Allergic Rhinitis - Hay Fever

Dealing With Hay Fever

Girl Sneezing
Allergic Rhinitis. Echo/Cultura/Getty Images

Hay fever got you down? The technical term for hay fever is allergic rhinitis and it affects 40 to 60 million Americans each year. Despite the term “Hay Fever”, you do not necessarily have an allergy to hay, nor do you have to have a fever. This disorder was actually only identified a little over 200 years ago in England by several scientists suffering from hay fever and they determined that they felt better moving closer to the ocean during certain seasons.

What Causes Hay Fever?

Our body’s immune system helps protect us from foreign antigens. Antigens within the body can attach to certain types of receptors (kind of like a gate key) on our cells. Sources of antigens include bacteria, viruses and pollens. Once an antigen binds to an immune cell, a reaction is started. While it serves as a protective function for our bodies, sometimes the side-effects are very undesirable, like the way we experience hay fever.

Common sources or triggers for developing hay fever include (but not limited to):

  • Pollens (trees, flowers, and other plants)
  • Dander from pets
  • Dust mites
  • Molds & mildews
  • Chemical irritants: smoking, perfumes, etc…

What Are The Symptoms of Hay Fever?

Nasal symptoms include:

  • Sneezing
  • Runny nose (rhinorrhea)
  • Itchiness

Eye-related symptoms include:

  • Itchiness
  • Watery eyes
  • Swelling under the eyes
  • “Allergic Shiner” blackness under the eyes, much like a black eye

    Throat-related symptoms include:

    • Frequent clearing of the throat
    • Cough

    Therapies for Treating Allergies

    There are several classes of medications that can be used to treat chronic allergy problems causing hay fever.

    • Antihistamine: cetirizine (Zyrtec), diphenhydramine (Benadryl), hydroxyzine (Vistaril), fexofenadine (Allegra)
    • Topical nasal steroids: fluticasone (Flonase), triamcinolone (Nasacort)
    • Oral steroids:
    • Topical nasal cromolyn: Nasalcrom
    • Leukotriene inhibitors: montelukast (Singulair), meclofenamate (Meclomen)
    • Oral decongestant: pseudoephedrine (Sudafed), phenylephrine (Sudafed PE)
    • Topical decongestant: oxymetazoline (Afrin) – should not be used for longer than 3 days due to the risk of rhinitis medicamentosa
    • Immunotherapy: allergy drops, Oralair, Grastek, Ragwitek

    What Are Some Alternative Treatments For Allergies?

    Traditional medicine aside, there are several alternative therapies, known as Complementary and Alternative Medicine (CAM) for the treatment of allergen causing hay fever. Listed below are a few of the potentially beneficial alternative therapies for treating your miserable side-effects from allergies.

    • Acupunture – while there is some disagreement on acupuncture as a therapy for hay fever, many studies and systematic reviews (organized review of several studies) show that there may be some validity to this method.
    • Neti pot – a neti pot or other device for rinsing the sinuses are commonly used to treat hay fever.
    • Butterbur – the herb butterbur has been shown to be useful in the treatment of allergies in several European studies. Butterbur contains an active ingredient petasin, which is thought to interact with a part of our immune system cells leukotrienes. Petadolex has some evidence showing it to be as effective as cetirizine hydrochloride (Zyrtec)
    • Probiotics – there is some thought that probiotics (supplement to restore normal gastrointestinal bacterial flora) can be useful in the treatment of allergic rhinitis
    • Honey – there are several beliefs as to why honey may act as a form of therapy for hay fever. Honey is made from the pollen of many flowers, so there is a belief that it may act as a form of natural immunotherapy. Other beliefs that may be valid include that honey may act as a natural antihistamine or anti-inflammatory agent and therefore reduce the side-effects of hay fever.

    Complementary and Alternative Medicine do not have the same strength of scientific evidence (through randomized-controlled trials) that modern medicines do or have FDA approval for use for allergies. While there is enough growing evidence that warrants consideration of alternative therapies for treating your hay fever, always be careful as improper use or monitoring may also result in harm. For example: improper neti pot use could result in an infection, butterbur contains certain substances that can cause liver damage and honey is a common allergen that can cause an allergic reaction. You should always discus CAM therapies with a physician before starting.

    Above all therapies, reducing exposure to the allergens that trigger your allergies is the best treatment. If you suspect you have allergic rhinitis or hay fever it is best to discuss with your physician as untreated allergies can lead to other health problems.


    American College of Allergy, Asthma & Immunology. (n.d.). Allergic rhinitis. Accessed on June 30, 2015 from

    Goldenberg, D. & Goldstein, B.J. (2011). Handbook of Otolaryngology Head and Neck Surgery. Thieme Medical Publishers: New York.

    National Center for Complementary and Integrative Health. (2014). Seasonal Allergies at a Glance. Accessed on June 30, 2015 from

    U.S. National Library of Medicine. (2014). Allergic rhinitis. Accessed on June 30, 2015 from

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