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Dr Karuna Keat

Dr Karuna Keat

Immunologist and Allergist
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Hayfever treatment

Experts — Posted 26/10/12

Advice from Dr Karuna Keat - Hay fever, also known as allergic rhinitis, generally refers to seasonal symptoms in a condition that afflicts up to 40% of Australians.

Allergic rhinitis can also occur all year round (perennial) with worsening symptoms during autumn and spring. It may be mild, or moderate to severe (affecting normal daily activities such as work, sleep and study), episodic or persistent (more than 4 days per week and more than 4 weeks at a time). It occurs as a result of allergies to things you breathe in; usually dust mites, grass pollen, mould and animal hair.

Allergic rhinitis occurs when there is an abnormal immune response to something in the environment (allergen).  This causes the symptoms of sneezing and an itchy, blocked and runny nose. Seven out of ten of people with allergic rhinitis also suffer from allergic conjunctivitis (inflamed itchy eyes).

What to do?

Allergen avoidance measures include wearing sunglasses, if you have allergic conjunctivitis, from a grass pollen allergy or asking someone else to vacuum regularly if you have a dust mite allergy. Reliable education and management information is provided by the ASCIA (Australasian Society of Clinical Immunology and Allergy) website at allergy.org.au

Treat mild symptoms with non-sedating antihistamines such as Zyrtec (cetirizine) or Claratyne (loratadine), if you are only occasionally bothered by the symptoms.  However the majority of sufferers will need to use intranasal steroid sprays (eg. Nasonex, Avamys, Rhinocort). Regular use is safe and effective in managing your symptoms. Up to ten percent of individuals may have mild nasal irritation. You can use antihistamines in addition to the nasal steroid sprays safely.  These medications can be prescribed by your family doctor and a lower strength dose may be bought over the counter.  These steroid sprays should not be confused with decongestants such as Drixine and Otrivin which should not be used longer than three days.

Immunotherapy or desensitization may be effective and should be supervised by a trained allergist (specialist doctor) in conjunction with your family doctor. Immunotherapy is an option in those who have allergic rhinitis and where the symptoms are not controlled by medications or medication is intolerable due to the side effects.  Immunotherapy can also be used in children to reduce their chances of developing further allergies, and reduce their chance of developing asthma by approximately half.

Hay fever facts

There is no cure for hayfever

There is no magical cure for allergic rhinitis - don’t believe anyone who says this - apart from living in a bubble. The closest we have to a cure is immunotherapy under the supervision of a trained and experienced doctor. There are ways to manage the symptoms using regular intranasal steroid sprays such as Nasonex (mometasone), Avamys (fluticasone) or Rhinocort (budesonide).

Hay fever is a significant health issue

Allergic rhinitis causes about 1 in 50 visits to the doctor. Allergic disease (of which allergic rhinitis is by far the most common) costs Australia around $5.6 billion in lost productivity each year (Access Economics, 2007). Persistent, severe symptoms result in people being unproductive at work and having difficulty sleeping. Hay fever that is not properly controlled can contribute to a worsening of asthma.

 

Children do not grow out of hay fever

 

Children do not grow out of allergic rhinitis, if anything, they may become more allergic if symptoms are not controlled and can be more likely to develop asthma if symptoms are not adequately managed. Allergic rhinitis is common in children (from as young as 2 years old) and adults.

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