hay fever

Synonyms in a broader sense

Allergic rhinoconjunctivitis, allergic rhinitis and pollen allergy

definition

Hay fever is a disease of the upper respiratory tract that is triggered by inhaled substances (allergens), which occurs more frequently every season and which causes inflammation of the mucous membranes.
Hay fever belongs to the group of diseases of the so-called atopic group of forms, which also includes allergic bronchial asthma and atopic eczema (synonym: neurodermatitis).

Symptoms

Typically, hay fever occurs seasonally at the same time. It always shows up when the pollen that you are allergic to is flying.
Depending on which pollen you are allergic to, the symptoms can recur in spring, summer or even autumn. The complaints are more pronounced, especially at night and in the morning hours, since these are the peak periods of pollen count.

There are a few signs and behaviors that can be used to identify hay fever.
For example, one often has watery and itchy eyes. People rub their eyes more often and some complain about sensitivity to light and glare. In addition, some may sometimes notice a slight deterioration in vision.
If allergic conjunctivitis occurs as part of hay fever, the eyes are often stuck together, especially in the morning. Sometimes this is so pronounced that you cannot open your eyes. Furthermore, it can be that you have a stuffy, constantly runny nose. The nasal secretions are usually watery and transparent or colorless. Often you sniff and pull your nose up.
Sometimes those affected also report that they can no longer smell and / or taste good or not at all.
Some seem to have less appetite. This can be due to the reduced taste or the fact that one has stomach pain. If the pollen is swallowed, it can also lead to stomach problems and diarrhea.
Snoring at night can also occur during the "allergy times" of some people affected. As it is often difficult for them to breathe through their noses, they can be noticed by an open mouth. Often you are particularly thirsty in the morning, as the mucous membranes dry out more intensely at night. In addition, severe sneezing attacks are not uncommon.
Some are still very active, others complain of fatigue and exhaustion and seek peace. A fever can also occur as part of hay fever.

If the symptoms mentioned show up in this way all year round, then an allergic runny nose should be ruled out as part of a house dust mite allergy. If the symptoms occur when the person concerned is in contact with a certain animal or animal hair, an animal hair allergy should be considered.

Read more about the topic here: Symptoms of hay fever

Hay fever with cough

A cough is common with hay fever. It may be due to an irritated throat from breathing through the mouth. This can lead to a dry, tickly cough. But there can also be a slimy cough if mucus builds up in the throat. Mouth breathing and irritated throat also make you more susceptible to bacteria, which can make your cough worse, and you are more susceptible to colds.
However, hay fever occurs in some people combined with asthmatic symptoms. As part of the asthmatic symptoms, in addition to coughing, wheezing and shortness of breath occur. If there is also a cough with hay fever, one should be careful to see whether there is also asthma, which should be treated.

Sore throat from hay fever

Hay fever primarily affects the nose and eyes, but symptoms in the throat can also express themselves. On the one hand, there may be an uncomfortable scratching and a dry throat. There is also an itchy and sore throat.
One reason for this is that breathing through the open mouth is due to the swollen nose. As a result, the mucous membranes dry out. In addition, the filter function of the nasal mucous membranes is missing. This makes it easier for bacteria or viruses to settle in the throat and thus lead to further complaints. Over time, inflammation and a sore throat can develop.
The complaints in the throat can be perceived as very unpleasant - especially if they are particularly severe and lead to swallowing difficulties. To combat dryness in the throat, it helps to drink a lot or gargle with salt water.

Fatigue from hay fever

Hay fever does not necessarily lead to fatigue. In the case of severe allergies, however, the immune system is very active and robs the body of a lot of strength and energy, as is the case with a normal cold.
This leads to tiredness and weakness. Physical performance is also limited. Therefore, you should be careful not to overload yourself when exercising.
If you suffer from hay fever and tiredness and at the same time take medication for hay fever, e.g. so-called antihistamines, it is worth taking a look at the list of side effects of the drug. Because fatigue is a possible side effect of antihistamines. However, there are differences among antihistamines in how strongly they cause fatigue. If necessary, a discussion with the treating doctor is recommended for clarification.

a headache

The swollen nasal mucosa and eyelids cause a feeling of pressure, so that headaches often accompany hay fever. The headache may manifest as aching pain behind the eyes or inside the head.
Sometimes hay fever can also trigger migraines. The exact connection is not clear. The headaches are then very strong and are accompanied by other complaints, such as sensitivity to light and noise.
Decongestant medication for the nasal mucosa can reduce the pressure and thus the headache.

skin rash

Rashes and itching are a very common and typical symptom of allergies. These can also occur in the context of hay fever. Sometimes hives can also develop. Here, flat red protrusions appear on the skin that are very itchy. People who are already affected by hives or neurodermatitis suffer more from them during the pollen season.
There are also contact allergies, in which skin contact with certain grasses causes a rash.

