For people with hay fever, sunny days lounging on the grass can be anything but pleasant. How can you manage the symptoms without forfeiting summer? As the Met Office issues a “pollen bomb” warning in the UK, allergy doctors advise on the best ways to survive the season.
Watch out for the onset
Hay fever is not experienced from birth, but develops as we age, explains Prof Adam Fox, a specialist in paediatric allergy at the Evelina London Children’s hospital. In the UK, 5% of five- to seven-year-olds and 10% of 10- to 12-year-olds are affected, he says: “You get to the bigger numbers as you get to later teenage years and early adulthood. There are lots of people who don’t get it until they are in their 20s and 30s.” Twenty-five per cent of UK adults are thought to have a pollen allergy.
The condition appears to be growing more prevalent, too, says Dr Sophie Farooque, an allergy consultant at St Mary’s hospital in London and the author of Understanding Allergy. “Climate change is described as Miracle-Gro for plants. They are producing more pollen, so hay fever season is starting earlier and lasting longer,” she adds.
Recognise the symptoms
“It ranges in severity from sneezing, itching and runny eyes to fatigue, rashes and facial swelling,” says Dr Helen Evans-Howells, a GP who runs an allergy clinic in Dorset. She experienced hay fever symptoms from the age of 10, but nothing was done about it. “It settled, partly I think because, as adults, we don’t tend to go outside as much,” she says. “Then I got dogs. I remember being on a video call for an allergy conference and someone saying: ‘Are you having an allergic reaction?’ because my face was swelling. The dogs had carried the grass pollen in with them and were sitting with me.”
Itchy? It’s probably not a cold
“Colds don’t make you itch,” says Farooque. “If you’ve got itchy eyes, throat and inner ears, that should make you think it is an allergy.” The time of year should also be a clue, she says. “If in doubt, you could try taking an antihistamine and see if your symptoms settle down a bit.” If you are still unsure, you can take a test, as Evans-Howells did to confirm it was pollen to which she was allergic, rather than dogs.
Understand what’s happening to your body
“The technical name is seasonal allergic rhinitis, which means inflammation in the lining of the nose due to allergy,” says Fox. “You create allergic antibodies which recognise the specific pollen. They sit in the lining of your nose, lungs and eyes and circulate in your blood. When you start breathing that allergen in, those antibodies recognise that pollen, which triggers a reaction that leads to the release of histamine. When histamine is released in the lining of your nose, it will cause itchiness, sneezing and inflammation. That inflammation will cause the nasal congestion and runny nose that are the hallmarks of hay fever.”
Learn the calendar
In the UK, “if you are allergic to tree pollen, it will cause you trouble from late January through until about April”, says Fox. “If it is grass pollen, it will kick off in April, peak in May and June, then settle down. If it is weed pollen, it might happen a little bit later.” “There are some really unlucky people out there who are allergic to all three,” says Farooque.
Be aware of the serious real‑world effects
“If you are a child with significant hay fever, you are 40% more likely to drop a grade from your mocks, which are typically at Christmas time, to your summer exams, which are in the middle of the grass pollen season,” says Fox. This is mainly because it hampers the quality of your sleep. “That will affect your mood, your ability to concentrate, your learning and your school performance.”
It also affects your reflexes, he says, “to the point that is broadly equivalent to being at the legal limit for drink-driving”.
Manage lifestyle factors
“Some people will advise closing windows and drying clothes indoors, otherwise you’re going to have pollen attached,” says Evans‑Howells. “Shower after a day out and change your pillowcases each day. People often find that they wake up in the morning quite swollen, probably because they’ve laid in the pollen in their hair all night.” Using an air filter in the bedroom may help a more extreme sufferer get better‑quality sleep, she adds.
Evans‑Howells also recommends putting petroleum jelly around the nostrils, an approach with which Farooque agrees: “Put a little at the start of your nose, so it captures the pollen.”
Find medication that works for you
“The medicines are very safe, effective and let you get on with your life,” says Fox. Farooque explains how they work: “Imagine there is a party next door and the sound is coming through. Well, there are different ways that you could approach it. You could put earplugs in so that you don’t hear the sound. That’s what an antihistamine is – it blocks the effects of histamine. Or you could try to break up the party in the first place. That’s what a steroid nasal spray is. It is getting rid of the cause of the problem [by reducing inflammation], which is why they tend to be a bit more effective.”
Dress accordingly
Wear wraparound sunglasses and wide-brimmed hats, advises Evans-Howells: “Anything to try to minimise direct contact with pollen.” Farooque says there is strong evidence for wearing an FFP3 mask: “It has been shown in studies that they will reduce your symptoms.”
Use nasal sprays correctly
“If you start about two weeks before the pollen season kicks in, it becomes far more effective,” says Farooque. “Rinse your nose out with a saltwater rinse. The spray works better if your nose is not snotty, as it allows the medication to be absorbed by the lining of the nose.
“When you put the spray in, whichever hand you use to pick it up, go for the opposite nostril, because that way the nozzle is facing the side of the nose, rather than the bony bit in the middle. When you squirt the spray, do not sniff. If you sniff, you’ll eat the spray.
