When to Start Hay Fever Treatment: Working Out Your Own Start Date
Start dates by pollen type and by treatment, how to adjust for where you live and the kind of spring it has been, what to do if you have already missed the start, and when it is safe to stop.
Part of the Complete Hay Fever Guide.
Key fact: The right time to start hay fever treatment is set by two things: when your pollen arrives, and how long your treatment takes to build up. For most people in the UK that means starting a steroid nasal spray around two weeks before their symptoms usually begin — early May for grass pollen, early to mid March for tree pollen.
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See hay fever treatments →The short answer
Hay fever treatment works best when it is already established before pollen reaches the nose. Repeated pollen exposure makes the nasal lining progressively more reactive as a season goes on, so a nose kept calm from the first day needs less treatment, and has fewer bad days, than one that is being chased once symptoms have taken hold.
The UK has three main pollen seasons, and most people react to one or two of them. Your start date follows from which one is yours. The full month-by-month picture is in the UK pollen calendar; the table below turns it into start dates.
| If your symptoms are triggered by | Usually troublesome | Start a steroid nasal spray |
|---|---|---|
| Tree pollen (birch is the main culprit) | Late March to mid May | Early to mid March |
| Grass pollen (around 95% of UK hay fever) | Mid May to July | Early May |
| Weed pollen (nettle, dock, mugwort) | Late June to September | Mid June |
| Tree and grass together | March to July | Early to mid March, continuing through July |
Those dates are averages. The sections that follow explain how to move them earlier or later for your own pattern.
Each treatment has its own lead time
“Start early” means different things for different medicines, because they work in different ways and take different lengths of time to reach full effect. Planning around the slowest treatment you use is what makes the rest of the season easier.
| Treatment | How far ahead to start | Why |
|---|---|---|
| Steroid nasal spray, such as fluticasone furoate (Avamys) | About two weeks before your usual first symptoms | Reduces inflammation gradually and takes up to two weeks of daily use to reach full effect |
| Mast cell stabiliser eye drops, such as sodium cromoglicate (Opticrom) | About one to two weeks before | Preventive only: they stop cells releasing histamine but cannot reverse a reaction already under way |
| Non-drowsy antihistamine tablet | A few days before, or at the very first symptoms | Works within hours, but performs best taken every day rather than only on bad days |
| Antihistamine eye drops | As needed | Fast-acting, so useful for breakthrough eye symptoms |
| Grass pollen immunotherapy tablet (specialist) | At least four months before the grass season | Retrains the immune response over months; a course lasts around three years |
How a steroid spray builds up over its first fortnight is covered in detail in using Avamys for hay fever.
2 weeks
Lead time for a steroid nasal spray
1–2 weeks
Lead time for sodium cromoglicate eye drops
4 months
Lead time for grass pollen immunotherapy
Working out your personal start date
The averages are a starting point, but the most reliable guide is your own history. Most people’s hay fever starts within a week or two of the same date each year. Three questions get you to a personal start date.
When did it start last year?
Think back to the first week you were sneezing or rubbing your eyes, not the worst week. Photos, messages and old prescriptions can help date it.
Which pollen does that point to?
Symptoms from March and April suggest tree pollen; from late May and June, grass; from July onwards, weeds.
What is your slowest treatment?
Count back from your first-symptom date by its lead time — two weeks for a steroid spray.
Put it in the calendar
Set a reminder a week before the start date so the medicine is in the house when you need it.
If you have no clear memory of last year, keep a simple symptom diary this season: the date, how bad your nose and eyes were on a scale of one to ten, and whether the pollen count was high. One season of notes is usually enough to set next year’s date with confidence, and it helps a clinician too if you ever need a referral.
If your symptoms carry on outside these seasons, or are worse indoors, in bed or around animals, the trigger may be dust mite, pets or mould rather than pollen. Timing treatment to a pollen season will not help with that; see year-round allergic rhinitis.