Hay fever in children

Hay fever is one of the most common childhood allergies. The Robert Koch Institute reported that the number of allergy sufferers in childhood continues to rise. From the age of 10, the allergy usually sets in. However, the symptoms often only become more pronounced in adolescence. But there are also toddlers and even babies who already develop hay fever.

Not only are the unpleasant to agonizing symptoms of hay fever troublesome for the child, they are also severely restricted in their everyday lives. His physical and mental capabilities can be enormously reduced by the hay fever. According to statistics, there is an increasing trend towards younger sufferers.

The earlier hay fever occurs, the greater the likelihood that secondary diseases can develop.
Hay fever can often lead to allergic asthma. It is therefore extremely important to address this early on. Adequate management and treatment of hay fever in children can prevent consequential damage.
Every third child with hay fever develops allergic asthma, which in turn increases the risk of other diseases.
To prevent this from happening, it is necessary to recognize the allergy at an early stage. Parents naturally play an important role in this.

You can find out more about the topic here: Hay fever in children

therapy

The basis of any good treatment for hay fever is the adequate handling of the pollen, the pollen count and the pollen count calendar.

So the first step is to avoid the pollen you are allergic to as much as possible.
This is known as allergen avoidance.
If this is not enough, home remedies, homeopathic or medicinal treatment can have a supportive effect.
The drug treatment of hay fever is in principle similar in adults and children. However, not all drugs are suitable for children.
So-called mast cell stabilizers are recommended as a preventive measure before the outbreak of hay fever. They are only used locally, i.e. in the form of inhalations, eye drops or nasal sprays. The mechanism of action of mast cell stabilizers has not yet been fully researched.

To alleviate the symptoms of an allergy that has already broken out, antiallergic drugs are used in the form of tablets, ointments, eye or nose drops. These are known as systemic and local antihistamines.
They inhibit what is known as histamine and can thus minimize allergic symptoms. However, certain substances can make you very tired. This can affect a child's concentration and everyday school life.

In the case of hay fever, eye drops with an active ingredient from the group of antihistamines are also used to alleviate the discomfort in the eyes, including Livocab® eye drops. Read more about this at: Livocab® eye drops against hay fever

Local cortisone preparations, for example in the form of ointments, can also have an anti-inflammatory effect. Systemic cortisone preparations can be used briefly as shock therapy. These can cause some undesirable side effects, especially with prolonged use. Further dehydration of the mucous membrane and nosebleeds can occur after only a short application. In addition, so-called alpha-sympathomimetics can have a short-term supportive effect when the nose is blocked and so-called anticholinerigka run against the nose. But both can also lead to all sorts of undesirable side effects. The decisive factor is the dose, the type and duration of the treatment and should be carefully considered, targeted and carefully selected.

Read more about the topic here: Therapy of hay fever

Hay fever is probably the most common area of application for Vividrin® eye drops. This allergy-related disease causes discomfort to the eyes and nose when the responsible pollen is distributed through the air. Read more on the subject below: Vividrin acute eye drops and Vividrin acute nasal spray

Desensitization / desensitization

Desensitization, also known as desensitization, is probably one of the few ways to permanently alleviate the symptoms of hay fever.
Desensitization does not treat the symptoms of hay fever, but rather combats the cause. If the substance causing the allergy has been identified through allergy tests, it can be used.
The allergy-causing substance is injected as a highly diluted solution to the person affected, initially once a week, then usually once a month for 3 years.
The concentration is increased individually every week. The aim is for the immune system to slowly get used to the trigger for the allergy and thereby turn off its excessive reactions.

This method is also possible with children. It is considered to be promising in children, as their immune system is still strong and flexible. Furthermore, the children usually only suffer from one allergy at first, so that treatment is easier than if several allergies have accumulated in later years. However, desensitization is usually only carried out from the age of 5, as there are still no well-founded studies on the effects and side effects of desensitization in children under five.
In addition, monthly injections can be problematic for the younger children. There is an alternative to syringes, known as sublingual immunotherapy, but this is controversial. With this method, the allergen is dripped or given under the tongue as a solution or tablet for over 3 years. Some studies showed only mediocre effectiveness. How this is to be explained and what possibilities for improvement there are is still being researched.

