Hay Fever: Is Treatment Needed? UK Guide to Allergic Rhinitis

Hay fever — also known as allergic rhinitis — is one of the most prevalent conditions in the UK, affecting over 13 million people. Over 1 in 5 people experience hay fever symptoms at some point in their lives. Despite its prevalence, many people manage their condition suboptimally — either under-treating, over-relying on antihistamines, or not seeking the more effective prescription options available. This guide covers everything you need to know about hay fever treatment in the UK, from understanding your symptoms to choosing the right medications.

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. This produces 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). Common indoor allergens include:

• House dust mites
• Pet dander (dogs, cats)
• Mould and fungal spores
• 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

Symptoms typically worsen on hot, dry, and windy days when pollen counts are highest. Rain reduces airborne pollen levels temporarily. People living 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
• Headache or facial pain (sinus pressure)
• Fatigue and difficulty sleeping
• Loss of smell

More Serious Symptoms

• Wheezing, shortness of breath, or chest tightness (may indicate asthma flare)
• Fever is NOT a hay fever symptom — if you have a fever, consider other causes

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:

Prescription Treatments Available from Access Doctor

• Avamys 27.5 micrograms nasal spray (fluticasone furoate) — first-line prescription intranasal corticosteroid
• Beclometasone nasal spray — effective intranasal corticosteroid
• Fexofenadine 120mg tablets — prescription-strength non-sedating antihistamine
• Opatanol eye drops (olopatadine) — for allergic conjunctivitis
• Optilast 0.5mg/ml eye drops (azelastine) — for allergic eye symptoms

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