Adjusting for place, weather and travel
Where you live
Pollen seasons generally start earlier and last longer in the south of England than in the north and in Scotland, where they can arrive a week or two later. Towns and cities tend to warm up sooner than the surrounding countryside, while coastal areas often have lower counts because sea breezes carry pollen inland. If you have moved since last season, your old start date may not hold.
The kind of spring it has been
Tree pollen in particular is sensitive to temperature. A mild late winter and warm March can bring birch pollen forward noticeably, and a cold, late spring holds it back. Grass pollen is steadier but peaks on hot, dry, sunny days after a damp spell. If the season is clearly running early, start early too. The Met Office pollen forecast runs from spring through the summer and is a useful cross-check in the fortnight before your planned date.
Travelling abroad
Pollen seasons are not the same everywhere, and a spring holiday can bring your season forward by weeks. Around the Mediterranean, grass pollen often starts in April, and olive and cypress pollen add seasons the UK does not have. In the southern hemisphere the seasons are reversed, so grass pollen in Australia, New Zealand or South Africa peaks around October to December. If you are travelling during your own trigger’s season somewhere else, start treatment two weeks before you go and take enough with you.
If you have already missed the start
It is never too late to start. Treatment begun mid-season still works; it simply takes longer to bring things under control than it would have done from a standing start, and the first week can be disappointing. The practical approach is:
- start the steroid nasal spray straight away and use it every day
- add a daily non-drowsy antihistamine for faster relief of sneezing, itching and runny nose while the spray builds up
- use antihistamine eye drops for itchy eyes, as these work quickly
- cut down how much pollen reaches you while treatment catches up — showering and changing after time outdoors, and keeping bedroom windows shut
- give it two weeks of consistent daily use before deciding whether it is working
A late start is not a reason to reach for a decongestant spray. Decongestant nasal sprays give fast relief, but used for more than about seven days they can cause rebound congestion. If you use one to get through the first few days while a steroid spray builds up, stop it within a week. If treatment still has not helped after a fortnight, see hay fever treatment not working.
When to stop
Keep taking treatment every day until your pollen season has finished, including on good days. Feeling well in the middle of June is the treatment working, not the season ending, and stopping early tends to bring symptoms back within days.
Once your trigger’s season is over — usually the end of July for grass pollen, mid May for tree pollen, and September for weeds — you can simply stop. Steroid nasal sprays and antihistamines used for hay fever do not need to be tapered off. If you react to more than one pollen, treat your season as running from the start of the first to the end of the last, rather than stopping and restarting in between.
If symptoms return when you stop, and the pollen season really has ended, that is a sign the trigger may not be pollen alone.
Exams, children and asthma
Exam season
GCSE and A-level exams run from mid May to late June, which places them squarely on the grass pollen peak. Research on UK exam candidates found that pupils with hay fever symptoms on exam days were more likely to drop a grade compared with their mock results, and the effect was larger in those taking sedating antihistamines. For a student with grass pollen hay fever, the start date is the end of April: a steroid nasal spray established before the first paper, and a non-drowsy antihistamine rather than a sedating one.
Children
In the UK, steroid nasal sprays are available from pharmacies only for adults; children usually need a prescription. That adds a step, so the planning needs to begin earlier — book the appointment in April for a grass pollen start in early May. Which medicines are licensed at which age is set out in hay fever in children.
If you have asthma
Pollen season is when asthma attacks driven by allergy rise, and it is also when preventer inhalers are most often quietly dropped. If you have asthma and hay fever, your start date applies to both: steroid nasal spray started two weeks ahead, preventer inhaler taken consistently, and reliever carried. The connection between the two is explained in hay fever and asthma.
Getting your supplies in
The most common reason people miss their start date is not forgetting the season but not having the medicine in the house when the reminder goes off. Working backwards from your start date:
| When | What to do |
|---|---|
| Three to four weeks before your start date | Check last year’s supplies. Unopened sprays and tablets may still be in date, but opened eye drops are usually only usable for a few weeks after opening, so check the label |
| About a week before | Order or collect what you need, allowing time for a consultation and delivery |
| Your start date | Start the steroid nasal spray, and preventive eye drops if you use them |
| When symptoms usually begin | Add a daily non-drowsy antihistamine if you need one |
| Mid-season | Check you have enough to finish the season; a 120-dose steroid spray at two sprays per nostril once a day lasts about a month |
The antihistamines most often used for hay fever, and how they differ, are compared in hay fever antihistamines compared.