You can find more information on the subject here: Desensitization for hay fever

Medicines for hay fever

Antihistamines

Antihistamines in tablet form start to take effect after about one to two hours and last for about 24 hours, so taking them once a day is sufficient. It is advisable to take the drug in the evening before going to sleep, as antihistamines can rarely make you tired.
In addition to antihistamines in tablet form, there are also locally applicable medicinal substances for ingestion in acute complaints and for rapid symptom relief, mostly the active ingredient Azelastine contain. This is used in the form of eye drops and nasal sprays. The local use of the drug means that side effects occur far less often than with oral antihistamines and the onset of action is achieved after a few minutes, but the effect does not last as long.

In the case of locally applicable antihistamines, care should be taken to buy products that do not contain preservatives, as these can also trigger allergies.
The suitability of the respective active ingredients and the correct dosage for children should be read in the package insert.
Contraindications for the administration of antihistamines of the first generation are existing prostate hypertrophy and narrow-angle glaucoma, as these can exacerbate the symptoms.
Other side effects can be: dry mouth, possibly in combination with a dry cough and allergic reactions to antihistamines.

With all antihistamines listed here, it should be noted that they should generally not be used during pregnancy and breastfeeding.

Read more on the topic: Antihistamines
In the case of hay fever, eye drops with an active ingredient from the group of antihistamines are also used to alleviate the discomfort in the eyes, including Livocab® eye drops. Read more about this at: Livocab® eye drops against hay fever

Cortisone

Corticoids are usually used for hay fever in the form of nasal sprays, which help improve the local inflammatory response. Since these sprays hardly help with itchy and watery eyes, a combination with antihistamines is recommended in this case. Corticoids in syringe or tablet form can be given at short notice to initiate therapy in very severe cases, but are not a recommended standard medication due to the increased risk of side effects.
However, the effect of the locally used corticoids only sets in with a certain delay, i.e. after hours or even days.

At the beginning of therapy with cortisone and if the symptoms are very pronounced, double the dose can also be used as an exception for the first two weeks. Possible side effects when using cortisone-containing nasal sprays are dry nasal mucous membranes with increased nosebleeds and headaches.

In order to avoid damage to the nasal mucosa from the outset, it is recommended not to use these sprays for a long period of time.

Read more on the topic: Nasal spray with cortisone

Mast cell stabilizers

It can, however after inhalation to a bad taste in the mouth and one Irritation of the nose, of Pharynx and the windpipe come, which can be accompanied by an urge to cough and a reflex narrowing of the airways.

Mast cell stabilizers are pronounced bad through the intestines into the body recorded, why just a local application, for example in the form of Sprays, makes sense. The swallowed portion is almost completely excreted through the stool.

eye drop

If your eyes are dry, burning, itchy, and sore, it can help to keep them moist. In this case, eye drops can have a soothing effect.
Here it is recommended to use eye drops with natural active ingredients if possible.
Furthermore, similar to the nose drops, there is a wide range of different antiallergic eye drops.
Especially in children, due to dosing problems, we advise against using some ingredients in eye drop and nasal drop form.

Nasal spray

For some people with a blocked, swollen nose, nasal sprays or drops help to reduce the swelling of the nasal mucous membrane.
As a rule, one puff should be given into each nostril 3 times a day.
It is important to pay attention to the ingredients, at best nasal sprays with physiological saline solution should be used. There is also a wide range of antiallergic nasal drops with different ingredients. Several drugs should not be taken in a row.

Furthermore, permanent use of nasal sprays is not advisable, especially if they contain chemical substances. If used for more than a week, the nasal mucous membranes can dry out and become inflamed.

Read more about: Nasal sprays

Home remedies

There are some home remedies that can relieve hay fever symptoms in both children and adults.
For example, a saline steam bath can reduce itching of the nose and eyes.
A damp cloth or washcloth on the eyes can reduce the itching of the eyes. For this, you can simply use cold water or water with a little eyebright.
Also, nasal rinsing with table salt can relieve itching by flushing out the pollen in your nose.

Moist room air can also be beneficial for dry nasal mucosa. Some of those affected also find essential oils such as peppermint oil as a fragrant room humidifier pleasant.
Because the pollen builds up in your hair, taking a shower with intensive head cleaning before bed can be soothing.

