Hay fever symptoms and treatment options explained

Hay fever season can cause misery for sufferers, but there are a range of medicines and treatments which can help to get symptoms under control.

We've talked to Thorrun Govind, chair of the Royal Pharmaceutical Society's English Pharmacy Board, to find out what you can do to reduce the misery of allergy symptoms. 

Our pricing research also reveals the cheapest ways to get hold of popular hay fever tablets and medicines to help you save on your summer essentials.

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Hay fever symptoms

If you've got a stuffy or runny nose, itchy eyes and can't stop sneezing, you could be suffering from hay fever.  The main symptoms are:

• Coughing and sneezing
• Blocked or runny nose
• Itchy, watery or red eyes
• Loss of smell
• Pain around the temples and forehead
• Headache
• Earache
• Tiredness

Those with asthma might also have a tight chest, shortness of breath, and wheezing and coughing. 

When is hay fever season?

According to ENT UK - the professional organisation representing ear, nose and throat surgery - hay fever (or seasonal allergic rhinitis) can actually be problematic for most of the year, depending on what you're allergic to.

While the majority of hay fever sufferers are allergic to grass pollen, which tends to peak in summer months, some people are allergic to both tree and grass pollen - which can mean having symptoms for much of the spring and summer.

Tree pollen: March to May

Grass pollen: May to July

Weed pollen: June to September

Mould spores: September to October

Weather patterns will also make a difference, determining if pollen season comes early or late, or if there's a bumper season. The Met Office says that climate change may lengthen the UK pollen season and potentially make pollen concentrations higher. 

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Hay fever medicines: what works best?

There are lots of options for treating hay fever, and what's best depends on what suits you and your needs, as well as what your main symptoms are. 

You can usually take oral tablets alongside symptom-specific solutions such as nose sprays and eye drops if your symptoms are particularly bothersome.

Other medication you’re on also needs to be taken into account. For example, some older types of antidepressant, stomach ulcer or indigestion medicines or cough and cold remedies shouldn’t be taken with antihistamines. Always check with your doctor or pharmacist.

Antihistamine tablets for allergies

These work by altering the way your body reacts to histamine - the chemical your body releases when it thinks it’s being attacked by a harmful substance and the substance that gives rise to hay fever symptoms.

There are several different active ingredients found in common OTC (over-the-counter) antihistamines, offering plenty to choose from depending on your requirements.

Most hay fever tablets are pretty tiny, though you can get oral antihistamines in liquid formats too if you struggle with swallowing pills (or for children).

The two most common ones you'll see on the shelf are generally well-tolerated with minimal side-effects. They are:

Cetirizine hydrochloride / dihydrochloride

This is a non-drowsy antihistamine, generally taken once a day.

Brand names include Benadryl Allergy One A Day, Piriteze Allergy and Zirtec Allergy - found in tablet and liquid form - but generic options are also widely available.

Some people shouldn’t use cetirizine hydrochloride medicines, including those who have an intolerance to or can’t absorb some sugars such as lactose or sorbitol and people who have an allergy to food additives E218 or E216.

Loratadine

Loratadine is a non-drowsy antihistamine that’s available to buy over-the-counter and on prescription. Brand names include Clarityn Allergy but there are plenty of generic and own-brand options available, too, in tablet or liquid form.

Other oral antihistamines include:

Chlorphenamine maleate / Acravastine

These older types of antihistamine can cause drowsiness. 

Chlorphenamine is not suitable for some people, including those with epilepsy or another health problem that puts you at risk of fits, and those with the eye problem primary angle closure glaucoma.

It also needs to be taken several times a day, which some people may find inconvenient. However, Thorrun Govind suggests chlorphenamine could be a good option if your hay fever is preventing you from sleeping.

Fexofenadine hydrochloride

Fexofenadine hydrochloride used to be prescription-only, but is now available over-the-counter in some stores.

Govind says: 'It gives hay fever and allergy sufferers another treatment option, which is especially helpful if they find existing medications aren't quite working for them.'

Nasal sprays for hay fever

There are several types on the market, including steroid (or corticosteroid) nasal sprays such as fluticasone (eg Pirinase or Flixonase) or beclometasone/beclomethasone (eg Beconase), to dampen down inflammation inside your nose.

Some nasal sprays contain both a corticosteroid and an antihistamine in one preparation.

Saline sprays and barrier sprays are also available. These aren’t medicated but either help to wash away trapped allergens or act as a barrier to them, thereby helping to reduce symptoms.

Hay fever eye drops

The active ingredient in these tends to be sodium cromoglicate, which inhibits the release of histamine. It also has anti-inflammatory properties to soothe red, inflamed eyes.

Some eye drops don't contain antihistamines, but instead ingredients intended to soothe and lubricate the eyes, such as witch hazel and glycerin. 

Wearers of soft contact lenses need to take extra care if using drops containing benzalkonium chloride (a preservative) because it’s been reported that it can cause eye irritation, dry eye symptoms and may affect the tear film and surface of the cornea.

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Hay fever medication in pregnancy

Medication is only advised if you have hay fever symptoms (rather than taking them preventatively) and instead, treatment should start with using sodium chloride nasal sprays or nasal irrigation followed by eye drops such as sodium cromoglicate eye drops or intranasal corticosteroid sprays.

