Hay Fever: Is Treatment Needed? UK Guide to Allergic Rhinitis
Hay fever, NICE stepped treatment, prescription options and lifestyle measures.
Part of the Access Doctor Allergy & Hay Fever guide.
Key fact: Hay fever (allergic rhinitis) affects over 13 million people in the UK — more than 1 in 5 adults. Despite its prevalence, many people manage it suboptimally. The most effective single treatment is an intranasal corticosteroid spray, yet most people reach for antihistamines alone. This guide explains the full treatment pathway.
>13M
UK adults affected by hay fever
1 in 5
people experience hay fever symptoms at some point in their lives
Feb–Sep
typical UK hay fever season
3 types
of pollen trigger hay fever: tree, grass and weed
What Is Hay Fever? Allergic Rhinitis Explained
Hay fever is an allergic reaction to airborne pollen that triggers inflammation of the nasal lining (rhinitis). Despite its name, it is not caused by hay and does not produce fever. It occurs when the immune system misidentifies harmless pollen particles as a threat, triggering the release of histamine and other inflammatory chemicals, which produce the characteristic symptoms of sneezing, runny or blocked nose, and itchy, watery eyes.
Hay fever can be seasonal (triggered by specific pollen types during pollen season) or perennial (year-round, triggered by indoor allergens including house dust mites, pet dander, mould spores and cockroach particles).
A 2015 study in the Journal of Clinical and Translational Allergy found that over 13 million UK adults are affected by hay fever — making it one of the most common chronic conditions in the country.
Hay Fever Season in the UK: When to Prepare
| Pollen Type | Season | Peak Period |
|---|---|---|
| Tree pollen | Late February – mid May | March–April |
| Grass pollen (most common trigger) | Mid May – end July | Early June & mid-July (two peaks) |
| Weed pollen | End June – September | July–August |
Symptoms typically worsen on hot, dry and windy days when pollen counts are highest. Rain reduces airborne pollen levels temporarily. People in the south of England often experience earlier and longer hay fever seasons than those in the north.
Hay Fever Symptoms: What to Look For
Common Symptoms
- Sneezing — often in repeated bursts
- Runny or blocked nose
- Itchy nose, throat or roof of the mouth
- Watery, red or itchy eyes (allergic conjunctivitis)
- Earache and headache (sinus pressure)
- Fatigue and difficulty sleeping
- Loss of smell
Note: Fever is not a hay fever symptom despite the name. If you have a raised temperature alongside respiratory symptoms, consider other causes (cold, influenza, or COVID-19).
Red flag: If you experience severe difficulty breathing, significant swelling of the face or throat, or a rash alongside hay fever symptoms, seek emergency medical attention — this may indicate anaphylaxis. Call 999.
Hay Fever Treatment Options: NICE Stepped Approach
NICE Clinical Knowledge Summaries recommend a stepped approach to hay fever management, adding treatments in sequence based on symptom severity:
| Step | Treatment | How It Works |
|---|---|---|
| Step 1 — Mild symptoms | OTC non-sedating antihistamine tablets (cetirizine, loratadine, fexofenadine) | Blocks histamine receptors; reduces sneezing, itching and runny nose |
| Step 2 — Persistent symptoms | Intranasal corticosteroid spray (Avamys, beclometasone) | Reduces nasal inflammation; most effective single treatment for hay fever |
| Step 3 — Eye symptoms | Antihistamine eye drops such as Opatanol (olopatadine) | Targets allergic conjunctivitis; reduces itching and redness |
| Step 4 — Severe/refractory | Short course of oral corticosteroids (under medical supervision) | Reserved for severe exacerbations; short-term only |
| Long-term option | Allergen immunotherapy | Desensitisation; produces long-term remission |
Prescription Hay Fever Treatments Available from Access Doctor
Nasal spray · Rx
Avamys
Fluticasone furoate 27.5mcg. First-line intranasal corticosteroid for hay fever.
View product →Antihistamine · Rx
Allevia 120mg
Fexofenadine. Non-drowsy once-daily antihistamine tablet.
View product →Antihistamine · Rx
Fexofenadine
Generic fexofenadine 120mg or 180mg. Non-drowsy, once daily.
