Allergy

Updated 10 March 2016

Treating hay fever

In most cases medical treatment for hay fever is unavoidable. There are four main groups of treatments.

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It is impossible to avoid the allergens which cause this form of rhinitis, e.g., grass pollens, so medical treatment is unavoidable in most cases.

Speak to your doctor about the most appropriate treatment for you.

Treatment for hay fever is divided into four main groups:

Antihistamines 

Recent developments in this field have seen the introduction of a new class of anti-histamines which no longer produce excessive drowsiness. In addition, some of these new anti-histamines need only be taken once a day, which is a big advantage. However, in some individuals, the amount of histamine being released in response is greater than the typical and correct dose of antihistamine being taken, so a higher dose may be required. Discuss this with your doctor.

Mast cell stabilisers

The only effective preparation in this group is sodium cromoglycate (Rynacrom) nasal spray. This is a very safe spray with no known adverse side-effects. It works well in some hay fever sufferers (but not in all).

Steroid sprays

Steroid sprays reduce and control the impact of many of the mediators that can cause inflammation in the nose. These medications improve all symptoms of allergic rhinitis and are the strongest medications available for the treatment of allergic rhinitis.There are several topical steroid sprays available which are effective in severe cases of hay fever. Most commonly available ones include Beclate and Beconase.

Generally speaking, steroid sprays will be less effective than antihistamines for symptoms that mostly include a runny nose, sneezing and itching eyes. However, if nasal blockage is a predominant symptom, then antihistamines on their own will not be very effective – nasal steroids will be required.  

The best way to use a nasal steroid is to direct the nozzle into the nose at the sides and above (superolaterally) and not towards the septum.

Specific immunotherapy

Allergen specific immunotherapy (SIT) is a process whereby steadily increasing amounts of a known allergen, e.g. grass pollen extract, are injected beneath the skin of the upper arm (subcutaneous immunotherapy, SCIT) or administered under the tongue (sublingual immunotherapy, SLIT).

The injections are initially given at weekly intervals, and later on, can be given every six weeks for a period of three years. SLIT doses are given at variable intervals, depending on the formulation, but should also be continued for 3-4 years.

Eventually the patient becomes tolerant of the allergen and will no longer react adversely when exposed to that particular allergen.

This is particularly effective if one is allergic to only one allergen.

Consult your doctor on whether immunotherapy will work for your allergy. Be aware that the treatment is expensive and may not be covered by medical aid. 

Read more: 

Causes of hay fever 

Symptoms of hay fever 

What is hay fever?

Revised and reviewed by Professor Sharon Kling, Clinical Unit Head, General Paediatrics, Intensivist at Tygerberg Hospital and Associate Professor, Department of Paediatrics and Child Health at Stellenbosch University. February 2015.

 

Ask the Expert

Allergy expert

Dr Morris is the Principal Allergist at the Cape Town and Johannesburg Allergy Clinics with postgraduate diplomas in Allergology, Dermatology, Paediatrics and Family Medicine dealing with both adult and childhood allergies. obesity and diabetes societies and runs a trial centre for new drugs.

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