Hay Fever Symptoms: Signs, Triggers and Relief

01Symptoms

Typical nose and eye symptoms

Mayo Clinic and NHS inform list the main symptoms of hay fever:

• frequent sneezing
• a runny or blocked nose
• itchy, red or watery eyes (allergic conjunctivitis)
• an itchy nose, roof of the mouth, throat or ears
• cough caused by postnasal drip, mucus running down the back of the throat

Less common symptoms listed by NHS inform include loss of the sense of smell, facial pain from blocked sinuses, headaches, earache and tiredness. Mayo Clinic adds swollen, bruised-looking skin under the eyes, called allergic shiners, and fatigue, often from poor sleep. If sneezing is your main problem, see also our guide on constant sneezing.

02Triggers

Pollen and timing

NHS inform explains that hay fever is caused by an allergic reaction to pollen, a fine powder released by plants that contains proteins that can make the nose, eyes, throat and sinuses swollen and irritated. Both sources describe three main types:

• tree pollen, in spring
• grass pollen, in late spring and summer
• weed pollen, such as ragweed, in late summer or autumn

These seasons are described for the UK and the US. Pollen calendars differ by region and year, so local pollen forecasts are a better guide to when your symptoms may flare. Our guide on allergy season covers this in more detail.

03Year-round

Seasonal versus year-round allergy

Mayo Clinic explains that symptoms may start or worsen at a particular time of year, known as seasonal allergies, or occur year-round. Year-round triggers include dust mites and cockroach droppings, and pet dander, which may be worse in winter when houses are closed up. Mold and fungal spores can be both seasonal and year-round.

The underlying mechanism is the same: the immune system wrongly identifies a harmless substance as harmful, produces IgE antibodies, and releases chemicals such as histamine that cause the symptoms.

04Cold or allergy

How hay fever differs from a cold

Mayo Clinic notes that symptoms can be so similar that it is hard to tell them apart, and compares them:

• Hay fever: runny nose with thin, watery discharge and no fever; starts immediately after exposure to allergens and lasts as long as the exposure continues.
• Common cold: runny nose with watery or thick yellow discharge, body aches and a low-grade fever; starts 1 to 3 days after exposure to a virus and lasts 3 to 7 days.

Not every runny nose is allergic. Rhinitis can also have non-allergic causes, which our guide on non-allergic rhinitis explains. Feeling better after taking an allergy medicine does not by itself prove that the cause is an allergy. See also allergies versus a cold.

05Daily life

Sleep, work and daily function

Mayo Clinic says hay fever can affect how well you perform at work or school and interfere with daily life. Symptoms can keep you awake or make it hard to stay asleep, leading to fatigue and a general feeling of being unwell. For many people, symptoms lead to missed work or school.

Mayo Clinic notes that many people, especially children, get used to their symptoms and do not seek treatment until they become severe, even though the right treatment might offer relief. Risk factors it lists include other allergies or asthma, eczema, a parent or sibling with allergies or asthma, constant exposure to allergens, and exposure to smoke.

08Treatment

Reducing exposure and treatment options

Mayo Clinic says there is no way to avoid getting hay fever, and the best approach is to reduce exposure to your triggers. NHS inform suggests:

• wearing wraparound sunglasses outdoors
• showering and changing clothes after being outdoors
• staying indoors and keeping windows shut when pollen counts are high
• applying a little petroleum jelly to the nostrils to trap pollen
• wiping surfaces with a damp cloth, avoiding fresh flowers indoors and not drying clothes outside on high-pollen days
• not smoking or being around smoke

NHS inform says there is no cure, but most people relieve symptoms with treatment, mainly antihistamines, which help prevent the allergic reaction, and corticosteroids, which reduce inflammation and swelling. Many are available over the counter. Mayo Clinic advises taking allergy medicines before exposure, as directed by a health professional. A pharmacist or doctor can help choose a treatment that suits your symptoms and health conditions.

09Sources

Where the sources differ

Triggers. NHS inform describes hay fever as an allergy to pollen. Mayo Clinic uses hay fever as another name for allergic rhinitis and includes indoor triggers such as dust mites, pet dander and molds.

Course. NHS inform says hay fever usually begins in childhood or the teenage years and that many people improve with age. Mayo Clinic focuses on how long symptoms last, as long as the exposure continues.

Prevention. NHS inform gives a detailed list of practical steps to reduce pollen exposure; Mayo Clinic emphasizes reducing exposure and taking medicine before it.

10Summary

In summary

Hay fever symptoms include sneezing, a runny or blocked nose, itchy, red or watery eyes, an itchy throat and a cough from postnasal drip. They start soon after exposure to pollen or other allergens and last as long as the exposure does, without the fever and aches of a cold.

Reducing exposure, antihistamines and corticosteroids relieve symptoms for most people. See a doctor if treatment does not help, if you have asthma or sinus problems, or if symptoms get worse. In our ENT practice in Bilbao we assess persistent nasal symptoms in adults (consultations are in Spanish).