Hay fever | Mate hei

Also known as seasonal allergic rhinitis

Hay fever (mate hei) is inflammation of the lining of your nose and eyes due to an allergy. It is very common in Aotearoa New Zealand.

Key points about hay fever

  1. Many people experience hay fever seasonally due to grass pollens, while other people are affected by pet dander and dust mites year round.
  2. Symptoms include blocked nose, runny and itchy nose, sneezing, coughing, red, itchy and watery eyes. 
  3. Severe hay fever may affect your sleep and concentration and make you tired. You may be more likely to get eye or sinus infections and it can make it harder to manage asthma.
  4. Avoiding the allergen, if possible, is the best way to prevent hay fever.
  5. Medicines such as antihistamine tablets or nasal sprays, corticosteroid nasal sprays, eye drops or decongestant medicines may relieve your symptoms.

What causes hay fever?

Hay fever is inflammation of the lining of your nose and eyes due to an allergy. When cells in the lining of your nose and eyes come into contact with an allergen, they release histamine, which causes inflammation.

Most often this response is triggered by grass pollen. Other allergens that can cause hay fever, include:

  • house dust mites
  • mould spores
  • hair and skin flakes from animals (also known as ‘dander')
  • cockroach droppings.

Hay fever is also known as allergic rhinitis, which has 2 types:

  • Seasonal allergic rhinitis – when symptoms happen at certain times of the year, eg, spring. Wind-borne pollens are the cause of seasonal hay fever, which usually occurs in spring and summer. The length of the pollen season depends on where you live and the plant species you are allergic to.
  • Perennial allergic rhinitis – when symptoms occur at any time of the year. Dust mites and domestic pets are the most common causes of perennial rhinitis.

What are the symptoms of hay fever?

Symptoms of hay fever include:

  • sneezing 
  • runny nose 
  • watery, itchy, red and puffy eyes
  • blocked nose
  • itchy throat, mouth, nose and ears
  • blocked ears
  • coughing
  • loss of smell
  • headache
  • earache
  • lethargic and fatigue.

These symptoms range from mild to severe, and can affect your daily life.

What are the complications of hay fever?

If hay fever is severe and untreated:

  • you may sleep poorly, which can leave you feeling tired during the day
  • you may be more prone to sinus infections and eye infections
  • you may also have poor concentration during the day
  • if you also have asthma, hay fever can make your asthma symptoms more difficult to manage.

How is hay fever diagnosed?

Hay fever symptoms can be similar to other conditions that affect your nose, such as the common cold or nasal polyps. See your doctor to get the right diagnosis. Your doctor will ask about your symptoms and when they occur. They will also examine your eyes, nose and throat for signs of irritation and congestion.

If the cause of your symptoms is not clear, your doctor may order blood tests or perform a skin-prick test to find out what you are allergic to. They may also refer you to an allergy specialist for further testing if your symptoms are severe.

Skin prick tests

  • This involves placing a drop of the allergen on your skin and then scratching your skin through the drop.
  • If you are allergic to the allergen, your skin will become red and swollen at the site within 15 minutes.
  • Skin tests are not a diagnosis by themselves and these results need to be considered with your history and symptoms.
  • As many as 30 allergens can be tested at the same time to help identify the particular substances you are allergic to.

How is hay fever treated?

The most important part of managing hay fever is to avoid the allergens if possible. Other treatment includes self-care measures, medicines and allergen immunotherapy (AIT).

Self-care measures

Although it is hard to avoid pollens at all, there are things you can do to minimise your exposure when the pollen count is high.

  • Stay indoors if possible.
  • Keep your windows and doors shut as much as possible.
  • Change your clothes and shower after you have been outdoors.
  • Vacuum your house and dust with a damp cloth regularly.
  • Get someone else to mow your lawn.
  • Wear wrap-around sunglasses to avoid pollen getting in your eyes.
  • Getting a pollen filter for the air vents in your car and a vacuum cleaner with a HEPA filter.

Read more about how to prevent hay fever.

Medicines

Medicines to treat and help prevent hay fever are available from your doctor or over the counter at your pharmacy. These can be very effective in reducing your symptoms. Keep avoiding your allergen whenever possible, even when taking medicines.

Medicines include:

If you also have asthma, see your GP (doctor) a few weeks before the hay fever season starts. Hay fever can make asthma worse and difficult to control.

Allergen immunotherapy (AIT)

Immunotherapy may also be an option if your symptoms are severe and the allergen is difficult to avoid. Immunotherapy works by changing the way your immune system reacts to allergens. Your doctor gives you a very small amount of an allergen you are allergic to over a period of 3–5 years. Immunotherapy can be given under your tongue, into your nose or by an injection.

The aim of immunotherapy is to make you develop tolerance to a particular allergen. Not everyone is suitable for immunotherapy, so ask your doctor or an allergy specialist about whether it would be suitable for you. 

How can I prevent hay fever?

The best way to avoid an allergic reaction is to avoid the allergens that trigger it. 

Pollens

  • Consider staying inside when the pollen count forecast is high, on windy days or after thunderstorms.
  • Choose plants for your garden that are pollinated by birds or insects, rather than plants that release their seeds into the air.
  • Avoid mowing the lawn, raking leaves or having an open compost heap.
  • Splash your eyes with cold water or shower after any activities expose you to a lot of pollen.
  • Rub petroleum jelly (like Vaseline) inside your nose to stop the pollen from coming into contact with the lining of your nose.

Pet dander

  • Ideally, don't have a pet.
  • If you do keep your pet outdoors and out of bedrooms.
  • Wash them regularly. 

Dust mites

  • Keep your house well ventilated to avoid a build up of moist air inside the house (house dust mites thrive in damp conditions).
  • Choose vinyl or leather furnishings rather than soft covers.
  • Cover mattresses and pillows with dust mite covers.
  • Use a vacuum cleaner with a HEPA air filter or, if possible, get someone else to do the vacuuming.
  • Dust with a damp cloth damp.
  • Wash soft toys regularly in hot water or put in the freezer for 1 to 2 days.

What support is available with hay fever?

Allergy New Zealand provides information, education and support for people with allergy, parents of children with allergy, teachers and healthcare providers. Find out more on their website.

Learn more

The following links provide further information about hay fever. Be aware that websites from other countries may have information that differs from New Zealand recommendations.   

Hay fever (allergic rhinitis) Australasian Society of Clinical Immunology and Allergy (ASCIA)
Allergic rhinitis and hay fever – causes  Auckland District Health Board Clinical Immunology and Allergy and Healthpoint, NZ
Hay fever HealthInfo Canterbury, NZ
Allergic rhinitis Allergy NZ
Pollen calendar Allergy NZ
Hay fever Better Health Channel, Australia
Hay fever and seasonal allergies Patient Info, UK
Hay fever NHS, UK

References

  1. Allergic rhinitis Auckland Regional HealthPathways, NZ
  2. Hay fever (allergic rhinitis) Australasian Society of Clinical Immunology and Allergy (ASCIA)
  3. Specific allergen immunotherapy (AIT) environmental (inhaled) allergies The Paediatric Society of New Zealand and New Zealand Child & Youth Clinical Network
  4. Allergic rhinitis Patient Info, UK
Credits: Health Navigator Editorial Team.