Hay Fever

What is hay fever?

Hay fever, also known as allergic rhinitis (say: rine-EYE-tis), is an allergic reaction to pollen. Symptoms of hay fever are seasonal, meaning you will feel worse when the pollens that affect you are at their highest levels. Hay fever is the most common form of allergy. It affects 1 in 5 people.

What causes hay fever?

Hay fever is caused by pollen, a common allergen. Allergens are chemicals that cause your body to respond with an allergic reaction. When you are exposed to something you are allergic to, your body releases chemicals. One type of chemical that is released is histamine. Histamine is your body’s defense against the allergen. The release of histamine causes swelling, itching, sneezing, watering eyes and nose—all the symptoms of hay fever.

Hay fever is usually caused by small, hard-to-see pollens, like those from trees, grasses and weeds. Common pollens and when they increase allergy symptoms (depending on where you live) include:
  • Tree pollen—early spring
  • Grass pollen—late spring and early summer
  • Weed pollen, such as ragweed—midsummer to late fall
If you are allergic to pollen, you will notice your symptoms are worse on hot, dry days when wind carries the pollen. On rainy days, pollen often is washed to the ground, which means you are less likely to breathe it.

What are the symptoms of hay fever?

Symptoms vary depending on the severity of your allergies. Symptoms can include:
  • Sneezing
  • Coughing
  • Itching (mostly eyes, nose, mouth, throat and skin)
  • Runny nose
  • Stuffy nose
  • Headache
  • Sore throat
  • Watery, red or swollen eyes
  • Circles under your eyes
  • Trouble smelling

How does hay fever differ from a cold or the flu?

Hay fever lasts longer than a cold or the flu—up to several weeks—and does not cause fever. The nasal discharge from hay fever is thin, watery and clear, while nasal discharge from a cold or the flu tends to be thicker. Itching (mostly eyes, nose, mouth, throat and skin) is common with hay fever but not with a cold or the flu. Sneezing is more prominent with hay fever and can occur in rather violent bouts.

When should I see a doctor?

If your symptoms interfere with your life, consider seeing your family doctor. Your doctor will probably do a physical exam and ask you questions about your symptoms. Keeping a record of your symptoms over a period of time can help your doctor determine what triggers your allergies.

How is hay fever treated?

Several medicines can be used to treat hay fever. Your doctor will help you determine what medicine is best for you depending on your symptoms, age and overall health.

Antihistamines help reduce the sneezing, runny nose and itchiness of allergies. They're more useful if you use them before you're exposed to allergens. Some antihistamines come in pill form (some brand names: Zyrtec, Dayhist, Claritin) and some are nasal sprays (one brand name: Astelin).

Some antihistamines can cause drowsiness and dry mouth. Others are less likely to cause these side effects, but some of these require a prescription. Ask your doctor which kind is best for you.

Decongestants, such as pseudoephedrine and phenylephrine, help temporarily relieve the stuffy nose of allergies. Decongestants are found in many medicines and come as pills, nose sprays and nose drops (some brand names: Sudafed, Afrin, Sinex). They are best used only for a short time.

Nose sprays and drops shouldn't be used for more than 3 days because you can become dependent on them. This causes you to feel even more stopped-up when you try to quit using them.

You can buy decongestants without a doctor's prescription. However, decongestants can raise your blood pressure, so it's a good idea to talk to your family doctor before using them, especially if you have high blood pressure.

Cromolyn sodium
is a nasal spray (one brand name: NasalCrom) that helps prevent the body's reaction to allergens. Cromolyn sodium is more helpful if you use it before you're exposed to allergens. This medicine may take 2 to 4 weeks to start working. It is available without a prescription.

Nasal steroid sprays (two brand names: Flonase, Nasacort) reduce the reaction of the nasal tissues to inhaled allergens. This helps relieve the swelling in your nose so that you feel less stopped-up. They are the most effective at treating patients who have chronic symptoms Nasal steroid sprays are available with a prescription from your doctor. You won't notice their benefits for up to 2 weeks after starting them.

Eye drops. If your other medicines are not helping enough with your itchy, watery eyes, your doctor may prescribe eye drops for you.

Allergy shots (also called immunotherapy) are an option for people who try other treatments but still have allergy symptoms. These shots contain a very small amount of the allergen you are allergic to. This helps decrease your body’s sensitivity to the allergen. Over time, your allergy symptoms will become less severe.

How can I avoid getting hay fever?

The best way to deal with hay fever is to avoid the allergens that cause it. Shower or bathe before bedtime to wash off pollen and other allergens in your hair and on your skin. Avoid going outside, especially on dry, windy days. Keep windows and doors shut, and use an air conditioner at home and in your car.

More Information

For more information talk to your doctor.


Written by familydoctor.org editorial staff.

American Academy of Family Physicians

Created: 11/09