How to treat hayfever and who can help

Hayfever symptoms can range from mild, moderate to severe. If your hayfever affects your day-to-day activities when your symptoms are at their worst, then you may need treatment for moderate to severe hayfever.

There are also practical things you can do to manage your symptoms.^1,2 If you know what causes your hayfever, avoiding or minimising your exposure to these triggers is an important first step to reducing hayfever symptoms.^1-3

It can be difficult to completely avoid hayfever triggers that can cause troublesome symptoms and affect your day-to-day living, so understanding your treatment options is important.^3,4

Several treatment options are available for the relief of hayfever symptoms.^2,4,5

There are many hayfever treatments available. To find one that’s right for you, start by choosing a treatment that matches severity of your hayfever.

Non-drowsy antihistamine nasal sprays or tablets

By themselves can effectively relieve mild hayfever symptoms.² Antihistamine nasal sprays may work faster and more effectively than antihistamine tablets for treating a blocked nose caused by hayfever.⁴ Antihistamine nasal sprays are fast-acting. They act in 15–30 minutes and can provide immediate relief of symptoms compared with tablets, which have a longer onset of action of 1–2 hours.^5,6Both tablets and nasal sprays can be used as needed or on a regular basis when symptoms are persistent.⁴

Allergy eye drops

Work directly on the eye to relieve allergy symptoms such as watery, itchy eyes.² Antihistamine eye drops work better for hayfever eye symptoms compared with antihistamine nasal sprays or tablets. They also have a faster onset of action for eye symptom relief compared with intranasal corticosteroids.⁷

Steroid nasal sprays

Are more effective in reducing nasal congestion than antihistamine nasal sprays or tablets. They contain a steroid medicine that helps control inflammation in the nasal lining.^3,5 Steroid nasal sprays are also called intranasal corticosteroids (INCS).

They are useful for people who experience intermittent or persistent moderate to severe hayfever symptoms, but they must be used regularly to be effective.² They may take several hours or days to begin clearing symptoms. Some are available in pharmacies as over-the-counter medicines and others are prescribed by a doctor.⁵

Steroid nasal sprays can be used alone or in combination with oral antihistamines.³ However, the combination of steroid nasal sprays with oral antihistamines may not offer any advantage over steroid nasal sprays alone.⁷

Combination nasal spray

If your hayfever is impacting your day-to-day activities when your symptoms are at their worst, you may have moderate to severe hayfever.

For patients with moderate to severe hayfever, a combination nasal spray containing antihistamine and corticosteroid (INCS) offer the combined advantages of both medications and is more effective than INCS or intranasal antihistamine administered separately.⁷ Dymista^® Allergy is currently the only over-the-counter combination nasal spray in Australia.

Other treatments to help relieve hayfever symptoms can include:

Saline irrigation

May help to wash away allergens (e.g. pollen) and inflammatory mucus in the nasal passages.^2,5,8 Saline nasal sprays may be used alone or in combination with other treatments.⁸ If using a saline irrigation, wait 10 minutes before using your nasal spray.⁹

Nasal decongestants

May be recommended for short-term use. If you have severe nasal congestion, they may be used for 3–5 days only.²

If you have asthma and hayfever, ensure you have spoken to your doctor regarding management and up-to-date treatment plans for both conditions. Prescription hayfever medicines are also available, speak to your doctor or pharmacist about options.

Duration of treatment

How long you need to take hayfever treatment will depend upon your symptoms:

If you have persistent hayfever symptoms, otherwise known as perennial allergic rhinitis, it is recommended that you take your medication all year round.
If you have hayfever symptoms from time to time only, otherwise known as seasonal allergic rhinitis, treatment is only needed when you are exposed to the trigger during the season.¹⁰

It is also important to ask your pharmacist or doctor:

How you should use the treatment
How long it takes for a treatment to start to work
How long it takes to reach its maximum effect
How long you should use your treatment for

Seek help from your doctor

If you are not sure what causes your hayfever symptoms or cannot find relief, it is a good idea to see a doctor.^11,12 It is also important to seek medical advice if hayfever symptoms are burdensome when they are at their worst, such as:

Making sleep difficult
Getting in the way of daily activities
Impacting your work or social life.¹²

Your GP can recommend treatments or allergy tests or refer you to an allergy specialist.

An allergy specialist, also known as an allergist, may have additional treatments to offer. If hayfever symptoms remain severe despite appropriate medications, they could recommend immunotherapy.⁵ Immunotherapy is a treatment that teaches your immune system to be less sensitive to certain allergens that trigger hayfever. It is also called ‘desensitisation’.^5,8

Desensitisation is reserved for people with severe hayfever that cannot be controlled by avoiding allergens and using hayfever medicines.^2,3 It is a long-term treatment and is available through an allergy specialist only.²

Learn more about when to see an allergy specialist

Your doctor or pharmacist can give you advice on which treatment is most appropriate for you, depending on the severity of your symptoms, how often you experience them and other medical conditions.

References

Australasian Society of Clinical Immunology and Allergy (ASCIA). Allergen Minimisation. Available at: https://www.allergy.org.au/images/pcc/ASCIA_PCC_Allergen_minimisation_2019.pdf Accessed: August 2023.
Australasian Society of Clinical Immunology and Allergy (ASCIA). Allergic Rhinitis (Hay Fever). Available at: https://www.allergy.org.au/images/pcc/ASCIA_PCC_Allergic_Rhinitis_2019.pdf Accessed: August 2023.
Small P et al. Allergy Asthma Clin Immunol 2018;14(Suppl. 2):51.
In: eTG complete [Internet]. Melbourne: Therapeutic Guidelines Limited. Available at: www.tg.org.au.
Australasian Society of Clinical Immunology and Allergy (ASCIA). Allergic Rhinitis Clinical Update. Available at: https://www.allergy.org.au/images/stories/pospapers/ar/ASCIA_HP_Allergic_Rhinitis_2022.pdf Accessed: August 2023.
Azep^® Nasal Spray Product Information.
Bousquet J et al. Nat Dev Dis Primers 2020;6(1):95.
Head K et al. Cochrane Database Syst Rev 2018;6(6):CD012597.
National Asthma Council Australia. Intranasal spray technique for people with allergic rhinitis (2017). Available at: https://www.nationalasthma.org.au/living-with-asthma/resources/health-professionals/information-paper/intranasal-spray-technique Accessed: August 2023.
Bosnic-Anticevich S et al. Allergy 2019;74(7):1219–1236.
Mayo Clinic. Hay fever. Available at: https://www.mayoclinic.org/diseases-conditions/hay-fever/symptoms-causes/syc-20373039 Accessed: August 2023.
Cleveland Clinic. Allergic Rhinitis (Hay Fever). Available at: https://my.clevelandclinic.org/health/diseases/8622-allergic-rhinitis-hay-fever Accessed: August 2023.

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