ASK A DOCTOR: WHY HAVE I SUDDENLY DEVELOPED HAY FEVER?

The itchy eyes, sneezing and stuffy nose of hay fever can make an otherwise beautiful spring day a misery. The condition is an allergic reaction to pollen – where an overreaction from the immune system triggers the release of histamine and other chemicals that lead to symptoms.

One in four people have hay fever, but according to more recent research from Allergy UK, 49 per cent of people reported its symptoms – suggesting it is becoming more common. Though it starts most commonly between childhood and the early 30s, it could develop at any age, says Dr Helen Evans-Howells, GP and allergy specialist.

Who gets hay fever?

“Pollen allergies tend to occur in secondary-school-age children and peak in the 20s and 30s. However, these allergies can show themselves at most ages,” she explains – though it “would be unusual for an older person in their sixties-plus years to develop hayfever for the first time if they have never had eczema, asthma or allergies”.

The exact reason why some people develop hay fever, but others do not, is not fully known – but there are likely to be several factors at play. 

“We know that the main reason is a genetic tendency to have atopic disease – also known as an allergy. This would include conditions such as food or environmental allergies and asthma and eczema. If your parents or siblings have one or more of these things, then it increases your risk, says Dr Evan Howells.

There are also some connections being made between the importance of gut microbiota for allergies and eczema, she adds: “It seems that factors such as early antibiotic use, being formula-fed, having a Caesarean delivery will all potentially impact on the gut flora and mean that we are more likely to develop allergies.” However, “this is not the whole story and certainly it is important that no one feels guilty about their feeding choices or the need to give their infants antibiotics.”

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Other potential triggers, says Dr Runa Ali – consultant in allergy and respiratory medicine at King Edward VII’s Hospital, London – might include “a severe infection like Covid-19, being exposed to pollution and/or going through hormonal changes like pregnancy or menopause. All of these may switch on your immune system to fire”.

And then, of course, there are environmental factors. Dr Evans-Howells suggests climate change and pollution are making many people more susceptible: “With the longer hotter seasons, pollen counts are increasing and persisting for longer. We are also seeing more allergies to weeds which typically thrive in hot climates. Pollution undoubtedly has a role to play as this can create inflammation in our airways meaning we are more susceptible to asthma and allergies.”

Hay fever usually manifests in child or teenage years, and tends to peak in the 20s and 30s, though it may develop later, says Dr Ali. “These people [who develop it later] will be genetically predisposed and often this tendency runs in families with other members having hay fever too.”

Is hay fever dangerous?

While hay fever can be serious if you have uncontrolled or unrecognised asthma, for the most part it is not life-threatening. But that doesn’t mean it is not debilitating, says Dr Evans-Howells.

As well as an irritating stuffy nose and itchy eyes, some may experience worsening symptoms including congestion, chronic sinus infection, poor quality of sleep, increased fatigue and inability to focus on day-to-day tasks. Hayfever can even lead to facial swelling, pain, and headaches.

As such, it’s important to know there are plenty of treatment options available – whether you’ve lived with hayfever for years or just developed it.

What are the best treatments for hay fever?

Limiting your exposure to allergens where possible is an important step. Recommendations include: do not open windows in high pollen seasons; use air conditioning instead; take a shower after spending time outside; regularly change clothes; wear wraparound sunglasses; and dry laundry indoors.

As for treatments, Dr Evans-Howells says that long-acting and non-drowsy antihistamines such as cetirizine (found in Piriteze) or loratadine (Clarytin) are useful for sneezing or itchy eyes.

“For those with more significant symptoms, an intranasal steroid spray such as mometasone or fluticasone (which can be bought over the counter) will be useful. These sprays need to be taken regularly to have a benefit and ideally, I would recommend starting them a month before the pollen season starts. Make a note in your diary for when you need to start this next year.”

However, it’s important to make sure these sprays are administered correctly – rather than being sniffed like decongestants, they should be inserted into the nostril and sprayed at an angle – not straight up but to the side, away from the centre of your nose. This ensures they work as intended.

If after regular use of these medicines your symptoms persist and are still disruptive, the next stage would be immunotherapy, says Dr Ali. “This is a three-year course of vaccination with pollen extracts, the purpose of which is to diminish the responses to convert severe hay fever to a much milder version. Please discuss this with your GP if you feel it may be required. It can be given as pollen injections or under the tongue extracts.”

What are the treatments to avoid?

Some nasal decongestant sprays containing oxymetazoline (Vicks) or xylometazoline (Otravine) or tablets containing pseudoephedrine (Sudafed) can lead to worsening symptoms in the long run. Using them for more than a few days consecutively can lead to something called nasal congestion rebound – your symptoms get worse if you stop using them. Dr Evans-Howells adds that sprays containing fluticasone (Avamys) or mometasone (Clarinaze) “are safe for long-term use”.

Steroid injections are even worse and are “advised against by the NHS and allergy specialists,” says Dr Evans-Howells. “These bring short-term risks of mood changes, weight changes, hormonal fluctuations and damage to the area they are injected. These treatments may benefit you but as they would be needed year-on-year they bring with-it longer-term risks of diabetes, immunosuppression, glaucoma, cataracts and breakdown of your joints.”

And finally, Dr Ali cautions against “folklore treatments” that circulate on social media platforms. Everything from eating honey to detox teas to coating your nostrils in Vaseline to salt water nasal sprays are recommended to cure hayfever. They may help a little with some symptoms, but the overall evidence is not there, she says.

Dr Ali adds: “It’s crucial to rely on scientifically proven treatments and consult healthcare professionals for advice, and save yourself money and time from unproven remedies.”

2025-05-13T05:44:18Z