“The other thing to bear in mind is that antihistamines will work within an hour or so, but if you want to break up that hay fever party, it takes at least a week for the nasal steroid to get going.” In other words, don’t quit before it has had the chance to take action and use it for the entire season, which there is no harm in doing, says Evans‑Howells. She says that her hay fever is “completely controlled” by using a combination nasal spray with steroids and antihistamines.
Avoid drowsy antihistamines
“Avoid the drowsy, first-generation ones such as chlorphenamine – Piriton is the brand name that often gets recommended,” says Fox. “Instead, go for second-generation, non-sedating, long-acting antihistamines such as cetirizine, loratadine or fexofenadine, all of which are available over the counter.” Evans‑Howells says: “If you are already feeling drowsy because of your hay fever, then you’re not going to be helping yourself if you take an antihistamine that is adding to that.”
Bulk-buy generic medication
The choice of antihistamines at the pharmacy can be overwhelming, says Farooque. “Patients will tell me: ‘I always buy brand X or brand Y,’ and there is a belief that since it costs more, it must be better. But the active ingredient, the drug, is the same. You’re not getting anything different from the product that’s not branded.” Stock up on cheaper generic medicines online.
If over-the-counter options don’t work, see a GP
“If you’ve already used the nasal spray and antihistamines and it is still affecting you, then, as per the NHS guidelines, that would warrant a referral to an allergy team for further assessment for immunotherapy,” says Evans-Howells. “You just have to be a bit pushy and ask for it.”
Fox adds: “For most people, antihistamine and nasal spray will do the job. But there are a group of people who, despite that, still really have a miserable time of it. There are fully licensed medications called sublingual immunotherapy that will really help them. These are grass pollen or tree pollen tablets made of huge doses of the pollen that they are allergic to, which they can put under their tongue from a few months before the season starts. It will retrain their immune system so that they are less sensitive and less allergic to the pollen. Consequently, their symptoms will improve and they will be less reliant on suppressing medication.”
For short-term relief, consider oral steroids
Fox describes a scenario in which a family is worried about a teenager who has an important exam and is really suffering: “Then there’s nothing like a short course of oral steroids to just reset the system.” These can be prescribed by a GP for “severe, uncontrolled symptoms that are significantly affecting quality of life”, according to National Institute for Health and Care Excellence guidelines.
However, Evans-Howells cautions: “Please don’t get Kenalog [triamcinolone acetonide]. Yes, it works, but the risks from it are huge – cataracts, glaucoma, joint damage – which is why the NHS doesn’t prescribe it. Unfortunately, there are some private GPs who still think it’s acceptable to do so. I would never have it – and I’ve suffered really badly in the past.”
Monitor the pollen count
“People like to know the pollen count so that they can feel prepared,” says Evans-Howells. “We’d like you to be in a position of symptom control so that it won’t matter to you whether the pollen count is high or low, because we have your symptoms better managed in the first place. But if you know the pollen count is going to be really high, maybe this isn’t the day that you’re going to take a walk in the long grass.”
The perfect conditions for hay fever are warm and windy, says Fox. “The temperature causes trees and grass to release their pollen. If it is a bit breezy, it blows it around.” Hay fever symptoms can worsen when pollution is bad, he adds: “It gets further into airways when it is combined with particulate pollution.”
Eating local honey won’t help
People often suggest eating local honey. Is there anything in that? “There is no evidence that would help,” says Evans-Howells. “Honey is made from bees pollinating flowers; the problem we have is with tree and grass pollen. It doesn’t make sense.”
Be wary of online algorithms offering solutions
“They are very clever,” says Evans-Howells. “As soon as you start looking at hay fever, you will be shown the same advert time and time again, which plays on your psyche to think: ‘Oh, it must work.’ But do some research. I acknowledge that not everybody in society likes traditional medicine. Some people will go for quercetin, which is meant to be a more natural antihistamine, but the clinical trials don’t support its benefit, so it’s not something that I recommend. But some people report it helps them.”
Don’t go out in thunderstorms
“If you’re allergic to grass pollen, some thunderstorms can cause the pollen to fragment. When you breathe it in, it can then give asthma-type symptoms,” says Farooque. “Don’t go running, keep your windows closed and wear a mask if you need to go out during the storm or for an hour or so afterwards.”
Be sympathetic
“Be kind, because it is horrible,” says Evans-Howells. “It makes you really fearful of this time of year, which sounds ridiculous if you don’t have allergies, but nobody wants to be swollen and have itchy eyes. As more people are affected, the thing I hear is: ‘I had no idea this is how it felt. It is awful.” How it feels when you’re at the peak of a cold – congested, can’t breathe, can’t sleep – that’s how they are feeling, but for the whole of the time that is meant to be enjoyable in the year.”
How can you help them? “Maybe cut your lawn before they come round; reducing the length of the grass might help. But I think mostly allergy sufferers would just love people to have some compassion.”
Go to the coast
“Think about how you are going to plan your days out, perhaps being by the seaside, rather than a picnic in a park”, says Evans-Howells. Farooque adds: “If I could prescribe holidays by the beach, I would. As a general rule, if you’re by the coast, especially if there’s an onshore wind and the pollen is blown out, you will be less symptomatic.”
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• This article was amended on 11 April 2025. An earlier version stated that “5% of those affected are five- to seven-year-olds and 10% are 10- to 12-year-olds”; in fact, those figures represent the percentage of those age groups estimated to suffer from hay fever.