Not everything in spring is hay fever. Seek urgent medical help for wheeze or breathlessness that is not settling, a painful red eye or changes in vision, or swelling of the lips, tongue or throat. If you have difficulty breathing or swallowing, call 999.
Ready for Your Start Date?
Order ahead of your season so treatment is established before the pollen arrives. Our pharmacist independent prescribers can recommend antihistamines, steroid nasal sprays and allergy eye drops after a GPhC-regulated online consultation.
See hay fever treatments →Frequently Asked Questions
When should I start hay fever treatment?
Start a steroid nasal spray about two weeks before your symptoms usually begin, because it takes up to two weeks of daily use to reach full effect. For grass pollen, which causes most UK hay fever, that means early May. For tree pollen it means early to mid March, and for weed pollen mid June. Antihistamine tablets work within hours, so they can be started a few days before or at the first symptoms.
Is it too late to start hay fever treatment once symptoms have begun?
No. Treatment started mid-season still works, but it takes longer to bring symptoms under control. Start a steroid nasal spray straight away, add a daily non-drowsy antihistamine for faster relief while the spray builds up, and give it two weeks of consistent daily use before judging whether it is working.
When can I stop taking hay fever treatment?
Keep going every day until your pollen season has ended, including on days when you feel well. That is usually the end of July for grass pollen, mid May for tree pollen and September for weed pollen. Steroid nasal sprays and antihistamines used for hay fever can be stopped without tapering. If you react to more than one pollen, continue from the start of the first season to the end of the last.
Should I start earlier if the spring is warm?
Often, yes. Tree pollen in particular arrives earlier after a mild late winter and warm March, and can be noticeably ahead of the average. If the season is clearly running early, bring your start date forward to match, using the Met Office pollen forecast as a guide in the fortnight before your planned date.
Do I need to start earlier if I am going abroad in spring?
It depends on where you are going. Around the Mediterranean, grass pollen often starts in April, weeks ahead of the UK, and olive and cypress pollen add extra seasons. In the southern hemisphere the seasons are reversed. If your trip falls in your trigger's season at your destination, start treatment two weeks before you travel and take enough for the whole trip.
When should a student start hay fever treatment before exams?
For a student with grass pollen hay fever, aim for the end of April, so a steroid nasal spray is fully established before exams begin in mid May. Use a non-drowsy antihistamine rather than a sedating one. Children usually need a prescription for a steroid nasal spray, so book the appointment in good time.
References
- National Institute for Health and Care Excellence. Clinical Knowledge Summary: Allergic rhinitis. cks.nice.org.uk
- NHS. Hay fever. nhs.uk
- Met Office. Pollen forecast and the UK pollen calendar. metoffice.gov.uk
- Scadding GK, et al. BSACI guideline for the diagnosis and management of allergic and non-allergic rhinitis (2017 revised edition). Clinical & Experimental Allergy. bsaci.org
- Walker S, et al. Seasonal allergic rhinitis is associated with a detrimental effect on examination performance in United Kingdom teenagers: case-control study. Journal of Allergy and Clinical Immunology, 2007.
- electronic Medicines Compendium. Summaries of Product Characteristics: fluticasone furoate, sodium cromoglicate, grass pollen allergen extract tablets. medicines.org.uk
Medical disclaimer: This article is for informational purposes only and does not constitute medical advice. Pollen seasons vary by year and region, hay fever medicines differ in who can take them, and decongestant nasal sprays are not for long-term use. Children usually need a prescription for a steroid nasal spray. Always consult a qualified healthcare professional for diagnosis and treatment. In a medical emergency, call 999.