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Pollen Allergy Hay Fever - Causes & Treatment

Pollen allergy (hay fever) is an allergic reaction to airborne pollen. Common symptoms include sneezing, itchy eyes, and a runny nose.

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Pollen allergy (hay fever) is an allergic reaction to airborne pollen. Common symptoms include sneezing, itchy eyes, and a runny nose.

What is Pollen Allergy (Hay Fever)?

Pollen allergy, medically known as pollinosis or allergic rhinitis, is one of the most common allergic conditions worldwide. Colloquially referred to as hay fever, it occurs when the immune system overreacts to pollen from grasses, trees, or weeds -- substances that are completely harmless to non-allergic individuals. In many countries, up to 20% of the population is affected.

Causes

Pollen allergy develops due to a malfunction of the immune system. Upon first exposure to pollen, the body produces specific antibodies (IgE). Subsequent exposures trigger an exaggerated immune response, releasing histamine and other inflammatory mediators that cause allergy symptoms.

  • Genetic predisposition: Individuals with a family history of allergies or asthma are at higher risk.
  • Common allergens: Birch pollen (spring), grass pollen (summer), mugwort and ragweed pollen (late summer/autumn).
  • Environmental factors: Air pollution and climate change intensify pollen loads and may contribute to rising allergy rates.

Symptoms

Symptoms are seasonal and correspond to the relevant pollen season:

  • Frequent sneezing and runny nose
  • Blocked nose (nasal congestion)
  • Itchy, red, and watery eyes (allergic conjunctivitis)
  • Scratchy or burning throat
  • Fatigue and difficulty concentrating
  • In severe cases: allergic asthma with coughing and shortness of breath

Diagnosis

Diagnosis is made by a physician based on medical history and specific allergy tests:

  • Skin prick test: Small amounts of various pollen extracts are applied to the skin to observe any allergic reaction.
  • Blood test (RAST/IgE test): Measures allergen-specific IgE antibodies in the blood.
  • Nasal provocation test: The allergen is applied directly to the nasal mucosa to assess the response.

Treatment

Medication

Several medications can effectively relieve hay fever symptoms:

  • Antihistamines: Block the effects of histamine, reducing sneezing, itching, and runny nose.
  • Intranasal corticosteroids: Reduce inflammation in the nasal lining and are considered the most effective first-line treatment.
  • Decongestant nasal sprays: Provide short-term relief of nasal congestion (not suitable for long-term use).
  • Eye drops: Relieve allergic eye symptoms (e.g., cromoglicate or antihistamine eye drops).

Allergen Immunotherapy (Desensitisation)

Allergen immunotherapy (AIT) is the only treatment that addresses the root cause of the allergy. The allergen is administered in gradually increasing doses to desensitise the immune system over time. It can be delivered as subcutaneous injections (SCIT) or as sublingual tablets or drops (SLIT). Treatment typically lasts 3 years and can provide long-lasting relief even after completion.

General Measures

  • Monitor pollen forecasts and reduce outdoor activities on high-pollen days
  • Keep windows closed during peak pollen periods
  • Wash hair and change clothes after spending time outdoors
  • Use pollen filter screens on windows
  • Plan holidays in low-pollen areas such as coastal or high-altitude regions

References

  1. World Health Organization (WHO): Allergic Rhinitis and its Impact on Asthma (ARIA) Guidelines, 2022.
  2. Bousquet J. et al.: Allergic Rhinitis and its Impact on Asthma (ARIA) 2008 Update. Allergy, 2008;63(Suppl 86):8-160.
  3. Kleine-Tebbe J. et al.: Specific Immunotherapy for IgE-mediated Allergic Diseases. Allergo Journal International, 2018;27:8-33.

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