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Allergies and Hay Fever

What are Allergies?

Hay fever, also known as allergic rhinitis, can cause cold-like symptoms such as a runny nose, congestion, sneezing or sinus pressure. But unlike a cold, allergies aren’t caused by a virus — it’s caused by an allergic response to specific substances in your environment. Allergy signs and symptoms start whenever you’re exposed to those substances.

You may have seasonal allergy symptoms that start or get worse at a particular time of year, triggered by tree pollen, grasses or weeds. If you’re sensitive to indoor allergens such as dust mites, cockroaches, mold or pet dander, you may have year-round symptoms.

While hay fever can make you miserable, you are not alone — it’s one of the most common allergic conditions, affecting about one in five people in the United States. You may never be able to completely avoid hay fever symptoms — but treatment and prevention can help a lot.

Over-the-counter medications may be enough to manage your mild hay fever symptoms. But if your symptoms are more severe — or if hay fever is a year-round nuisance — see an allergy specialist for evaluation and treatment. Without proper treatment, hay fever can impair your quality of life and cause sleeplessness, fatigue and irritability that affect your performance at work or school. It may increase your risk of developing more serious allergic conditions such as asthma or eczema.

What are Allergies?

Signs and symptoms of Allergies

Signs and symptoms of hay fever can range from mild to severe. If your condition is mild, you may have brief, infrequent episodes of a runny nose and itchy, watery eyes. At the other extreme, you may have persistent, severe symptoms that last more than four days a week or longer than four weeks at a time. Chronic congestion may cause facial pressure and pain, alter your sense of taste and smell, and affect your appearance. The skin under your eyes may swell and turn bluish as you develop what are sometimes called “allergic shiners.”

Hay fever symptoms usually develop immediately after you’re exposed to specific allergy-causing substances (allergens). Common allergens include pollen, dust mites, cockroaches, mold and pet dander. Sometimes, exposure to irritants such as perfume and tobacco smoke can trigger or worsen symptoms.

Signs and symptoms of hay fever may include:

  • Runny nose
  • Watery eyes
  • Congestion
  • Frequent sneezing
  • Itchy eyes, nose, roof of mouth or throat
  • Swollen, blue-colored skin under the eyes (allergic shiners)
  • Cough
  • Facial pressure and pain

Hay fever can also cause:

  • Sleeplessness
  • Fatigue
  • Irritability

It may be difficult to distinguish hay fever from a cold. Here’s how to tell the difference:

  Hay fever Colds
Signs and symptoms Runny nose with thin, watery discharge; no fever Runny nose with watery to thick yellow discharge; low-grade fever
Onset Immediately after exposure to allergens One to three days after exposure to cold virus
Duration As long as you’re exposed to allergens Five to seven days

Causes of Allergies

If you have hay fever, you may react to one or more common inhaled allergens. No matter what you’re allergic to, the underlying cause of your misery is the same. During a process called sensitization, your immune system mistakenly identifies the allergen as an invader and produces an antibody against it called immunoglobulin E (IgE).

The next time you’re exposed to the allergen, your immune system launches an allergic reaction. The IgE antibodies trigger the release of inflammatory chemicals, including histamine, which swells the mucous membranes in your nose, sinuses and eyes, causing a runny nose, watery eyes and sneezing.

Hay fever doesn’t mean that you’re necessarily allergic to hay. Despite its name, hay fever is almost never triggered by hay, and it doesn’t cause a fever. It got its name in the early 1800s when British doctors noticed that some rural residents experienced sneezing, itchy eyes and coughing after exposure to cut hay or grass. At the time, doctors didn’t realize that the probable culprit was an allergic reaction to pollen or mold. They called the condition a “fever” because it caused nervousness, one of the old English definitions of fever. Most hay fever reactions are triggered by seasonal allergens or by environmental allergens that are present year-round.

Seasonal hay fever symptoms can be caused by:

  • Tree pollen, common in the spring
  • Grass pollen, common in the late spring and summer
  • Weed pollen, common in the fall
  • Spores from fungi and molds, which can be worse during warm weather months

Year-round (perennial) signs and symptoms can be caused by:

  • Dust mites
  • Animal dander (dried skin flakes and saliva)
  • Cockroaches
  • Spores from indoor and outdoor fungi and molds

Heredity plays a key role in determining who gets allergies, including hay fever. You may be more likely to develop hay fever if allergies or asthma runs in your family.

Although hay fever can begin at any age, you’re most likely to develop it during childhood or early adulthood. As you get older, your symptoms may worsen or improve. The severity of hay fever tends to diminish slowly, often over decades.

Risk factors for Allergies

The following risk factors may increase your risk of developing hay fever:

  • Family history of allergies
  • Male gender
  • Birth during pollen season
  • Being a firstborn child
  • Exposure to cigarette smoke during your first year of life
  • Exposure to dust mites

When to seek medical advice

If you have occasional symptoms of hay fever and haven’t found relief from using over-the-counter medications, see your doctor to design a treatment program. You may need an allergy specialist for an accurate and complete diagnosis. See your doctor if:

  • Your problems are persistent
  • You have side effects from medications or your medications haven’t worked
  • You have another condition along with hay fever, such as nasal polyps, asthma or frequent sinus infections
  • Your child has hay fever — early allergen immunotherapy may help prevent your child from developing asthma

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