Hayfever is the common name for allergic rhinitis, a condition affecting one in five Australians. Dr Sam Hay joins us to discuss this frustrating ailment.
At this time of year it seems almost inevitable Aussies will suffer an itchy runny nose or set of eyes. The winds are up, trees and flowers blossom, and pollen counts soar. And lets not forget all the smoke in the sky as our tireless Fire Services battle hard to keep us safe with their critical back-burning operations.
When allergens for the world (environment!) land in the lining of our eyes and nose, a ‘hayfever’ response will be triggered.
The most common allergens are:
The problem in hayfever, is that the immune system response is grossly exaggerated. An excess of mucous is produced, plus all the immune chemicals are released. For example, there’s an abundance of histamine which results in all the itchiness.
The classic hayfever symptoms are:
- Itchy runny eyes
- Itchy runny nose
- Rubbing of the nose – the ‘allergic salute’
- Nasal congestion
Hayfever can affect us all year round – from allergens such as animal dander, pollution, dust mite, or moulds. The classic ‘seasonal allergies’ of springtime usually results from the weeds, grasses, and pollens.
How hayfever effects people varies significantly from person to person, and even from year to year for each sufferer. Some find symptoms are mild and easily ignored. Others find them intrusive, with interruption motivation, plus sporting and work performance
Some symptoms are less obvious:
Poor or interrupted sleep
Poor concentration with work and tasks, or playing and school work for kids
Recurrent upper respiratory tract infections
Hayfever doesn’t always occur in isolation. Sufferers frequently have asthma and eczema as co-existing ailments. Plus, if you any of these ‘atopic triad’ conditions, then there’s a high chance your kids will suffer some or all of them too, as family history is a very strong risk factor.
How do you manage hayfever?
Stay away from your triggers!
Your best weapon to combat hay fever is to avoid allergens in the first place. But that’s not always easy is it?! Identifying culprit allergens can be a very tricky task. Sometimes it’s easy – your partner wears a certain perfume, or walk into a florist and your eyes go crazy. But for most, there’s not just one allergen, or it’s subtle and obscure – so impossible to avoid.
And that’s where the immunologists can help, by offering specialist allergy tests called ‘skin prick tests’, which might be combined with some blood tests. If we get a better idea about which exact allergens are involved, then it can make it easier to avoid them.
Some specific allergens do have some specific strategies that work:
Moulds - Mould is found anywhere in the house, especially poorly ventilated and damp areas. The key is to clean regularly with mould reducing products and keep your house well ventilated and dry. Sometimes, the only option will be extensive work on foundations to combat rising damp.
Pollen - The role of pollens flaring atopic conditions, especially asthma and hayfever, has prompted increased awareness in the community in recent years. Most news bulletins and online weather resources report on daily pollen forecasts, which allow people to manage pollen exposure.
Spring to Christmas is certainly the worst time of the year, but just what can you do to avoid these troublesome allergens?
Stay indoors when it’s windy.
Sunglasses keep airborne allergens out of your eyes.
Roll up the car windows, put the aircon on and set it to recycle can also help.
Don’t mow the grass if it doesn’t need it!
Don’t dry bedding outside (as it gets covered in pollen).
Shower after playing outside to wash pollens away.
Animal hair - Sweat glands for cats and salivary glands for dogs release culprit allergens, leading to much annoyance for susceptible people. As the animals shed hair, the allergens become airborne, and last in the house for many months after you remove the animal, especially if it’s a cat.
Keep animals out of the main living areas. Many vacuum cleaners claim their HEPA filters reduce animal hair allergens, but evidence is poor. Plus, there’s no such thing as a ‘hypoallergenic pet’, but, different animals and breeds do release different amounts of allergens.
Dust mite - House dust mite is by far and away the most common trigger of hay fever, especially in humid coastal areas like Australia.
The bottom line is that it’s almost impossible to get rid of the entire amount of dust mite from your house.
Here are my top five tips:
Vacuum and mop regularly! Once a week at least.
Ventilate your homes and let the sunlight in.
Wash bedding weekly in hot water.
Remove all stuffed toys from beds and replace pillows regularly.
Consider hard flooring instead of carpets to reduce dust buildup.
What if all of that doesn’t work?
The critical step of management is avoidance, but when that’s not enough, we need to manage symptoms. Try these basics, but if you’re still struggling, then see your doctor.
- Congested noses should get regular sprays of saline.
- Dry itchy eyes can be relieved by flushing regularly with saline, lubricating drops, or even just warm water.
- During the worst weeks and months a daily dose of an oral antihistamine can certainly reduce symptoms, but they aren’t as effective with severe nasal congestion. There are even antihistamine eye drops and nose sprays.
- For more troublesome nasal symptoms, steroid nose sprays can reduce the inflammation in the lining of the nose.
- Whilst there are decongestant tablets and sprays available, they really must only be used when symptoms are diabolical, and for only a couple of doses. If symptoms persist, see your doctor – there just might be something else going on.
When these simple things fail, the next option is immunotherapy. Immunotherapy aims to desensitise people against their allergens, reducing symptoms or the reliance on medications. You need to see an immunologist, and it comes in the form of injections or drops under the tongue. But be patient, as a treatment course lasts three to five years!
Need more information? Then visit www.allergy.org.au