You will usually feel one or more of these symptoms immediately after coming into contact with an allergen:

• Sneezing and/or an itchy nose
• Runny nose and/or nasal congestion (a “stuffy nose”)
• Watery, itchy and red eyes (allergic conjunctivitis)
• An itchy, scratchy or sore throat, which may cause a cough
• Black colourant on (dark circles) underneath the eyes (called allergy “shiners”)
• A loss of smell or taste
• Headache, especially around the sinuses, nose and eyes
• Feeling tired or run down.

The symptoms of hay fever are similar to that of a cold or sinus infection, and telling the difference between these conditions can be difficult.

However, hay fever cannot be spread person-to-person, unlike a cold, as it is an allergic reaction. Hay fever generally causes itchy eyes and can be associated with hives or other allergic skin conditions; while a cold generally causes a sore throat, full body aches and fever, which are absent with hay fever.

A sinus infection, on the other hand, usually produces a thick, yellow or green “post-nasal drip” and mucous discharge from your nose.

Additionally, allergies can impact your immune system, making it more likely for you to pick up viruses that you come into contact with, such as those that cause the common cold.

According to the Allergy Foundation of South Africa (AFSA), hay fever occurs in 20-30 % of the population, and as many as 40 % of sufferers may also have asthma, often undiagnosed.

Hay fever is an allergic reaction, which means that your immune system incorrectly identifies a harmless airborne substance as a “threat”, producing antibodies in response.

The substances that can cause an allergic reaction are called allergens.

The next time you come in contact with the allergen, the antibodies signal your immune system to release the chemical histamine into your bloodstream, which leads to inflammation and causes the associated symptoms.

Hay fever symptoms are usually worse at a particular time of year. This is usually during early spring when tree pollens are most common, or late spring or summer when grass pollens are typically most prevalent. Certain weeds may also produce pollens during autumn.

Pollen blown on the wind is the most common cause of hay fever. Therefore, you are more likely to be exposed to pollens on hot, dry and windy days; while on cool, damp and rainy days, most pollen is washed to the ground.

Other Triggers:

• Dust mites
• Pet allergens: These include allergies to the hair, skin cells, saliva or urine of pets (typically dogs and cats) and other animals
• Cockroaches
• Spores from indoor or outdoor fungi or moulds.

• Having other allergies or asthma
• Having atopic dermatitis (eczema)
• Genetics/having a close family history (such as a parent or sibling) with allergies or asthma.
• Living or working in an environment that constantly exposes you to allergens, such as dusty or outdoor environments
• Being exposed to cigarette smoke at a young age.

The following measures may help you avoid hay fever or manage symptoms:

• Avoid known triggers: The best way to prevent allergy symptoms is to avoid or eliminate the allergens that trigger them. This can include keeping a diary when trying to identify what causes or worsens your symptoms by tracking what you are exposed to and when symptoms occurred.
• Try to avoid or eliminate allergens from your life; for example, keeping windows closed on dry, windy days. It is also important to know when your exposure to certain allergens might be highest so that you can take actions to avoid them; for example, staying indoors during seasonal hay fever/pollen season.
• Make your house allergy-free: This includes regularly cleaning your house of dust and mould and washing bedlinens or fabrics in warm water to avoid dust mites and other allergens. You can also install small particle or HEPA air filters to rid your living spaces of airborne allergens. Removing carpets or curtains and decluttering spaces may also reduce accumulated dust and make it easier for you to clean.
• Enjoy a healthy lifestyle: Avoid cigarette smoke and pollution, as these are known allergens. If you smoke, you can talk to your doctor about ways to quit.
• Also exercise regularly to help manage your weight, get enough sleep, and find ways to relieve stress. High levels of stress have been proven to cause allergy flare-ups and may worsen allergy symptoms.
• Eating a healthy diet rich in fruit and vegetables, with high amounts of vitamins and minerals, is also important. Vitamin C is a natural antihistamine, while there is growing evidence that zinc and vitamin D plays a protective role against developing atopic disease, with some studies indicating that supplementation in early childhood may prevent the development of certain allergies as children grow older.

There are several different types of medications available in different forms (tablets, liquids, nasal sprays, eyedrops and ointments or skin creams) to help relieve and manage the symptoms of hay fever, including:

• Antihistamines: These are the most common medication for the relief of allergy symptoms, including the symptoms of hay fever. They work by blocking the chemical, histamine, that causes the symptoms of allergy. There are several different types of antihistamines available over-the-counter in different forms to ease the different types of allergy symptoms. Take these medications with precaution as they tend to cause drowsiness and may make you feel tired. As such, antihistamines may not be suitable for use if you are going to be driving or doing any activity that requires full alertness.
• Decongestants: These are usually available as nasal sprays that can relieve congestion (stuffiness) in the nose or sinuses.
• Corticosteroids: These medications help relieve symptoms by reducing inflammation. Steroids can be found in some nasal sprays and skin creams but are also available in tablet or inhaler form. Your doctor may need to prescribe you a steroidal medication that can help manage your symptoms.
• Long-term corticosteroid use can cause cataracts, osteoporosis, muscle weakness, thinning of the skin, stomach ulcers, increased blood sugar (glucose) levels, delayed growth in children and can also worsen high blood pressure. Talk to your doctor or healthcare provider if you are going to be using corticosteroids for a long period of time.
• Mast cell-stabilisers: These medications block mast cells from releasing histamine. Your doctor may prescribe these when you cannot use antihistamines or when antihistamines are not working effectively to relieve your symptoms. Mast cell stabilisers do not provide immediate relief of symptoms but require at least a few day’s use to be effective.
• Leukotriene inhibitors: These tablets block the other chemicals that help to cause allergy symptoms. Your doctor will have to prescribe these medications as they are sometimes known to cause, or aggravate, psychological conditions like anxiety and depression.

If you cannot use these medications or if they have not worked to relieve your allergy symptoms, your doctor may suggest allergen immunotherapy. The goal of immunotherapy is to try to train your body’s immune system not to react to specific allergens by the carefully timed and gradually increasing exposure to allergens, such as pollens, dust mites and mould. Immunotherapy is usually given as a series of injections at a healthcare facility or immunology clinic. Immunotherapy needs to be carefully monitored by a healthcare professional, as it can cause side effects, such as swelling and pain at the site of injection, or even anaphylaxis.

|Recently, cellulose powders as barrier protections, such as hydroxypropyl methylcellulose (HPMC), which literally ‘shields’ the nasal membrane from airborne allergens, or other similar products used as nasal sprays have been found to provide some benefit in preventing or relieving hay fever symptoms. Some of these products may be available over-the-counter to purchase.

While the symptoms of hay fever may seem trivial, problems that may be associated with hay fever can be serious and may include:

• Reduced quality of life: Hay fever can reduce your enjoyment of activities and productivity, leading to absences from work or school. Hay fever can also cause poor sleep, causing you to experience fatigue or a feeling of being generally unwell.
• Asthma flare-ups: Hay fever can exacerbate asthma and its symptoms.
• Sinusitis and ear infections: Hay fever can cause prolonged sinus congestion that may increase your susceptibility to infection of the membranes that line the sinuses or the middle ear (especially in children).