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Children’s Health Queensland Hospital and Health Service Children’s Health Queensland Hospital and Health Service

Hay fever (allergic rhinitis) fact sheet

Hay fever (allergic rhinitis)

Hay fever is the common name for allergic rhinitis, a chronic condition that causes an allergic reaction in the inside of the nose. However, hay fever can also affect the eyes, sinuses and throat.

Seasonal hay fever occurs mainly in spring and summer and affects people allergic to pollens (fine powders produced by trees, plants, flowers, weeds and grasses). Hay fever can also occur all year round – this is called perennial hay fever.

Hay fever is very common and affects up to 30 per cent of children.

If hay fever is not managed well, it can also be a risk factor for the development of asthma, sinusitis (sinus infections), or middle-ear infections.

Signs and symptoms

Children with hay fever may experience mild to severe symptoms including:

  • A runny nose
  • Frequent bouts of sneezing
  • Itchy, swollen and/or watery eyes
  • Itchy ears, nose, throat and roof of the mouth
  • A blocked nose
  • Headaches
  • Snoring

If hay fever is left untreated, it can cause poor quality sleep and tiredness during the day, which can significantly impact learning and quality of life.

What causes hay fever?

Hay fever is triggered by dust, pollens, mould, animal hair and other tiny particles in the air we breathe. Someone with hay fever is allergic to some of the particles that get trapped by the small hairs and mucus in the nose.

Hay fever symptoms can be triggered by seasonal changes or occur throughout the year. Triggers include:

  • pollen (from grasses, flowers and trees)
  • dust mites
  • animal fur or hair (dander)
  • mould spores
  • cigarette smoke.

How is it diagnosed?

Diagnosis is generally based on having the above symptoms. Allergy testing (blood tests and skin prick tests) can help identify what is contributing to your child’s hay fever.

A skin prick test (also called a puncture or scratch test) safely checks for an immediate allergic reaction when a small amount of a known substance is applied to the skin (usually on the forearm).

Hay fever treatments

Hay fever can not be cured but there are ways to manage it and improve symptoms.

Avoiding allergens

If specific environmental triggers or allergens are identified as a cause of your child’s hay fever, the best way to reduce the frequency and severity of hay fever symptoms is to avoid or at least minimise exposure. See our fact sheet: Reducing allergens in the home.

Medical management

  • Saline nasal spray is a saltwater spray available over the counter. Apply one spray to each nostril and then blow the nose to clear mucous. This should be done before using steroid nasal sprays to ensure a clear nose and better contact between the medicated spray and their nasal lining.
  • Intranasal corticosteroid and/or antihistamine nasal sprays are medicated steroids – most require a prescription. Intranasal corticosteroids are well tolerated by children and can be used long-term without problems. Most side-effects are due to local irritation and can be reduced if used with appropriate technique. Your allergist will advise on which nasal sprays to use.
    • Use once a day for at least 4–6 weeks until symptoms resolve then stop.
    • If symptoms recur, restart sprays for at least 3-4 days or until symptoms are controlled.
  • Oral antihistamines (non-sedating) should be taken when symptoms are severe, or prior to going into a situation which usually causes symptoms.

It’s important to seek advice from your pharmacist or doctor on the best treatments as extended use of some medicines may cause more problems for your child.

Immunotherapy

Immunotherapy (also known as desensitisation), reduces the severity of symptoms and the need for regular medications. Small amounts of allergen are given by injections or by sublingual tablets, sprays or drops (under the tongue). Treatment is usually for 3 to 5 years and is typically offered for people older than five years of age with severe allergic rhinitis. This is a long-term treatment that should be initiated by an immunology/allergy specialist.

Key points

  • Hay fever is an allergic reaction that mainly affects the nose.
  • It is common in spring and summer but can occur all year round.
  • There is no cure for hay fever but symptoms can be managed.
  • Avoiding triggers is the best way to manage symptoms.

For more information

Australasian Society of Clinical Immunology and Allergy (ASCIA) | allergy.org.au

Developed by the Paediatric Immunology and Allergy Service, Children’s Health Queensland. We acknowledge the input of consumers and carers.

Resource ID: FS279 Reviewed: July 2021

Disclaimer
This information has been produced by healthcare professionals as a guideline only and is intended to support, not replace, discussion with your child’s doctor or healthcare professionals. Information is updated regularly, so please check you are referring to the most recent version. Seek medical advice, as appropriate, for concerns regarding your child’s health.

CHQ