“We recommend starting reasonably early – as soon as the pollen count starts to creep up, take antihistamines,” says Morris. “If that’s not controlling things, migrate onto the nasal spray and eye drops.”
GPs can also prescribe steroid treatments when these options don’t work.
People who are still debilitated by their hay fever symptoms after trying these methods may be offered immunotherapy, which involves being given tiny amounts of pollen in the form of a tablet or a wafer that is placed under the tongue. It may also be offered as an injection but this is becoming less common as the oral options are more convenient for patients.
In theory, this method of controlled exposure to pollen teaches the immune system to tolerate it rather than try to fight it off – effectively reversing the allergy.
“It really does transform people’s quality of life, particularly those with a grass pollen allergy because it’s a long season – they can be really incapacitated for four months of the year,” Morris says. Around 70 per cent of immunotherapy patients have “fantastic” results, 20 per cent have modest results and 10 per cent find that it does not ease their symptoms, he says.
The tablets or wafers are taken daily from two months before the pollen season begins. “If you do it for three consecutive years, you get a long-term cure of the hay fever to that pollen,” he explains.
“That cure lasts for about 10 years, and then it sort of fizzles out, so you might do it when you’re 30 and you have a wonderful time but you’re 40 and then suddenly discover the hay fever starts to come back again and repeat the treatment.”
However, it is not risk-free. In rare cases, immunotherapy can trigger severe allergic reactions, though this is more common when it is offered as an injection, Morris says. Meanwhile, the tablets and wafers can cause severe itching under the tongue, which causes some patients to stop taking it.
Additionally, it is not widely available. Just 1,000 NHS allergy patients per year are estimated to be offered immunotherapy, in part due to its high price of around £100 per month, meaning that a three-year course would cost £3,600.
“A lot of the private medical insurance won’t actually pay for it and the NHS will only give it if it’s absolutely essential – they would rather recommend antihistamines,” Morris says.
Immunotherapy should be offered more widely but there is a lack of specialists to deliver the treatment, with just one allergist for every 500,000 people with an allergy, according to Warner.
Some patients have sought out another supposed hay fever treatment in the form of a jab called Kenalog, which is the brand name for the prescription-only steroid injection triamcinolone acetonide. However, it is not licensed for treating hay fever and can be risky, as it works by temporarily suppressing the immune system.
“It can last anything from a week to a month and give you benefits for that period of time,” says Morris. “But because it’s quite a high dose of steroid, it has downsides and can cause things like osteoporosis, cataracts and diabetes, so we frown upon it now. It’s not offered in mainstream allergy clinics any longer.”
A safer option would be to go to the GP for oral steroids to temporarily nip hay fever symptoms in the bud. “For an emergency, you can take a small amount of oral steroid just for a day or two to get through something that’s important, such as a wedding or exam, in the middle of grass pollen season,” he says.
The jury is still out on whether home remedies can ease hay fever, with a teaspoon of honey a day often suggested. “The theory behind that is there’s going to be a little bit of pollen in the honey and you may effectively desensitise yourself a bit,” Morris explains. “I don’t know if it works or not. I’ve never seen any evidence but it’s a nice idea.”