13-05-2025
Top allergy expert reveals ultimate guide to managing hay fever - and why jabs are never the answer
Suffering from a blocked nose, itchy eyes and a scratchy throat suddenly? Sounds like you may have hay fever. While for many people, it's just a common allergy that bothers them for a few days of spring and summer each year, there is a significant number of people for whom it's a real problem, and has a massive impact on their quality of life. So what's the best way to treat it?
Professor Adam Fox, one of the UK's leading allergy experts, sat down with Dr Daniel Gordon on his YouTube channel, The Health Perspective, to discuss what actually works when it comes to managing hay fever symptoms.
@drdanielgordon
I asked one of the UK's leading allergy specialists @dradamfox exactly what he recommends to patients who feel like nothing is working when it comes to Hay Fever. When to start treatment, what to prioritise, what actually makes a difference… he laid it all out. And honestly, I learnt more in this episode than I think I have known in a lifetime! If you're relying on antihistamines alone, or considering more drastic options, this is a must watch. Full episode on YouTube. #HayFever #TheHealthPerspective #AllergySeason #AdamFox #SpringAllergies #Pollen #NasalSpray #allergy
♬ original sound - Dr Daniel Gordon | GP - Dr Daniel Gordon | GP
Start by getting the right antihistamines
The first step, for people whose hay fever is a mild irritation, is to visit your pharmacy and ask for the right antihistamines.
'Make sure it's a long-acting, non-sedating antihistamine, because one of the common problems – and frustratingly sometimes this is the advice from the pharmacy – is to use a short-acting, sedating antihistamine, which can make you feel worse and doesn't really do that much for your hay fever,' explains Dr Fox.
'So, avoid Piriton – or chlorphenamine, which is the medical name – and go for cetirizine, loratadine or fexofenadine.'
If you know you're going to need antihistamines all season, Dr Fox recommends buying them in bulk from online pharmacists. 'It's really cheap compared to buying the colourful-packet, branded stuff.'
Pair with non-medical solutions
While antihistamines offer a medical solution for treating hay fever, Dr Fox also shares a few non-medical tips that will help to alleviate your allergy symptoms.
Salt water nasal sprays are surprisingly good – they just rinse all the allergen out and also have a bit of an anti-inflammatory effect.
Putting a bit of pollen balm or Vaseline around your nostrils will stop the pollen going up.
Washing your hair before bedtime will prevent the pollen that's collected in your hair from rubbing on your pillow and rubbing on your nose overnight.
Avoid drying your clothes outside on days when the pollen count is high.
'All of those things are only going to have a small effect, but if your hay fever is mild, you don't need to get more medical than that,' he advises.
Steroid nasal sprays are the next step
If, however, you've got proper hay fever symptoms and the antihistamines aren't doing the job, then the next step is a nasal steroid. For adults, these are over-the-counter; for kids, these are on prescription.
'They're very safe,' reassures Dr Fox. 'They've been around for a very long time and the dose is very small. It stays locally rather than being absorbed into your system. As long as you stick to the regular doses, you shouldn't have to worry about things like growth.'
'He also mentions that nasal steroids work better when you start using them before the season's kicked off.
'So if you know you've got hay fever and you know that every mid to late April your symptoms from the grass pollen season are going to kick off, then in late March/early April, start your regular nasal spray and that'll make a real difference.'
'There's no value in starting antihistamines in advance, you can just take those as and when you need them,' he adds.
If all else fails: double dose
According to Dr Fox, most people can treat hay fever if they start using their nasal steroid spray early, use it regularly throughout the season, and take extra doses of antihistamine when they suffer from breakthrough symptoms. If they have particular eye symptoms, they might also want to get eye drops.
If all of that isn't working together, he recommends having a chat with your pharmacist or doctor, because usually you can double up all of those medicines. 'Over-the-counter doses are pretty conservative because they're for over-the-counter use – you can certainly do better than that.'
There is, however, a small group of patients – probably around 15 per cent of hay fever sufferers – for whom, even though they're doing all of that, it's still a problem. 'That's when we'll start to talk to them about the other options,' says Dr Fox.
Steroid injections are never a solution
That said, no matter how bad your hay fever gets, you should never use steroid injections to alleviate your symptoms, warns Dr Fox.
'It's a hard position to take because there's no point pretending – they do work. And the way they work is that a huge dose of steroid gets injected into your bum and is very gradually and slowly released over the course of a couple of months.'
'The frustration is that people aren't properly counselled on what the longer term side effects are, and the longer term steroid risks of bone fractures, poor bone density, glaucoma, cataracts – things that aren't going to affect you just after the injection.
'And if you keep doing this year on year, your risk gets really, really significantly higher.'
'The truth is that most people are getting it because it's a quick fix, and they're not aware there are other ways of managing hay fever that will be harder work, but will have similar outcomes and not have any of those risks.'
