Hay Fever and Allergies: When to See a GP
Why Hay Fever Hits Australians Hard
If you’re one of the four million Australians who dread the arrival of spring, you already know that hay fever is more than a minor inconvenience. Itchy eyes, a constantly blocked or running nose, sneezing fits, and a permanent feeling of fatigue can derail your work, sleep, and quality of life for months on end.
Australia has some of the highest hay fever rates in the world. Between September and December, much of the country becomes a pollen battleground — particularly Victoria, the ACT, and southern NSW where ryegrass season triggers severe symptoms. In some years, Melbourne even experiences thunderstorm asthma events, where the combination of high pollen counts and certain weather patterns can be life-threatening for those with grass pollen allergy.
The good news: hay fever is highly treatable, and your GP can do far more than recommend an antihistamine. Persistent or severe allergies often have a clear treatment pathway that can dramatically improve symptoms.
What Hay Fever Actually Is
Hay fever — properly called allergic rhinitis — is an immune system overreaction to harmless airborne particles. When your nose, eyes, or airways come into contact with the trigger (the allergen), your body releases histamine and other inflammatory chemicals, causing the familiar symptoms.
Despite the name, hay is rarely the actual culprit. Common allergens in Australia include:
- Grass pollens — particularly perennial ryegrass (the main trigger in southern Australia from October to December)
- Tree pollens — birch, cypress, oak, and others (late winter to early spring)
- Weed pollens — including Paterson’s curse, plantain, and ragweed (late summer to autumn)
- Mould spores — present year-round, peaks after rain
- Dust mites — perennial allergen, worst in bedding and carpeted areas
- Animal dander — from cats, dogs, horses
- Cockroach proteins — common in older inner-city homes
Symptoms of Hay Fever
- Sneezing, often in fits
- Runny or blocked nose
- Itchy nose, throat, or roof of the mouth
- Itchy, watery, or red eyes (allergic conjunctivitis)
- Postnasal drip and persistent throat clearing
- Cough (especially at night)
- Headache or facial pressure
- Fatigue and difficulty concentrating
- Disturbed sleep
- Worsening of asthma symptoms
When to See a GP About Hay Fever
Many Australians manage hay fever with over-the-counter antihistamines and never see a doctor. That works for mild, intermittent symptoms. But you should see a GP if:
- Symptoms persist for more than 4 weeks per year (defined as persistent allergic rhinitis)
- Symptoms interfere with sleep, work, school, or daily activities
- Over-the-counter antihistamines are not working
- You also have asthma, particularly if asthma symptoms worsen during pollen season
- You experience facial pain, fever, or thick green nasal discharge — possible sinusitis
- You have severe eye symptoms — possible vernal or atopic keratoconjunctivitis
- You’re pregnant or breastfeeding and unsure which medications are safe
- Your child has hay fever symptoms — children often respond well to early treatment
How a GP Manages Hay Fever
Your GP will take a detailed history of your symptoms, triggers, family allergy history, and existing conditions. They will look at your nose, throat, and eyes and may listen to your chest to check for asthma involvement.
Allergy Testing
If your GP wants to identify your specific triggers, they can refer you for:
- Skin prick testing — quick, performed by an allergy specialist or some GPs. A small amount of allergen is applied to the skin and observed for a reaction
- Specific IgE blood test (RAST) — measures antibody levels for specific allergens. Useful when skin testing is contraindicated
Treatment
- Saline nasal sprays and rinses — flush allergens from the nasal passages, safe for everyone including pregnant women and children
- Intranasal corticosteroids (Avamys, Nasonex, Flixonase) — the most effective treatment for moderate to severe hay fever. Take daily during pollen season for best effect. Available over the counter for adults but should be discussed with your GP for long-term use
- Non-sedating antihistamines (loratadine, cetirizine, fexofenadine, desloratadine) — reduce sneezing, itching, and runny nose. Daily use during peak season is safe
- Antihistamine eye drops for itchy, watery eyes
- Combination medications — corticosteroid + antihistamine in one nasal spray
- Oral corticosteroids — short course for severe symptoms, prescribed by GP
Allergen Immunotherapy (Desensitisation)
For patients with confirmed allergic rhinitis who do not respond well to medication or want a long-term solution, immunotherapy may be life-changing. This involves giving small, gradually increasing amounts of the allergen — either as injections or sublingual tablets/drops — to retrain the immune system. Treatment takes 3–5 years, but symptom improvement is often dramatic and can be permanent.
Your GP can refer you to a clinical immunologist for assessment.
Hay Fever and Asthma: A Critical Link
Up to 80% of people with asthma also have allergic rhinitis, and untreated hay fever significantly worsens asthma control. This connection is particularly important in Australia because of our risk of thunderstorm asthma — a phenomenon where springtime thunderstorms break grass pollen into smaller particles that penetrate deep into the lungs, triggering severe asthma attacks even in people who have never had asthma before.
If you have hay fever and asthma, or hay fever and have ever had wheezing, see your GP before pollen season starts. Pre-treatment with intranasal steroids and asthma preventers can dramatically reduce your risk of an attack.
Practical Tips to Reduce Allergen Exposure
- Check daily pollen counts (the BoM and various weather apps publish them)
- Stay indoors on high-pollen days, especially windy afternoons
- Keep car and bedroom windows closed during peak season
- Shower and change clothes after spending time outdoors
- Use a HEPA filter air purifier in the bedroom
- Wash bedding weekly in hot water (helps with dust mites)
- Vacuum with a HEPA-filter cleaner
- Avoid hanging washing outside on high-pollen days
- Wear wrap-around sunglasses outdoors to reduce eye exposure
Frequently Asked Questions
Do non-sedating antihistamines really not cause drowsiness?
Most patients find newer antihistamines (loratadine, cetirizine, fexofenadine, desloratadine) cause minimal or no drowsiness. Some people are more sensitive than others. Avoid older antihistamines (chlorpheniramine, promethazine) for daytime use.
Is it safe to use a steroid nasal spray every day?
Yes, intranasal corticosteroids are safe for daily use during pollen season and are far less risky than oral steroids. They are the most effective single treatment for moderate to severe hay fever. Discuss long-term use with your GP.
My child has hay fever. What can I give them?
Children’s antihistamines and saline nasal sprays are safe from a young age. Some intranasal corticosteroids are approved for children as young as 2. Always check with a GP or pharmacist for age-appropriate dosing.
Can I outgrow hay fever?
Some people experience reduced symptoms with age, but most adults who have hay fever continue to have it. Immunotherapy is the only treatment that has been shown to provide lasting reduction in symptoms after treatment ends.
Is thunderstorm asthma really a risk for me?
If you have grass pollen allergy AND have ever wheezed or had asthma, yes. Melbourne’s 2016 thunderstorm asthma event killed 10 people and sent thousands to hospital. See your GP for an asthma action plan and consider preventer medication during pollen season.
Don’t Suffer Through Another Pollen Season
Hay fever is more treatable than ever, and a good GP can transform your spring from miserable to manageable. Family Doctor clinics across Australia can assess your symptoms, prescribe effective medications, refer you for testing, and create a personalised plan — including pre-season treatment to get ahead of the worst weeks.