With the remarkably high pollen counts this year, hay fever seems to be more of a problem than ever. Whilst many suffer only mild symptoms, for an important minority, the impact on quality of life can be very significant, despite good advice about taking antihistamines and nasal sprays. For those patients whose symptoms remain troublesome, despite these medications, or for those who prefer not to rely on them, there are still other solutions.
One option is depot steroid injections (Kenalog) but I would never recommend these because of the risk of long term side effects, such as an increased risk of fractures.
However, another alternative is immunotherapy (or desensitisation). This is not a new approach – giving small but increasing amounts of the allergen (such as grass or tree pollen) in the months before the season as a way to reduce the strength of the allergic response. Traditionally, injections of allergen were used but this involves numerous visits to the doctor and can have serious side effects. More recently, studies have shown that sublingual immunotherapy (where the allergen is squirted under the tongue) has been shown to have a very similar effect but much safer. It can also be given at home.
“Recent studies have also strongly suggested that desensitisation can reduce the risk of developing asthma (which is as high as 50% in children with hay fever) as well as significantly improving hay fever symptoms in the long term.“
3 years of treatment (usually for 6 months of the year) can provide benefit for a number of years after the treatment stops. Recent studies exploring the link with asthma used an enormous prescription database from Germany. This study showed a significant reduction in the development of asthma symptoms in those who had been treated with pollen immunotherapy and in those who already had asthma, a reduction in the amount of asthma medicine they needed. Sublingual immunotherapy is a safe treatment which can before reduce hay fever symptoms and also go some way to halting the allergic march – the all too common progression from hay fever to asthma.