Hay Fever Treatment and Asthma

What Options Are Available?

A young woman sitting on the grass, blowing her nose
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A hay fever treatment plan that works (and fast) is coveted by anyone who suffers from this problem. Doctors recommend a combination of options -- trigger avoidance, environmental modifications, over-the-counter and prescription medications -- to do the job.

Reduce Trigger Exposures: An Effective Hay Fever Treatment

The first step in dealing with hay fever is to identify and attempt to avoid likely triggers.

Amongst the most common allergens is animal dander, which can also cause your asthma to flare if you're a sufferer. While you can remove your pet from your home to decrease your exposure, many people wish to try other environmental controls, such as allergen-impermeable bedding, before going to that extreme. Other common environmental triggers that can be modified include:

  • pollens
  • cockroaches
  • dust mites
  • molds

Are Air Filters An Alternative Hay Fever Treatment?

All sorts of air filterers and purifiers are advertised to asthma and allergy patients. While extremely popular, none has been proven to treat hay fever or improve asthma. Additionally, some types of air filters have been shown to increase ozone that may actually worsen your asthma.

Medications For Hay Fever Treatment

Medications for hay fever treatment can be obtained over the counter or by prescription. Additionally, over-the-counter nasal saline washes have been very effective in the treatment of hay fever and allergic rhinitis.

Many people also say neti pots also improve sinus and nasal allergies.

However, just because a medication is available over the counter does not mean it is safe. Overuse of over-the-counter decongestants Afrin (oxymetazoline) or Neo-Synephrine (phenylephrine) can lead to rebound congestion and a condition called rhinitis medicamentosa.

Nasal Steroids

Nasal steroids are, by far, the most effective medical treatments for hay fever. Despite this, antihistamines are the most commonly used medications for this purpose.

How well do steroids work?: In multiple studies, nasal steroids effectively treat the runny nose, congestion, and sneezing symptoms associated with hay fever. The only symptoms not treated as well are watery and itchy eyes.

How do nasal steroids work? Inhaled nasal steroids decrease hay fever symptoms by acting directly on eosinophils and IgE.

Side effects: The most common side effect associated with nasal steroids is nose bleeding. Additionally, there is some risk for cataracts and glaucoma, but this seems most common in people with a family history of these diseases. Nasal perforation is a rare but significant side effect. The body-wide side effects of oral steroids are generally not seen with the nasal preparations.

Some popular nasal steroids include:

  • Beconase
  • Flonase
  • Nasacort
  • Veramyst


Antihistamine medications for hay fever are also available over the counter and by prescription.

While antihistamines are the most commonly used medications for hay fever, they are not the most effective.

How well do antihistamines work?: Antihistamines will decrease the sneezing, itching, and runny nose symptoms, but typically have not improved nasal congestion associated with hay fever.

How do antihistamines work? The chemical histamine is released from mast cells and basophils when you are exposed to allergens. When histamine is released, the allergic response begins. Antihistamines block the release of histamine, improving hay fever symptoms.

What are the side effects of antihistamines? Common side effects of antihistamines include:

  • difficulty concentrating
  • dry eyes, mouth, and nose
  • sleepiness
  • decreased reaction time

Some popular anti-histamine medications include:

  • Zyrtec
  • Allegra
  • Claritin
  • Benadryl

Cromolyn Sodium

How well does cromolyn work?: While cromolyn can improve some of the sneezing, runny nose, nasal congestion, and eye symptoms associated with hay fever, most studies find nasal steroids more effective.

How does it work? Cromolyn prevents mast cells from releasing histamine.

Side effects: Side effects from nasal cromolyn are generally local and include nasal sores and possible bleeding. Sneezing, throat irritation and wheezing may also occur. Some patients do not like the nasal spray because it must be used every 4 hours.

Some popular cromolyn-containing medications include:

  • Nasalcrom
  • Intal

Leukotriene Modifiers

Leukotriene modifiers are approved for the treatment of allergic rhinitis and asthma. However, they are equally as effective as antihistamines and less effective than nasal steroids. As a result, the use of leukotriene modifiers in hay fever is limited.


How well does ipratropium work? Ipratropium is most beneficial for runny nose symptoms related to cold air and upper respiratory tract infections. It is less effective than nasal steroids as an overall treatment.

How does ipratropium work? Ipratropium decreases secretions in the nose.

Side effects: The nasal spray is not absorbed well into your blood stream, so you're not likely to experience the anxiety that is sometimes seen with use of the inhaled form. As with cromolyn, you can see a variety of local effects (nose bleeds, ulcers, and irritation of the throat).

Atrovent nasal is an example of an ipratropium-containing medication.

Allergy Shots

How well do allergy shots work?: Allergy shots (immunotherapy) have been shown to effectively treat the sneezing, runny nose, nasal congestion, and eye symptoms associated with hay fever.

How does immunotherapy work? In the United States, immunotherapy is primarily given through injections. Specific allergy extracts of allergens, such as pollen or animal dander, induce immune changes that blunt your body from sensing these allergens as foreign invaders. You have fewer symptoms as a result. In Europe, while the primary form of immunotherapy is an injection, an under-the-tongue form is also available, although it is associated with a possible serious reaction called anaphylaxis.

Side effects of allergy shots: While swelling at the injection site is common, there are more severe (although less frequent) side effects to consider before choosing this treatment for your hay fever.


Weber, RW. Allergic Rhinitis. Primary Care Clinics In Office Practice. Volume 35 (2008): 1-10.

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