Our host speaker at the Allergy and Free From Show, and Leading Paediatric Allergy Consultant, Dr José Costa, shares his expert insights on hay fever, offers tips on managing symptoms, and explains the benefits of immunotherapy treatment.
Q: Can you tell us about yourself?
“I am a senior paediatric allergy doctor, practising at Nuffield Leamington Spa, The New Foscote Hospital, Banbury, The Royal Buckinghamshire Hospital, Aylesbury, and my own practice at The Children’s Allergy Clinic, where I support families affected by allergies from across the UK. I specialise in the latest research and medical guidance on childhood food allergies, eczema, and I have a special interest in airborne allergies (Allergic Rhinitis), which includes hay fever, allergies to dust mites, animals and mould, etc), allergic asthma and associated conditions.
“Over the past 20 years, I have practised as a senior medic in both the NHS and private sector, leading both the Paediatric Allergy Services at University Hospitals Coventry & Warwickshire and Sherwood Forest Hospitals NHS Foundation Trust. I am a member of the Royal College of Paediatrics and Child Health and part of a group of medics, writing the National Allergy Guidelines for the British Association of Allergy and Clinical Immunology (BSACI).”
What is hay fever?
“Hay fever is a hypersensitivity reaction to pollen, typically occurring in the nose and eyes.
In this reaction, inflammatory mediators are released, leading to inflammation of the nasal mucosa, which manifests itself as sneezing, itching, blocked nose, and runny nose.”
When does the hay fever season run from?
“The pollen season begins in January and will go on until September. Hay fever symptoms at the start of the season tend to be pollen from Alder trees, closely followed by pollen from Hazel trees. In mid to late February and early March, we will then have pollen from Elm, Willow and Birch causing symptoms.”
Why do people seem to struggle with hay fever/ allergies? Do we know much about why some people are more susceptible than others?
“Some people are more prone to hay fever due to genetic predisposition, including a family history of allergy, as well as diet/lifestyle choices – some studies have also suggested a link between low Vitamin D and higher risk of hay fever. Having other airborne allergies can also make people more prone to hay fever.”
What are some of the practical ways hay fever sufferers can limit their exposure to pollen?
“Simple ways include wearing wide sunglasses, which helps to prevent direct pollen contact with your eyes, and applying petroleum jelly to your nose, which can help to stop pollen from getting inside the nasal passages.
“Nasal filters can also be quite useful here, and there are also some natural products, which can be bought over the counter, that can also reduce either the exposure or the symptoms of hay fever. “These range from nasal or eye sprays, lozenges or eye gels – your pharmacist can advise on the best options for you.
“At home, you can use filters on the windows and vacuum cleaners or fans with HEPA filters to remove pollen from the air and floor.
“Identify where and when your symptoms are worse and avoid those areas if possible. Keeping an eye on the weather forecasts will help you plan and limit your exposure where possible. Bear in mind that pollen count isn’t just high in warm, dry weather – rain after the weather has been dry will increase the pollen in the air, making your symptoms worse.”
What treatments would you recommend for hay fever symptoms?
“Nasal sprays with Fluticasone Propionate can be bought over the counter to alleviate your hay fever symptoms, and you can also try a nasal antihistamine – your pharmacist can advise you on the options over the counter. For adults and children of 12 years and above, Azelastine Hydrochloride can be used up to three times a day.
“To treat eye-related symptoms, there are a couple of choices. Olopatadine eye drops can be used for anyone three years old and above, as well as drops with Sodium Cromoglicate.
“If symptoms are not under control, speak to your pharmacist about second-generation antihistamines. Cetirizine Hydrochloride can be used by adults and children over one year of age. Loratadine would be another choice – suitable for adults and children over two years old. Both medications can be bought over the counter.”
Are there any further options if standard medications aren’t managing hay fever symptoms?
“If all of the above is not helping you manage your symptoms and your hay fever is affecting your quality of life, it is advisable to seek medical advice from an allergy specialist. The closest thing to a cure for hay fever is immunotherapy, given by either an injection under the skin (known as subcutaneous immunotherapy), or either a liquid spray or a tablet under the tongue (sublingual immunotherapy). Giving regular low doses of the allergen trains the immune system to ignore the allergen, developing what is known as an immune tolerance. Treatment takes 3 years and leads to decades of reversal, or near reversal of symptoms.
“Although immunotherapy costs around £1,500 to £2,000 a year per patient and is more expensive than antihistamines, it can save money in the longer run by preventing people living with seasonal asthma becoming more sensitive to other airborne allergens, such as dust mites, leading to all year round (perennial) asthma.”
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