurrent viral infection may be present alongside your hay fever.
Treating Hay Fever: From Over-the-Counter to Prescription
Hay fever cannot be cured, but it can be very effectively managed. Treatment follows a stepped approach depending on symptom severity.
Non-drowsy antihistamines are the first-line treatment for mild-to-moderate hay fever. They reduce sneezing, runny nose, and itching. For best effect take them daily throughout pollen season rather than only when symptoms flare. Several options are available, from OTC to prescription-strength.
Nasal steroid sprays are among the most effective treatments for hay fever — significantly better than antihistamines alone for nasal congestion. They must be used consistently; effects build over several days. Multiple options are available from OTC to prescription-only.
For patients whose predominant symptom is itchy, watery eyes, antihistamine eye drops such as sodium cromoglicate offer targeted relief alongside systemic treatment.
For moderate-to-severe hay fever that does not respond adequately to a single agent, a combination of a daily antihistamine with a nasal corticosteroid spray is the recommended approach per NICE guidelines. Access Doctor’s GPhC-registered pharmacist independent prescribers can assess and prescribe appropriate combination therapy online — no GP appointment needed.
For patients with severe, poorly controlled hay fever, subcutaneous or sublingual allergen immunotherapy can provide long-term desensitisation. This is arranged through a specialist referral — treatment courses typically last three years.
Practical tips to reduce pollen exposure
- Keep windows and doors closed during high-pollen periods, particularly in the morning and early evening when counts peak
- Wear wraparound sunglasses outdoors to protect eyes from airborne pollen
- Shower and change clothes after spending time outside during peak season
- Apply a small amount of Vaseline around the nostrils to trap pollen before it enters the nose
- Avoid drying clothes and bedding outdoors on high-pollen days
- Check the Met Office pollen forecast and plan outdoor activity around lower-count days
When to Seek Medical Advice
- Severe breathlessness or difficulty breathing
- Chest pain alongside respiratory symptoms
- A very high temperature (above 39.5°C) that is not responding to paracetamol
- Symptoms of a severe allergic reaction (anaphylaxis): swelling of the face, throat, or lips; dizziness; rapid heartbeat
Call 999 for anaphylaxis. Call 111 or your GP for other concerning symptoms.
You should also speak to a prescriber or GP if:
- Over-the-counter hay fever treatments are not controlling your symptoms adequately
- Your hay fever is significantly disrupting sleep, work, or daily life
- You have both hay fever and asthma, and your asthma symptoms are worsening during pollen season
- You are unsure whether your symptoms represent hay fever or another condition
Many people undertreat hay fever because they assume it is something they simply have to endure. Prescription nasal sprays and tailored treatment plans can transform symptom control. Access Doctor’s GPhC-registered pharmacist independent prescribers can assess and prescribe appropriate treatment online, without a GP appointment.
Frequently Asked Questions
Struggling with hay fever this season?
Get prescription-strength hay fever treatment online — reviewed by a GPhC-registered pharmacist independent prescriber, delivered to your door across the UK.
View All Hay Fever Treatments
