Ask the doctor: Nothing is helping my hay fever this year. Are there stronger remedies?
Question: I suffer from terrible hay fever and this year it is almost unbearable. I’ve been on antihistamines since March and use pharmacist recommended eye drops and nose spray but it doesn’t seem to make a difference. I remember someone mentioned a vaccine he used to cure this hay fever, but I can’t find any information about it. Are there stronger remedies that I could ask the GP? Please don’t talk to me about washing the bedding and closing the windows, because I’m already doing all of that.
Doctor Grant replies: Hay fever is also known as ‘allergic rhinitis’ or ‘rhinosinusitis’ and treatment has come on leaps and bounds over the past decade. It’s virtually curable if you invest in the right treatment and give it time to work.
I think the “injection” you are referring to is probably a depot steroid injection – as far as I know it is no longer given for hay fever as there are now better treatments.
Hay fever can start at any age. The risk is higher for people with a family history or people with asthma or eczema. Rhinosinusitis is a reaction to small airborne particles called “allergens” that cause swelling of the lining of the nose and/or sinuses, leading to sneezing, rhinorrhea (runny nose) and nasal obstruction, accompanied by itching of the eyes, nose and palate. It can also cause fatigue, irritability, postnasal drip, and coughing.
It can help to identify exactly what is causing your hay fever symptoms – an allergy specialist can do skin tests or blood tests to help identify your triggers. This can help you avoid them and will highlight whether you can seek immunotherapy, which can possibly reduce reliance on long-term medication use.
Antihistamine drugs have been the gold standard of treatment for decades and can be purchased at any pharmacy. Oral antihistamine tablets have good efficacy in reducing itching, sneezing, and some symptoms of runny nose/eye.
Some people with severe eye symptoms find that topical antihistamine eye drops work well. Scientific evidence suggests that topical steroid eye drops (not safe to use long-term) or steroid nasal sprays (can be used for several months each year) are the most effective single maintenance treatment – they work within hours , although maximum benefit may take a few days or weeks to be seen. In general, patients tend to underuse steroid nasal sprays.
Fortunately, there are two very effective new treatments. The first is called SubLingual ImmunoTherapy (SLIT) – it is given as a dissolvable tablet or liquid extract and is taken daily for three years. SLIT not only treats your hay fever as effectively as steroids or antihistamines, but also retrains your immune system to be “less allergic” allowing you to get rid of your hay fever symptoms for good.
The second treatment is called “Rhinolight” intranasal phototherapy. It involves inserting a small nasal endoscope into the nostril that emits UV-A, UV-B and visible light (safe ranges of the light spectrum) to reduce inflammation, while partially desensitizing the nose and sinuses against allergies. It is painless and does not damage tissue. Additionally, it is an effective treatment for the vast majority of allergic rhinitis triggers.
Dr Jennifer Grant is a GP at Beacon HealthCheck