The best treatments for hay fever ?
It’s that time of year again when the pollen count starts to climb, and hay fever sufferers begin to experience the dreaded, familiar symptoms of itchy eyes, runny nose, congestion and sneezing. For some people, it’s mild enough, but others get more severe symptoms that interfere badly with daily life. However, quite often, when doctors ask hay fever sufferers what treatment they’re using, it turns out they’ve been sticking to the same old antihistamine tablet for years, and are not aware of other helpful treatment options. Nasal sprays in particular can cause confusion- as there are so many types- some over the counter, some prescription-only. So what are differences between them and which is the best nasal spray for hay fever ?
Corticosteroid nasal sprays
Corticosteroid nasal sprays (also known as “steroid nasal sprays”) reduce runny nose, nasal congestion and itch. They work a bit like an asthma preventer puffer- by taking them every day, over time they reduce inflammation and maintain your symptom control. They do not give quick relief over minutes or hours- it takes a few days for them to kick in, and up to a few weeks to get the full result. Some people need to use them all year round if they have allergies to dust, but for seasonal allergies such as hay fever, they may be needed for weeks or months at a time. Some patients worry that taking steroids is bad for their health, but we know that the very tiny daily dose of steroids used in hay fever nasal sprays is safe and can be used long term if required. Steroid sprays are generally available over the counter at the pharmacy.
Decongestant nasal sprays
Decongestant nasal sprays are available over the counter at the pharmacy. There are many types. They make the blood vessels in your nasal passages constrict (shrink), and can quickly dry up a runny nose. However, they should only be used for 2 to 3 days at a time, as your nose can develop “rebound congestion” from them. They may also be unsuitable if you have high blood pressure or an eye condition called glaucoma.
Antihistamine nasal sprays
These contain ingredients similar to those contained in antihistamine tablets, but in the form of a spray. They can help to treat an itchy, runny nose and sneezing. You can still take an antihistamine tablet.
Combination nasal sprays
There are also combination sprays that contain both steroids and antihistamine. They can be helpful, particularly if other over-the-counter options have not worked. Ask your doctor or pharmacist for more details.
Ipratropium nasal spray
This spray does not help itch and sneezing but it can treat a runny nose. It is also used to help symptoms of the common cold, in a similar way. It works by reducing mucus production.
How to choose the best nasal spray for hay fever?
- The usual advice from doctors is to find a steroid nasal spray that works for you and take it regularly for the full hay fever season, bearing in mind it can take a few weeks of daily use to see the results.
- You can get a steroid nasal spray without a prescription from your local chemist- the specific brand does not matter much (ask the pharmacist for advice if you’re unsure)
- Decongestant sprays are best avoided or used only occasionally for a day or two.
- You can also continue to take a daily antihistamine tablet, antihistamine nasal spray or eye drops, if helpful.
- If this approach is not controlling your symptoms properly, speak to your pharmacist about a combination spray, and other treatment options.
- You can also read more about using your nasal spray correctly here.
- Finally, it is always worth considering ways to reduce exposure to your pollen triggers.
Article Resources:
Chong L et al. (2016). Different types of intranasal steroids for chronic rhinosinusitis.
Passali D et al. (2016). Mometasone Furoate nasal spray: a systematic review
Cain R, Lal D. (2013). Update on the management of chronic rhinosinusitis
Deckx L et al. (2016). No nasal decongestants used alone relieve cold symptoms
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