If the bronchi are also affected, a bath with eucalyptus, fennel or dill oil can have a calming effect on them. A healthy diet, rich in vitamins and varied, containing zinc and histidine, can also reduce allergy symptoms.
Sufficient fluid intake is also important to moisten the mucous membranes. If you have poor eyesight, it is advisable to wear glasses instead of contact lenses during the allergy period.

Ginseng, which can be steeped in hot water, can help against tiredness and fatigue. Frequent hair washing and cleaning is recommended to keep exposure to pollen to a minimum. Fresh air also alleviates the symptoms. In the city, it is best to ventilate the room in the morning and in the country in the evening, since there is very little pollen at this time. It is also advisable to avoid stress, eat a healthy diet and drink plenty of water.

homeopathy

Homeopathic treatment can help with hay fever. Different substances are recommended depending on the symptoms.

For example, Allium cepa is used when the symptoms worsen when exposed to heat. Instead, Arsenicum album is recommended if the symptoms worsen in the cold. Aralia racemosa is also recommended if you experience sneezing attacks and irritable coughs with difficulty breathing. It is recommended to take 5 globules in the potency D 6 every 2 hours for the first 12 hours. Then 5 globules should be taken 3 times a day.

In the case of pronounced runny nose with watery secretion, potency D12 is recommended in some cases. Homeopathic remedies can also have a preventive effect. For example, Thryallis glauca is recommended in the potency D4 or D6 3 times a day.

As a preventive measure, before the allergy season, 5 globules of pollen 30C are recommended once a week. The homeopathic treatment should always be done individually and be instructed by a specialist.

Hay fever and bronchial asthma

Many people suffer from hay fever, but only a fraction of it is adequately treated. Many simply endure the symptoms because they trivialize the disease or find it tolerable.
However, hay fever is not quite as harmless as is generally assumed, since it carries the risk of developing into allergic asthma if it is not adequately treated.
It is not known exactly why some people develop allergic asthma and others develop allergic rhinitis (hay fever), a genetic disposition probably plays at least a role. It is also not known why some of the hay fever develops into allergic asthma while others do not. However, hay fever is considered to be the biggest risk factor for developing allergic asthma.
In this case one speaks of a change of floor: The inflammation of the upper respiratory tract upon contact with the triggering allergen gradually spreads towards the lower respiratory tract.
The symptoms range from coughing, shortness of breath and, in the worst case, even to respiratory failure. The inflammation, which triggers swelling and secretion production of the mucous membranes in the upper area of the airways, can also do this in the lower area of the airways, the bronchi. In these, however, the diameter is often relatively small. As a result, some sections swell up completely due to the inflammatory reaction and / or are additionally relocated by secretion; cramps of the muscles around the airways are also possible. Thus, the connected lung areas are cut off from the air supply and the remaining air cannot be exhaled, or only with difficulty. This leads to attacks of shortness of breath, which occur particularly often at night.
Such an asthma attack should be treated immediately because in the worst case it can be life-threatening.
In addition to the assumption that the inflammation is migrating down the airways, another explanation is plausible: Due to the swollen nasal mucous membranes, the affected patients breathe in more often through the mouth, the allergens and especially pollen get deeper into the airways, which makes them possible Allergens are more exposed than before.
Another explanation is based on the fact that the allergen composition has changed in the meantime. New plants have been introduced into our latitudes, for example ambrosiathat release strong allergens that interact with the pollen of other plants, such as mugwortCause cross-reactions and thus result in more aggressive courses. In addition, the allergen load is increased by the changed lifestyle.
Air pollutants such as fine dust and diesel soot in particular attach to the pollen and can lead to an increased and more frequent allergen response. The symptoms of hay fever, which are tolerable at the beginning, can develop into a very unpleasant disease that can severely impair the quality of life.
However, by treating the hay fever early and during the hay fever season, it is possible to prevent the development of allergic asthma in this way. Although neither can usually be cured, there is at least the possibility of immunization with hay fever. Treatment prevents the development of more serious complications, such as the later development of chronic bronchial asthma.

Read more on the topic: bronchial asthma

Hay fever in pregnancy

During pregnancy, the concentration of the so-called estrogen is increased.
Among other things, this hormone causes the nasal mucous membranes to swell and the nose to become blocked.