View product →Antihistamine · Rx
Desloratadine 5mg
Non-drowsy, once daily. Prescription option for persistent hay fever.
View product →Nasal spray · OTC/Rx
Beclometasone Nasal Spray
Beclometasone dipropionate 50mcg. Available OTC and on prescription.
View product →Nasal spray · OTC/Rx
Nasobec
Beclometasone dipropionate 50mcg. Aqueous nasal spray for seasonal allergic rhinitis.
View product →Nasal spray · Rx
Benacort
Budesonide 100mcg. Prescription nasal spray for moderate-to-severe seasonal allergic rhinitis.
View product →Nasal spray · Rx
Flixonase Nasal Spray
Fluticasone propionate 50mcg. Intranasal corticosteroid for seasonal and perennial allergic rhinitis.
View product →Antihistamine · OTC
Benadryl Allergy Relief
Acrivastine 8mg. Fast-acting OTC antihistamine for acute symptom relief.
View product →Access Prescription Hay Fever Treatments Online
Access Doctor provides prescription hay fever medications including Avamys nasal spray, antihistamine tablets and more, following a GPhC-regulated online consultation with our pharmacist independent prescribers.
Start Consultation →Hay Fever Lifestyle Measures: Reducing Pollen Exposure
- Check the daily pollen forecast and limit outdoor activity on high pollen days
- Wear wraparound sunglasses outdoors to reduce eye contact with pollen
- Keep car and home windows closed during peak pollen times
- Shower and change clothes after spending time outdoors
- Avoid drying clothes or bedding outside during high pollen days
- Use a vacuum cleaner with a HEPA filter
- Avoid grassy areas and freshly cut grass during pollen season
- Wipe pets with a damp cloth after they come indoors
- Apply a small amount of petroleum jelly around the nostrils to trap pollen
Frequently Asked Questions
What is hay fever and is it the same as allergic rhinitis?
Yes — hay fever and allergic rhinitis are the same condition. Hay fever is triggered by pollen and is seasonal, while allergic rhinitis can also be perennial (year-round), triggered by indoor allergens such as house dust mites, pet dander and mould spores.
Do I need medication for hay fever?
Not everyone with hay fever requires prescription medication. Mild symptoms can often be managed with over-the-counter antihistamines and lifestyle measures. However, moderate to severe hay fever — particularly symptoms affecting work, sleep or school performance — should be treated appropriately. NICE guidance recommends a stepped approach beginning with antihistamines and adding nasal corticosteroids for persistent symptoms.
What are the best hay fever medications?
The most effective hay fever treatments are intranasal corticosteroid sprays (such as Avamys/fluticasone furoate), which reduce nasal inflammation. These are considered first-line by NICE for persistent hay fever. Antihistamine tablets and eye drops (such as Opatanol for allergic conjunctivitis) are used alongside or for milder cases.
When does hay fever season start in the UK?
Hay fever season in the UK typically runs from late February to September. Tree pollen is highest from late February to May, grass pollen from mid-May to July, and weed pollen from late June to September. Grass pollen is the most common trigger and has two peaks — early June and mid-July.
Can hay fever trigger asthma?
Yes. In people with both hay fever and asthma, pollen can trigger or worsen asthma symptoms including wheezing, chest tightness, coughing and shortness of breath. Managing hay fever effectively can help reduce asthma exacerbations during pollen season.
Can hay fever be cured permanently?
Currently there is no cure for hay fever, but allergen immunotherapy can produce long-term remission or significant reduction in symptoms. This involves gradual, controlled exposure to the allergen to reduce immune sensitivity over time.
References
- National Institute for Health and Care Excellence (NICE). Allergic rhinitis: Clinical Knowledge Summary. Updated 2023. cks.nice.org.uk/topics/allergic-rhinitis
- NHS. Hay fever. nhs.uk/conditions/hay-fever
- Walker S et al. The burden of hay fever in the UK. Journal of Clinical and Translational Allergy. 2015. PubMed: 26770682
Medical disclaimer: This article is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional for diagnosis and treatment. In a medical emergency, call 999.