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Managing Summertime Hay Fever

This spring and summer have seen some of the highest recorded levels of pollen in living memory.  The snow in March delayed the start of the tree pollen season which then resulted in a number of different trees pollinating at the same time, something that the Sunday Times described as a “pollen bomb”.  Inevitably, the impact on hay fever sufferers was very significant.  It has long been established that whilst for many, hay fever can be an irritating inconvenience, for a significant minority it can go far beyond that.  For example, research has shown that children who suffer from hay fever are 50% more likely to drop a grade from their mock exams (which typically happen around Christmas time) in their summer exams (which typically happen in the middle of the pollen season).  Children taking the wrong sort of medication, such as sedating antihistamines can suffer even greater effect on their exam performance.

 

Like all allergies, there are generally three approaches to try to manage it;

 

1 – Try and avoid the allergen itself which with pollen can be very tricky.  Whilst pollen filters in cars, wearing wrap-around sunglasses or washing your hair before bedtime (to avoid rubbing your nose in the pollen that is collected in your hair) can all help, these are seldom enough to make a difference with troublesome hay fever.

 

2 – Medication and long-acting, non-sleeping antihistamines can certainly make a difference but are not as effective as nasal sprays.  Nasal sprays contain a small amount of steroid and sometimes mixed in with antihistamine and can make a marked difference in reducing hay fever symptoms.  Interestingly, as well as helping with the nasal symptoms, they could also improve symptoms in the eyes which are normally caused by a reflex which connects to the inflammation in the nose.

 

3 – Desensitisation, otherwise known as immunotherapy.  This is an approach with a 100-year long history of effectiveness, but more recently has stood up to the most rigorous scientific clinical studies.  The principle is to use the allergen itself in very high doses either injected, or more commonly in paediatric practice given under the tongue on a daily basis.  This slowly but surely reduces the immune response directed against the allergen and as a result, if it is started a number of months before the start of the pollen season, can lead to a marked reduction in symptoms.  Better still, this effect is sustained and after a 3-year course of treatment, it can lead to many years of reduced hay fever symptoms.  There is also now strong scientific evidence suggesting that it can reduce the risk of progressing to asthma which is a very common scenario in children with hay fever.

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