Hay fever is a condition caused by an allergy to airborne substances such as grass or hay pollens, which affects the upper respiratory passages. The allergic reaction happens when your body mistakes the allergen e.g. pollen for a harmful substance.
Hay fever, asthma, food allergy and eczema are related allergic conditions and the tendency to develop them seems to run in families. Your body produces an antibody called immunoglobulin E (IgE) when you come into contact with an allergen. If there is a lot of pollen in the air you will produce IgE in reaction to it.
Signs and symptoms of hay fever can range from mild to severe. Mild hay fever is where you would get episodes of a runny nose, itchy and watery eyes. At the other extreme, you may experience persistent symptoms that last more than four days a week. Chronic congestion can cause facial pressure and pain and the possibility of change in taste. The skin beneath your eyes can swell and turn blue.
Hay fever signs and symptoms usually develop immediately after you're exposed to specific allergy-causing substances (allergens). Common allergens include pollen, dust mites, cockroaches, mould and pet dander. Sometimes, exposure to irritants such as perfume and tobacco smoke may trigger or worsen symptoms.
There is an injection that can relieve the symptoms of hay fever and it is available on the NHS. It is called Kenalog and contains a steroid. There are risks with steroids so the injection is only suitable for occasional use.
Up to two injections a year, are quite safe, and should be sufficient to cover the worst of the hay fever season. Kenalog is not used for mild symptoms of hay fever. It is only used for severe symptoms where the patient’s quality of life is affected.
Injections for hay fever are given as second or third line treatment; only after anti histamines and nasal sprays have been ineffective.
The possible risks associated with the use of injection therapy have to be weighed up against the benefits and in the light of the severity of the hay fever, as the injection is a steroid. It is given as a single intra-muscular injection into the buttock.
This injection is given when allergic symptoms appear, and can be effective in controlling symptoms for three months. It should only be given with caution to patients with inflammatory bowel disease, stomach ulcers, kidney and heart disease, liver failure and diabetes.
Ongoing review of the treatment is important. The patient is given a steroid treatment card, outlining the dosage and preparation given, so that should another doctor see them following an infection or accident, the details are available.
Depending on the dosage and length of treatment, there are side effects such as raised blood pressure, water retention and muscle weakness. Research has shown psychological effects such as euphoria after treatment.
Use should be limited in children, the elderly and pregnant or breastfeeding mothers. Dose and duration of treatment should be high enough to be effective, but no more. Advice is given to avoid contact with chickenpox or shingles for three months after injection, because a reduced immune response whilst on treatment increases the likelihood of severe infection.
Contact your local doctor if you think you have hay fever or if you think you may benefit from the injection.
