Hayfever: What's the best treatment for you?

With the beautiful summer comes the not-so-beautiful hayfever season, which will unfortunately affect many of us. It may feel as though you are doomed to a summer of sneezing, puffy eyes and a red nose but don’t worry – we’ve got all the information you need to battle those allergies!

Our Managing Supervising Pharmacist, Lisa Coffey, has got the background on what causes these reactions and how best they can be treated so that you soak up the sun and smell the freshly bloomed flowers in peace.

 So….what is Hayfever?

Hayfever is a type of allergic rhinitis. Allergic rhinitis is a condition where an allergen (something that causes an allergic reaction) makes the inside of your nose inflamed.

It can be caused by either pollen or spores. If the symptoms of hayfever occur mainly during Spring/Summer, then the likely cause is pollen. Trees, grass and plants release pollen as part of their reproductive process mainly during these months. This is then called seasonal rhinitis or more commonly hayfever. If the symptoms occur all year round then these are typically triggered by dust, animal dander or mould spores. This is called perennial rhinitis.

Allergic reactions often result in an increase in a substance called Histamine being produced in the body. Histamine is released naturally in response to something “harmful” being detected in the body. It causes blood vessels to expand and the skin to swell in an attempt to fight the “harmful reaction”. In the case of hayfever, the body produces histamine in response to pollen, house dust, animal dander or spores. This then results in an itchy throat, runny nose, itchy red eyes, sneezing etc.

According to the Asthma Society of Ireland, hayfever will affect 1 in 5 people so learning to recognise the symptoms and knowing the relevant information on suitable treatments and lifestyle advice is essential.  

It affects the nose, sinuses (small air-filled cavities behind your cheekbones and forehead), throat and eyes.

The most common symptoms include but are not limited to:

• Sneezing
• Itchy, blocked or runny nose
• Red, itchy, watery eyes
• Itchy throat/mouth (oral allergy syndrome)
• Itchy inner ear
• Fatigue
• Reduced sense of taste and smell
• Headaches
• Loss of concentration and generally feeling unwell.

Given that some of the symptoms are similar to those experienced by patients suffering from COVID-19, here is a handy table created by the Irish Pharmacy Union comparing the two. It is important to note, if in doubt at all around any symptoms, please contact a Healthcare Professional via phone or email to get more information.

How can it be treated?

Hayfever symptoms can be quite debilitating and frustrating to say the least when you are trying to enjoy potentially the only fine day of the year! But fear not, there are loads of things that can be done to alleviate your symptoms.

Firstly, there are many medicated over-the counter products available to treat hayfever. They come in all different forms to best suit your needs, whether it be small once a day tablets, nasal sprays, nasal rinses or eye drops, you name it, we have it! When treating hayfever the best piece of advice I can give you is to treat the symptoms early, particularly if you have a history of hayfever. Beginning hayfever treatments before the hayfever season begins is often a great way to ward off any extreme suffering.

The first line treatment I would recommend to my patients would be an anti-histamine preparation. An antihistamine will help stop the histamine reaction from occurring, particularly if taken before you come into contact with the substance you're allergic to (i.e. pollen). Or they can reduce the severity of symptoms if you take them afterwards.

There are many types of antihistamines available, but the main over-the-counter ones are Cetirizine and Loratadine. The brand Cetrine is a great Irish product we recommend constantly in store as it is basically an “all-in-one” product. It relieves all types of hayfever symptoms including runny and blocked up nose, sneezing, itchy watery eye’s and symptoms of hives. It is a non-drowsy once daily dose antihistamine and the effects last for 24hours. The tablet itself is small so perfect for any of those who struggle swallowing tablets.

For those suffering specifically with skin reactions for example insect bites, Piriton, which is the antihistamine chlorphenamine, is effective. As this type of treatment can cause drowsiness, this can help those who suffer from interrupted sleep due to their allergies, however, it is not to be used as a long-term solution.

Cetrine also comes in a liquid form which is suitable to give to children aged 2 and over. For those between the ages of 2-6 years old, they can take 2.5ml up to twice daily and for children between 6-12years old the dose is 5ml up to twice daily.

While the anti-histamine preparations are very effective at alleviating symptoms, sometimes they are not enough depending on how sensitive the person is to the allergen and how high the pollen count is. Other items are available to take alongside the anti-histamines to control symptoms. 

Nasal Sprays

Nasal Sprays are also available over-the-counter. These come in the form of steroid nasal sprays such as Nasacort, Flixonase and Beconase.

Steroid nasal sprays function by reducing inflammation in the nasal passage which can also lead to relief of eye symptoms. Relief can be seen on the first day of use, however as with many steroid sprays both over the counter and prescription, it can take up to four days for maximum effects to set in.

My first line nasal spray is Nasacort Allergy. Nasacort used to be a prescription-only steroid nasal spray that has recently become available over-the-counter in Ireland. It provides 24hour relief of nasal symptoms and only requires one dose a day. It can only be used in adults over the age of 18. It is non-drowsy, scent-free, alcohol-free and is safe to use with blood pressure medication.

 “Drug-free” nasal sprays such as Becodefence and Becodefence Plus are fantastic alternatives for any pregnant or breast-feeding ladies out there who typically have limited options. Becodefence works by defusing pollen rapidly, supporting fast clearance of allergens and forms a microgel barrier to prevent against further irritation. The difference between it and Becodefence Plus is the Becodefence Plus is a 2 in 1 product. So it too defuses pollen, clears allergens and creates a microgel barrier but also reduces sensitivity to allergens due to its therapeutic oil with anti-allergic properties. Both products begin to work within 3minutes. Becodefence kids is also available for children between the ages of 6-12years. 