Only if symptoms persist should oral antihistamines be used but you should always speak to your doctor first.

How to save money on hay fever remedies

Choose own-brand or generic options

By far the biggest savings can be made by switching from branded to own-brand or generic products. These use the same active ingredients as the big brands and are typically a fraction of the cost - we've found they can be more than 10 times cheaper.

Generic medicines in the UK must comply with exactly the same standards of quality, safety and efficacy as all medicinal products, so if it's got the same 'active ingredient' listed, then it will do the same thing.

It might not be your first thought when shopping for anti-histamines, but discount stores such as B&M, and supermarkets, are often some of the cheaper options. If you're not sure what you need though, it's best to buy from a pharmacy where you can ask for guidance.

Take advantage of multibuys, deals and bundles

Particularly if you need a regular supply to get through pollen season, there are economies of scale when buying hay fever meds and you’ll find that many retailers offer deals - especially in the summer months, which may mean you can make savings.

Make sure you check the pack size / dosage when comparing prices.

See our story on the best deals on hay fever medicine for more. 

Only buy what you need

One word of warning about bulk buying - don't get too over-enthusiastic about stocking up.

Thorrun Govind says: 'There's absolutely no problem with buying medicines and storing them but you should also be aware that as well as making sure they're in date when you use them next year, your health situation may have changed and therefore they might not be appropriate for you to use any more.'

Look for the longest expiry date on any medication you buy, and check before you use old packs you find at home. 

Products such as nose sprays and eye drops have a relatively short shelf life once opened (often four to six weeks). Store your medications in a cool, dry, lockable place away from children. 

Plan ahead

Buying from a convenience store is handy if you're in a hurry, but most smaller stores tend to only stock branded varieties and with no multibuy offers, so you'll probably end up paying more. 

For better deals, head to larger stores when you can.

If buying online, make sure it's from trusted sources

These include known, trusted retailers and registered pharmacies. 

Find out more about buying medicines safely online - including how to check that an online pharmacy is registered on the General Pharmaceutical Council website.

Get the best from your hay fever medicine

It's one thing having the right medication but it's important to use it properly, too, for maximum effect.

• Start using before your symptoms begin. This might be as early as February, when it could still be wintry and cold outside, but it won't be long before the start of the tree pollen season in March
• Use medication regularly during high season if you are prone to hay fever. Use it preventatively, not just reactively to keep symptoms at bay.
• Switch up your meds. If you find that your regular medication isn't working as well, try a different formulation. If you’re running out of treatment options, see your doctor to work out what to do next. 

What about natural or drug-free hay fever treatments?

If you don’t want to go the conventional medicine route for treating hay fever, there are an increasing number of 'drug-free' options you can try. 

Where pharmaceutical remedies tend to work inside the body to reduce histamine production and to settle inflammation, natural remedies tend to work externally to provide a barrier against allergens in the nasal passages or to flush them out.

These might be worthwhile for those with mild symptoms, or if you're having issues with side-effects from conventional medicines. They can also be handy if you’re pregnant, breastfeeding or already taking a medication that interacts with antihistamines.

Some people also swear by things such as eating local honey but studies show there is no evidence for this being effective. 

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Tips for minimising hay fever misery

As well as medicines and remedies, there are lifestyle and environment changes you can make to relieve hay fever symptoms, particularly when the pollen count is high:

• Keep windows closed in the evening. Pollen can make its way inside through open windows and vents. Keeping windows closed, particular at times when the pollen count is high - first thing in the morning and during the evening - can help. Using an air purifier may also help.
• Keep house dust mites at bay. House dust mite allergies can be associated with hay fever and asthma symptoms but the trouble is they are microscopic and therefore hard to detect. As they gravitate to beds and humid environments, it’s advisable to wash your bedding weekly at 60°C or above to ensure you’ve killed them.
• Don’t hang washing outside. As pollen wafts around, it can fall onto your washing then when you take it off the line and inside you'll be bringing the pollen in with you. 
• Shower and change your clothes when you get home. When you close your front door you may think you’re shutting pollen out but you could still be bringing it in on your hair and clothing.
• Use a DIY barrier balm. You could buy a specialist balm to apply to your nostrils to help prevent pollen entering your nose but a simple petroleum jelly (such as Vaseline) can be just as effective.
• Keep pets out of the bedroom. Pet hair can be a carrier of airborne allergens such as pollen so don’t let your pets sleep on your bed or even in your bedroom. Pets can bring pollen in on their fur after they’ve been outside, too, so give them a wash down as well, especially if your hay fever is particularly severe. Buying a vacuum cleaner that makes light work of pet hairs is also a good option
• Keep a diary of symptoms. Keep track of when your symptoms are worse, if anything makes them better and how effective your medication is. This will give your pharmacist and GP valuable information about your allergy - and enable them to better tailor your treatment to suit your individual needs.

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What to do if high street hay fever remedies aren’t working

If over-the-counter remedies aren't working for you and you're really struggling with your symptoms, pay a visit to your GP. 

They should be able to prescribe something more powerful, and if these don't work they can refer you to an allergy specialist for tests. The tests performed will depend on your type of allergy but can include a blood test or a skin prick test, which will help to throw light on which allergens are causing you problems.

If you are sent for specialist tests, you'll be given instructions on what to do but you shouldn't take antihistamines beforehand as this may mask the results.