Managing Hayfever and Seasonal Allergies

ByFamily Doctor Editorial

Hayfever — allergic rhinitis — affects around 20% of Australian adults and children. For many, it’s a seasonal nuisance. For others, it’s a year-round problem that disrupts sleep, concentration, and daily life. Treatment has come a long way; most people can get their symptoms largely under control with the right approach.

What Causes Hayfever

Hayfever is an allergic reaction to airborne particles. Common triggers:

  • Pollens — grasses (worst in spring/early summer), trees (late winter/spring), weeds (summer/autumn)
  • Dust mites — year-round; worse in bedrooms
  • Mould spores — year-round; worse in humid weather
  • Pet dander — year-round if exposed
  • Occupational exposures — flour, wood dust, latex, chemicals

Symptoms

  • Sneezing, often in bursts
  • Runny nose with clear mucus
  • Blocked or congested nose
  • Itchy nose, eyes, throat, or palate
  • Watery, red, puffy eyes
  • Post-nasal drip and throat clearing
  • Reduced sense of smell
  • Tiredness, poor sleep, impaired concentration
  • Worsening of asthma if you have it

Diagnosis

Most hayfever is diagnosed clinically — by your GP asking about symptoms and triggers. Tests that can help identify specific allergens:

  • Skin prick testing — done by an allergy specialist; drops of allergen extracts applied to the skin.
  • Specific IgE blood tests — your GP can order these, though they’re less sensitive than skin testing.

Testing isn’t always needed — if your triggers are obvious and treatment works, further investigation may not change management.

Treatment Options

Avoidance (when practical)

  • Check local pollen counts; stay indoors during peak
  • Keep windows closed on high-pollen days; use air conditioning
  • Shower after being outdoors to remove pollen
  • Dust mite covers on mattresses and pillows; wash bedding weekly in hot water
  • Reduce pet exposure to sleeping areas

Antihistamines (non-sedating)

Loratadine, cetirizine, fexofenadine, desloratadine. Available over the counter. Effective for sneezing, itching, and runny nose. Less effective for blocked nose. Daily use during the allergy season is usually more effective than reacting to symptoms. Avoid older sedating antihistamines (diphenhydramine, promethazine) for routine use — they impair driving and work.

Intranasal corticosteroid sprays

The most effective single treatment for moderate-severe hayfever. Options include fluticasone, mometasone, budesonide, ciclesonide. Take 1-2 weeks for full effect — use daily, not just when symptomatic. Technique matters — spray toward the outside of the nostril, not straight up. Some are over-the-counter; others require prescription.

Combination sprays

Steroid + antihistamine sprays (e.g., azelastine + fluticasone) combine two mechanisms — more effective than either alone for moderate-severe symptoms.

Saline rinses

Nasal saline rinses (neti pots, squeeze bottles, or ready-made sprays) wash out allergens and mucus. Simple, safe, and surprisingly effective — especially combined with other treatments.

Eye drops

For itchy, watery eyes: antihistamine drops (olopatadine, ketotifen) or combination drops. Often more effective than oral antihistamines alone for eye symptoms.

Allergen immunotherapy (desensitisation)

For people whose symptoms aren’t controlled by standard treatments, immunotherapy can retrain the immune system. Options:

  • Sublingual tablets (under the tongue) for grass, dust mite, or ragweed allergies.
  • Sublingual drops — customised allergen formulas.
  • Subcutaneous (injection) immunotherapy — monthly injections after a build-up phase; typically 3-5 year course.

Immunotherapy can produce lasting improvement after treatment ends — unlike symptomatic treatments. Your GP can refer you to an allergist or immunologist if this interests you.

Hayfever and Asthma

Hayfever often coexists with asthma — and untreated hayfever frequently worsens asthma control. Treating nasal allergies often improves asthma symptoms. If you have both, make sure both are optimally managed.

Thunderstorm Asthma

A specific Australian phenomenon, particularly in Victoria. During grass pollen season, certain thunderstorms can trigger severe asthma attacks even in people with mild or no usual asthma symptoms. If you have a history of spring hayfever or asthma, check your preventer medication is up to date, have a reliever on hand, and pay attention to thunderstorm asthma forecasts.

Frequently Asked Questions

Can children use nasal steroid sprays?

Yes — specific products are approved for children from age 2 or 6 depending on the brand. Check with your GP or pharmacist.

Are nasal steroid sprays addictive?

No. You’re thinking of decongestant sprays (oxymetazoline, xylometazoline) — which shouldn’t be used more than 5 days because of rebound congestion. Steroid sprays are safe for long-term use.

Why does my hayfever get worse over time?

Cumulative exposure can increase sensitivity, new allergens can develop, or your overall immune response can change. Sometimes a different or stronger treatment helps.

Should I see an allergy specialist?

Consider specialist referral if your symptoms aren’t controlled on standard treatments, if you want allergen testing and immunotherapy, or if you have other allergic conditions (food allergy, severe asthma).

Book a Hayfever Review

If over-the-counter treatments aren’t controlling your symptoms, see your GP. Find your nearest Family Doctor clinic.

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