If there is now hay fever, the symptoms are even worse. Every 4-5. Woman suffers from hay fever during pregnancy.
First you should try to avoid allergens as much as possible. Before going to bed, hair should be washed to remove the pollen.

Since stress often increases allergy symptoms, it should be reduced as much as possible.
If the symptoms of the allergy are very pronounced and no home remedies provide relief, certain anti-allergic medications may also be taken. However, this should be considered as a last resort. A detailed consultation from the gynecologist is advisable. The extent to which an antiallergenic diet for pregnant women can prevent allergies on the unborn child is still being researched and discussed controversially.

causes

Hay fever is triggered by pollen from those plants that are pollinated not by insects but by wind - the latter are called “anemophil” in botanical terminology.
In spring, the pollen from alder, hazel and birch are the main causes; in summer it is the pollen from grass and rye.
With an appropriate genetic disposition (medical: disposition), the mucous membranes are so sensitive (medical: "sensitized") that only a few, in extreme cases 5-50 individual pollen can cause the symptoms typical of hay fever (see below).
It should be noted that a multiple of this amount is inhaled daily (more than 5000 pollen), which is the only form of treatment that addresses the basic problem of allergies (medical: "causal therapy"), i.e. the avoidance of the triggering allergen makes it difficult or impossible - a single ear of rye already contains more than 4 million pollen!
Hay fever can also occur in autumn: the pollen that causes it is herbs such as mugwort and plantain.
The plantain is also known in medicine for another effect on the human organism: The leaves of this annual or perennial, including Herbs native to Europe have a hemostatic effect and promote wound healing. Sometimes they are even used as food in the form of salads or side dishes.

Read more on the topic: Cross allergy

frequency

Between 15% and 25% of the population are affected in western, “civilized” countries. The disease is even more common among adolescents, at over 30%.
As a result of a changed lifestyle, hay fever and allergic diseases are on the increase.

diagnosis

Basically, as with any allergy, hay fever is detected according to a scheme with up to four levels:
The medical history (anamnesis) of the patient, who describes the above-mentioned complaints, is fundamental for the doctor in recognizing a pollen allergy.

Read more on the topic: Allergy diagnostics

Prick test

This is followed by a physical examination that includes, in particular, the examination of the nasopharynx and the eyes.
An existing allergy can also be proven by various tests: The principle of the prick test consists in applying a small amount of the suspected allergen in the form of a standardized, laboratory-made solution to a puncture site created by a fine lancet on the inside of the forearm to apply and assess the skin reaction after a quarter of an hour.
The test is then considered “positive” in the sense of an existing allergy (not as a rating!) If a relevant reddening and swelling (wheal) occurs. The prick test is now the routine and by far the most frequently used test; Alternatives such as the scratch test (using the unchanged allergen, not a standardized extract solution) or the much less reliable rub test (the unchanged allergen is rubbed over the intact skin on the inside of the forearm) are rarely used.
The prick test is also a non-specific search test for suspected illness, just as it is carried out to confirm a justified suspicion of allergy to one or more specific substances.

You can find more information on our website: Prick test

RAST test

For all skin tests, however, the fact that sensitivity (medically: sensitization) proven in this way does not yet have any disease value in itself; Only the existence of complaints with a positive test result allows an allergy to be diagnosed.
If a skin test is inconclusive or cannot be carried out (e.g. for infants), a blood test can bring further clarity: The principle consists of detecting the proteins formed by the immune system that are specifically directed against the triggering allergen (and then as so-called specific IgE antibodies are designated).

There are many different methods available for doing this. The best known is the RAST (abbreviation for Radioallergo-Sorbent Test). Existing IgE antibodies are detected by means of other proteins that are structurally similar to the allergen and labeled with a radioactive substance. (The chemical similarity is usually limited to certain sections, so-called epitopes, and is the cause of the specific binding of the IgE antibodies sought.)
In detail, this works as follows: The doctor takes blood from the patient. The serum, which has been cleaned of solid components, is applied to an industrially prefabricated disc coated with the allergen to be detected (medical: incubated, i.e. under the required ambient conditions such as sufficient heat, low humidity, etc.). The antibodies that may be present in the patient's blood can now react with the antigens applied to the disc (here the allergens) and create complexes, i.e. Form stable chemical compounds.
These complexes are then detected by reacting with the radioactively labeled proteins by measuring the radioactivity of the entire sample. (To do this, the radioactive proteins that have not reacted with one of the complexes of allergen and patient antibody to be detected are removed).