Tissues at the ready. The season is finally here. 
Allergy season, that is. 
So, what exactly is hay fever, why do we get it and how can we best manage it?

The Long Battle

Allergic rhinitis – more commonly known as hay fever - is an allergy to inhaled pollen that causes the inside of the nose to become inflamed. 
When you have an allergic reaction, it is essentially your body overreacting to something it perceives as a threat. In hay fever, an allergy to pollen leads your immune system to respond as if it were being attacked by a virus, releasing a number of chemicals designed to fight off what it wrongly perceives as an infection, manifesting as symptoms of that allergic reaction.
The typical symptoms of hay fever are sneezing, a stuffy nose and red, sore eyes. 
Based on the symptoms you’re experiencing, your GP should be able to diagnose hay fever, and in some cases, you may be referred for allergy testing (a skin prick test and a blood test).
The differential diagnosis is infection, but when the symptoms affect both nose and eyes at the same time in the absence of a coloured discharge and when it is seasonal, the diagnosis is clear. In severe and long-standing cases, there can be sinus pain caused by congestion and blockage and we can even see swelling of the bridge of the nose caused by grossly congested sinuses.

Beyond the Wall

Our nasal passages are designed to remove impurities from the air we breathe in: passageways in the walls called turbinates help to moisten the air that flows in through the nose, filtering and depositing impurities such as dust, pollen or bacteria onto the walls, where goblet cells produce sticky mucus to trap these particles, which are expelled by sneezing or swallowed and destroyed by the stomach acids. This system is triggered inappropriately in those with allergies, to the extent that the airways and other mucous membranes become inflamed and swollen (over time, this hypertrophy of tissues can lead to the formation of nasal polyps), causing the symptoms associated with hay fever. 
Hay fever can be seasonal (caused by an allergic reaction to pollen from grass, trees and weeds during the early spring and summer months), or perennial, where people experience symptoms year-round (from allergens such as such as house dust mites, pets, or moulds). 

The Winds of Winter

If you’re allergic to pollen, you may finally get a break as the long nights of winter arrive and the weather turns cold. Between late March and September, however, (between Easter and the end of the summer school holidays), hay fever is usually worse, especially when it's warm, humid and windy. This is when the pollen count is at its highest and more likely to be spread, making symptoms of hay fever worse. 
Depending on the type of pollen you're allergic to, symptoms also differ during the year as trees and plants produce their pollen at different times.
It also tends to be slightly worse around the middle of the day, so sufferers are advised to exercise at the beginning or at the end of the day, where pollen levels tend to drop. 
The Children 
You can get hay fever at any age, though it is more commonly developed in childhood or teenage years. 
Along with asthma, eczema, hives, nut allergy and food/antibiotic allergies, hay fever is a Type 1 Hypersensitivity allergy. If you have a family history of allergies (particularly asthma or eczema) or a parent with Type 1 Hypersensitivity, after exposure to pollen there is a chance of your allergic system becoming intolerant of it, increasing your likelihood of developing hay fever. 
Hay fever is also most common in children, particularly boys. Many people partially or completely grow out of it, and in adults it is equally common in both sexes.

Hold The door

Although it’s difficult to completely avoid pollen, there are some things you can do to manage exposure to it, for example keeping indoors when pollen levels are high, wearing wrap-around sun glasses, putting Vaseline around the nostrils to trap pollen, and using medication as required. Medication consists of antihistamines and steroids, which we prefer to give topically (i.e. creams and drops) to minimise side effects.
If you have hay fever, it is also best to avoid outdoor exercise when pollen levels are high#HoldTheDoor

Summer is Coming

With hay fever season upon us, there are some other steps you can take to manage your symptoms, for example opting for foods high in antihistamine with anti-inflammatory effects, such as:
·      Coffee, which reduces the tendency of mast cells to excrete antihistamine
·      Omega 3 fatty acids found in oily fish
·      Fresh fruit containing anti-oxidants and vitamin C 
Additionally, we recommend treatment for severe and persistent hay fever, as untreated rhinitis places you at risk of developing nasal polyps which comes with further complications. Immunotherapy, aimed at retraining the immune system to reduce allergy symptoms, is an interesting and ongoing area of research, though it has a long way to go yet.
Although there is currently no cure for hay fever, there are treatments available and ways to help mitigate its symptoms - particularly during allergy season when pollen levels are high. 
So, there you have it. With the long days upon us you now know everything, Jon Snow, about how you can best manage your symptoms this season. 
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