Nasal rinses and saline sprays are also a brilliant way of clearing up nasal symptoms and in my opinion, are definitely a secret weapon when treating hayfever. These are great products to flush the pollen out of the nasal cavity and can be used along with the other allergy treatments. Many people avoid using these products as they aren’t keen on the idea of squirting water up their nose, but if you’ve ever experienced the sneezing fits that come with hayfever or the streaming nose or even a congested nose - read on!

Neilmed Sinus Rinses are very efficient easy-to-use nasal rinses. The starter kit is ideal for a first timer as it comes with everything you need; the sinus rinse sachets and a delivery bottle. Once the initial sachets are used, a box of refill sachets can be purchased separately without having to get another bottle. It is recommended to replace the bottle every three months. The sachets contain a mixture of USP grade sodium chloride and sodium bicarbonate and is of a very high quality. 

Never rinse the nasal passage with just plain water as this results in a severe burning sensation as the plain water is not compatible with the nasal lining. Additionally, the type of water used to make the rinse is important. Plain tap water poured directly from the faucet into the bottle, even if very pure and drinkable, is not suitable. It is advisable to use cool boiled water as boiling sterilizes the water. You can actually store cool boiled water in a clean container for up to seven days, so if you made one kettle full, you’d have your supply for the week.

Neilmed Sinus Rinses are easier to use than people think. To start, wash your hands (which we are all professionals at this by now). Fill the bottle with cool boiled water up to the line marked on the side of the bottle. Cut the top off the sachet and pour the contents directly into the bottle. Replace the lid and secure tightly. Place one finger over the top of the cap and shake the bottle gently until the contents are dissolved. Stand in front of a sink, bend forward and tilt your head down. Keeping your mouth open and without holding your breath, place the cap of the bottle against the nasal passage as snugly as is comfortable. Squeeze the bottle very gently until the solution starts to drain from the opposite nostril. Keep doing this until a quarter of the bottle is gone. Then stop and blow your nose very gently. Do not pinch the nose tightly when blowing as we want to avoid putting too much pressure on the eardrums. Then sniff gently to remove any residual solution left in the nasal passage.

This action will clean out the posterior nasopharyngeal area which is a hard to reach area at the back of the nose. Do not swallow the solution. Repeat the rinsing action in the other nostril. Once finished, rinse out the bottle and cap and leave to air dry.

Sterimar products are another 100% natural drug-free, preservative-free range that are suitable for everybody in the family. They have an array of products that can be used from birth, in pregnancy and breast feeding. Sterimar are purified seawater based nasal sprays and are rich in salts, minerals and trace elements which are helpful in overall health and wellbeing.

Sterimar Breathe Easy daily is the original formulation. It is an isotonic solution meaning it has the same concentration of salt in it as in cells in the human body. It cleanses and eliminates impurities in the nasal passage and facilitates breathing. The Hayfever and Allergy Relief and Stop and Protect Allergy Response Sterimar sprays are an easy way to remove pollen and other allergens from the nose. It encapsulates, inactivates and neutralizes the allergen and so decreases symptoms. Sterimar Congestion Relief is slightly different in that it is a hypertonic solution. This means it has a higher concentration of salt than found in the cells in the body. It is enriched with Copper and Magnesium salts which help clear thick mucus. All of these products can be used from 3 years and up. 

A blocked or runny nose can be difficult to manage in babies and young children. For the first few months of life, babies mainly breath through their nose so if that is congested or runny, it can cause further issues like not sleeping or having difficulty feeding which can be upsetting for both baby and parent. Sterimar have a Breathe Easy Baby product which is safe to use from birth and will help alleviate nasal symptoms. It has a specially patented nozzle that is non-slip and that has a micro-diffusion spray to allow for a very gentle experience. Sterimar is a very easy product to use as it can be used at any angle. Please contact any of our stores or our helpline on 01 485 3098 about ordering Sterimar Breathe Wasy Baby.

Eye Drops

Perhaps one of the most uncomfortable symptoms of hayfever are red, itchy, watery, puffy eyes. There is nothing worse than having stingy eyes when out on a walk, or worse, the heartache around leaky mascara!  

Opticrom allergy eye drops are fantastic at alleviating these symptoms fast. The drops come in a small 10ml bottle or in individual single dose units that can be easily kept in a handbag, a rucksack, or even the door of the car. The recommended dose is one to two drops into both eyes up to four times a day.  These can be used by contact lens wearers however you should remove the contact before you put in the drops and should wait 15 minutes before putting the contacts back in.

If your eyes become very irritated and sore, Optrex eye baths can be useful to wash the eye out and hopefully remove any pollen in and around the eye.

Hay-bands are also available to help alleviate hayfever symptoms. These bands are another natural drug-free, non-drowsy product that are designed to apply a small amount of pressure on the LI-11 acupressure points on either side of the arm. They can be used once hayfever symptoms have begun but can also be used as a preventative measure. 

It is Important to note that despite the fact that hay-bands are drug-free, these are NOT to be used in pregnancy. The LI-11 pressure points have been used to assist in the onset of labour so must be avoided. These bands can be worn by adults and children from the age of 3. For all queries relating to hay bands, please phone any of our stores or our helpline on 01 485 3098.

If you have any further questions about hayfever and what is the best treatment for you, don't hesitate to contact any of our stores by phone or email. You can also contact our helpline on 01 485 3098 or email help@meagherspharmacy.ie. Our team of pharmacists are here to help and advise.