Millions of people worldwide suffer from seasonal allergic rhinitis caused by pollen or other allergens. Common symptoms of seasonal allergic rhinitis—often referred to as hay fever—are sneezing, runny nose, itchy and watery eyes, and nasal congestion.
“People can get postnasal drip, and itching of the palate or throat can occur as well, but those nasal symptoms are the hallmark features of seasonal allergic rhinitis,” explained Anne Ellis, MD, FRCPC, FAAAAI, a professor of medicine and chair of the Division of Allergy and Immunology at Queen’s University in Kingston, Ontario.
Allergies or COVID-19?
Yet how do the symptoms of COVID-19 and seasonal allergies differ? “Hay fever will cause those nasal symptoms, and you might get a bit of a cough from postnasal drip, but with a viral infection, you could have a fever, a sore throat, and/or muscle aches and pains,” said Dr. Ellis.
And despite seasonal allergic rhinitis often being called hay fever, fever is not a symptom. “That’s just the way the term was coined back in 1867 by Charles Barkley,” emphasized Dr. Ellis.
While the pollen counts and seasons will differ depending on where you live, not all pollen causes symptoms. “Pine pollen is bright yellow, and you’ll often see a dusting on cars each morning, causing people to worry about how symptomatic they’re going to be. However, this pollen isn’t inhaled very well because it is so heavy. It tends to fall to the ground and doesn’t end up in our mucosal surfaces. It’s the wind pollinated lighter pollens that get blown around and cause symptoms,” said Dr. Ellis.
Treatment for seasonal allergic rhinitis
Treatment options for seasonal allergic rhinitis include medications such as over-the-counter (OTC) second generation (non-sedating) anti-histamines and nasal steroids. “Although, don’t expect immediate relief from one spray of a nasal steroid. You must use it daily to get the best benefit, so keep it next to your toothbrush and build it into your morning routine,” suggested Dr. Ellis. There are also prescription versions of these medications available.
For those still struggling with persistent symptoms, finding out what you are allergic to can help. “Let’s say someone has a lot of symptoms first thing in the spring. You might assume it’s due to tree pollen, but if you haven’t been tested, it could be some of these seasonal molds that are causing your issues. And if you are going to pursue something like immunotherapy as a treatment, you need to know precisely what you’re allergic to, because that will change the formula your allergist will recommend for managing your symptoms,” said Dr. Ellis.
“The goal of immunotherapy is to induce a shift in your immune response from one that’s allergic, where you get all the symptoms you’re currently experiencing, to one that’s more tolerant so that you’re able to inhale your allergens and tolerate them better,” added Dr. Ellis.
There are two forms of immunotherapy: subcutaneous (allergy shots) and sublingual (a tablet that dissolves on the tongue). “You can put all the allergens a person needs to be desensitized to in the allergy shot. Whereas with the tablets, it’s one tablet for one type of allergen, and there are only three tablets currently available in the United States and four in Canada for certain types of allergens,” said Dr. Ellis.
Other allergy treatments
Non-medication therapies include saline rinses and avoidance strategies such as keeping your windows closed and running your air conditioning on days when pollen counts are high, taking a shower and changing into clean clothes if you have to go outdoors, and avoiding hanging clothes outside to dry. If you are wearing a mask during the pandemic, this might provide a physical barrier from the pollen, but it will not help when it comes to the eyes. And contrary to popular belief, eating local honey will not cure seasonal allergies caused by pollen.
“With seasonal allergies or allergic rhinitis in general, it’s not just a sneeze and sniffle. This disease carries serious quality of life burden for a lot of patients who suffer from it, so don’t be afraid to seek out an allergist and get relief,” stressed Dr. Ellis.