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Health and Wellness Advice

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Hayfever and effective over the counter treatments

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Hayfever is a term to describe a group of symptoms which sometimes appear to be cold-like in presentation such as runny nose, nasal congestion, sneezing, sinus pain, itchy eyes and itchy throat.  However, hay fever is an immune response to environmental allergens (indoor or outdoor), such as pollen, dust mites, animal fur, dead skin, general dust. Whereas the cold or flu is caused by a virus.

How many people does it affect and what is its' impact?

Hayfever affects a huge number of Australians, according to the 'National Health Survey: First Results, 2017–18', Nearly 1 in 5 Australians (more than 4.6 million people) had allergic rhinitis in 2017–18.  The condition can have a considerable impact on your quality of life as it can affect your performance, at school, work, sports and general enjoyment of life.

Hay fever signs and symptoms can include:

  • Runny nose and nasal congestion
  • Itchy, watery and red eyes
  • Sneezing
  • Cough
  • Itchy nose, roof of the mouth and or throat
  • Post nasal drip
  • Fatigue

What causes hayfever?

It is often hard to pinpoint the exact cause of hayfever as there can be several environmental factors such as dust mites, pollen and fungi spores. Hayfever can also be seasonal such as the start of spring or autmun. 

When you have hay fever, your immune system identifies a harmless airborne substance as harmful. Your immune system then produces antibodies to this harmless substance. The next time you come in contact with the substance, these antibodies signal your immune system to release chemicals such as histamine into your bloodstream, which cause a reaction that leads to the signs and symptoms of hay fever.

What Treatments are available over the counter?

Non-Pharmcological : 

Understanding your symptoms and what allergens trigger them is highly important in managing your hayfever. These include allergens such as pollens, dust mite faeces, contact with certain animals and mould spores. Minimising your exposure can be highly helpful in managing your symptoms.

Requesting a skin prick test from your doctor can be helpful in identifying which allergens your are sensitive to. We recommend you to discuss this further with your doctor or allergen specialist if you require one.

Pharmacological Treatments:

Anti-histamines - Oral anti-histamines in tablet, capsule or liquid form are commonly used to treat the symptoms of hayfever. They fast acting and highly effective the relief of hayfever symptoms. There are two categories of anti-histamines:

Sedating antihistamines (drowsy and sometimes known as 1st generation antihistamines). These include dexchlorpheniramine (Polaramine) and promethazine (Phenergan 10mg or Phenergan 25mg or Phenergan liquid )  - they can make you feel drowsy and recommended to be taken at night. Both of these are pharmacist only medicines and require a quick consult with our pharmacist. 

Non-sedating anthistamines (non-drowsy, also known as 2nd generation antihistamines) . These include: loratadine, cetrizine and fexofenadine. 
Which one is best for you? Non-sedating antihistamines are considered first-line for most people as you are less likely to experience side effects such as drowsiness. There is insufficient evidence available to suggest one antihistamine is better than any other in relieving symptoms of hayfever, and people often find some will be more effective than others.  You may require to trial several different antihistamines before you find one that works for you.

Nasal coritcosteroids - These are nasal sprays which contain a small dose of corticosteroid and have been widely established as the first line for the prevention of hayfever/allergic rhinitis.  These work by reducing sinus inflammation and consequently treating nasal itching and runny nose. For many people, these are the most effective treatments for hayever.  

Over the counter treamtents include include mometasone (Nasonex) and budesonide (Rhinocort), and Fluticasone (Flixonase)

What are the pro's and con's of nasal corticosteroid sprays?
Pros: 1. Safe for long term use in most people 2. used as a preventer to keep symptoms away. This is particularly useful for seaonsal allergies as people can start treatment prior allergy season 3. good for people who do not like tablets.

Cons: 1. may not provide relief for those who get skin allergy symptoms, 2. slow onset: as it can take 3 - 7 days of continuous use for the full effect to kick in. 3. Side effects can include unpleasant smell or taste after spray.

Nasal Ipratropium - Ipratropium bromide (Atrovent) nasal spray is useful as it will stop a runny nose, but it will not prevent congestion. Ipratropium works by preventing the glands in your sinsues (nose) from producing excess fluid.  Side effects may include : dry nose, nose bleeds and sore through. Please discuss with your doctor or pharmacist prior starting this treatment.

Sinus rinse - Using a sinus rinse in a bottle or a neti pot to rinse out your nasal passages with saline is a fast and cost-effective method to provide immediate relief of nasal congestion. This can help clear congestion and clear your sinsues of allergens.

As you can see there are many reasons for hayfever and it affects many of us. However, you don't have to suffer through the symptoms as there are many effective and safe treatments available. If you have any further questions, please feel free to contact us.

Posted at 02 December 20