Professor Mimi Tang is the Director of the RCH Department of Allergy and Immunology and the Group Leader of Allergy and Immune Disorders at the Murdoch Childrens Research Institute and the University of Melbourne Department of Paediatrics.

We have now entered the start of the hay fever season, as the most common allergic trigger for hay fever in Victoria is grass pollen. Grass pollen levels start to rise from October, and peak in December and January before declining during February.

Hay fever symptoms include sneezing, itching of the nose, runny nose, itchy eyes, blocked nose (congestion) and mouth breathing. Poorly controlled hay fever symptoms can lead to poor sleep, snoring, poor concentration, headaches, sinus problems and ear infections or fluid in the ears.

If you or your child has hay fever you might notice that symptoms worsen over the spring and summer months, and are particularly bad in December and January on those hot blowy north wind days, as these days are when grass pollen counts are highest.

Here are some tips on how to manage hay fever symptoms:

• Speak to your doctor about available medical treatment, such as the use of topical corticosteroid nasal sprays and antihistamine medications, which can dramatically improve symptoms. Topical corticosteroid sprays are the first line treatment recommended for people who have symptoms of nasal congestion (a feeling of having a blocked nose) or other persistent symptoms (present for more than four days a week on more than four weeks of the year) or for symptoms that are particularly bothersome and affect daily activities.
• Remember that the corticosteroid spray acts to prevent symptoms from developing, so just as for asthma preventer treatments, it is important to use the topical nasal corticosteroid spray every day to achieve the best effect from this treatment.
• Your doctor may have explained that it is important to start corticosteroid nasal spray in September before symptoms become noticeable as this will provide more effective control and protection against symptoms than waiting until symptoms are noticed before starting the nasal spray. This is because of the ‘priming effect’ which means that once inflammation sets in, then lower amounts of pollen can trigger symptoms. So if you can prevent the inflammation from getting started, higher levels of pollen can be tolerated without symptoms.
• Antihistamines can be used to control sneezing, itching and runny nose but do not help with nasal blockage. Antihistamines can be used as needed when symptoms of sneezing, itching or a runny nose develop and can help control milder cases of hay fever. They can also be used together with a daily corticosteroid spray if sneezing, itching or a runny nose develop.

Other things you can do (in addition to topical corticosteroid nasal spray and antihistamine medications) to help reduce symptoms include:

• Keeping windows and doors shut to avoid pollen coming into your home, particularly on those hot blowy days.
• Drying your clothes indoors.
• Keeping car windows closed and the ‘air recirculation’ option activated in your car during the pollen season to avoid pollen coming into the car.
• Wearing sunglasses on hot blowy days.

So, why is it important to treat hay fever symptoms?

Symptoms from hay fever have been shown to reduce school performance and concentration, disturb sleep, cause breathing problems and make asthma worse. The effect on asthma is especially a problem if your child also has food allergy – this is because poorly controlled asthma is known to be a risk factor for having a more severe allergic reaction to food (anaphylaxis) and also a risk factor for fatal anaphylaxis to food.

For more information you can read our parent information sheet on hay fever here.