Hay fever can make asthma symptoms worse

Hay fever is the common name for allergic rhinitis.

It is an allergic reaction to allergens, or triggers, breathed in through the nose. This causes an immune response in the lining of the nose where the nasal passages become red, swollen and sensitive. Some people may experience hay fever at certain times of the year, for example spring or summer, and other people experience these symptoms all year round.

Symptoms of hay fever

Common symptoms of hay fever

  • Itchy nose or eyes
  • Runny nose
  • Sneezing
  • Blocked nose
  • Throat clearing or coughing to clear the throat
  • Snoring
  • Mouth breathing
  • Always feeling like you have a head cold

Other symptoms

  • Disturbed sleep
  • Daytime tiredness
  • Poor concentration
  • Recurrent headaches
  • Frequent sore throats
  • Hoarse voice
  • Facial pain or pressure
  • Reduced sense of smell
  • Recurrent sinus infections in adults
  • Frequent ear infections in children

You may only experience some of these symptoms. You do not need to have all symptoms to have hay fever.

How can hay fever impact your asthma?

Asthma affects 2.7 million Australians, and about 80 per cent of people with asthma also have hay fever.

Asthma and hay fever both involve airway inflammation and sensitivity throughout the respiratory system. This means it is important to treat the nose as well as the lungs to achieve good asthma management.

Hay fever can make asthma worse and more difficult to control

The reason that the presence of hay fever can make asthma more difficult to control is not entirely clear.

It has been suggested that breathing through your mouth when your nose is blocked can further aggravate asthma by bypassing the nose’s filtering and humidifying function. Another thought is that nasal inflammation triggers lower airway inflammation and narrowing.

People with asthma who have hay fever experience:

  • More asthma flare-ups
  • More visits to their GP and asthma-related hospitalisations
  • More time off work or school
  • Higher annual medical costs 2,3,4

Research shows treating hay fever can reduce asthma-related emergency department visits and hospitalisations, and may help to improve your asthma symptoms.

It is important to treat and manage both your asthma and hay fever well.

Tips for people with hay fever

If you have hay fever and asthma, treating your hay fever will help keep your asthma under control.

Manage your asthma and hay fever

  • Know the symptoms of hay fever and asthma
  • Have the right plan and medications in place to best handle your symptoms
  • Check you are using your asthma and hay fever medications correctly

Before starting hay fever treatment tell your doctor or pharmacist if you have any other medical conditions, are pregnant, taking other medications, or experience nose bleeds

If you have hay fever and/or asthma you may be at risk of thunderstorm asthma.

For information and support about asthma call our Asthma Educators on 1800 ASTHMA (1800 278 462).

Treat your hay fever symptoms

Managing hay fever is an important part of overall asthma care as hay fever can make asthma worse and more difficult to control. Treatment of hay fever depends on the severity and frequency of your hay fever symptoms.

There are a range of different treatments available.

For mild intermittent hay fever symptoms, speak to your doctor or pharmacist about:

Antihistamines

Antihistamines tablets are the most common choice for people with mild or occasional hay fever. They help to relieve a runny nose, sneezing, itching and eye symptoms. They are less effective in treating a blocked nose.

Antihistamines are available over the counter at your pharmacy. You should avoid the types of antihistamines that can make you drowsy.  Newer antihistamines known as non-sedating antihistamines are less likely to make you drowsy and are a common choice for people with milder or occasional symptoms of hay fever. Avoid using sedating anti-histamines in children.

Saline sprays/irrigation:

Saline solutions can be used to help clear nasal congestion, wash away dust, pollen and other irritants and as a result, have the potential to relieve hay fever symptoms. They should be used about 10 – 15 minutes before other medicated nasal sprays. Ask your pharmacist or doctor about preservative-free nasal salines or washes especially if you’re using other medicated nasal sprays.

If your hay fever symptoms are persistent or moderate-to-severe intermittent, speak to your doctor or pharmacist about:

Corticosteroid nasal sprays:

These nasal sprays are the most effective treatment for persistent or moderate to severe hay fever symptoms. They work to reduce the swelling in the lining of your nose (just like your asthma preventer medications). They can reduce all symptoms of hay fever, particularly nasal congestion (blocked nose) but need to be taken regularly to work properly – they may take a few days to work.

Some corticosteroid nasal sprays are available over the counter at your pharmacy and others are available with a prescription. You should speak to your doctor or pharmacist about which nasal spray is best for you.

Tips for using nasal sprays

  1. Shake the bottle before each use.
  2. Blow nose before spraying if blocked by mucus.
  3. Tilt head slightly forward and gently insert nozzle into nostril.
  4. Aim the nozzle slightly away from the middle of the nose in line with the roof of the mouth.
  5. Press down the spray, but avoid sniffing hard during or after spraying.

Short-term addition of antihistamines or decongestants

Decongestant nasal sprays or tablets are used to unblock the nose. They should not be taken for more than a few days at a time. If you still continue to experience symptoms you should speak to your doctor. Ask your pharmacist or doctor about using a preservative-free nasal decongestant spray and when and how long to use it for.

Antihistamines are available over the counter at your pharmacy. You should avoid the types of antihistamines that can make you drowsy.  Newer antihistamines known as non-sedating antihistamines are less likely to make you drowsy and are a common choice for people with milder or occasional symptoms of hay fever. Avoid using sedating anti-histamines in children.

Speak to your doctor or pharmacists about the best treatment for your hay fever.

References and further information

  1. Australian Institute of Health and Welfare. Allergic rhinitis (‘hay fever’) in Australia. Cat. no. ACM 23. Canberra: AIHW; 2011. Available from: http:// www.aihw.gov.au/publication-detail/?id=10737420595
  2. Bousquet, J., Gaugris, S., Kocevar, V. S., Zhang, Q., Yin, D. D., Polos, P. G. and Bjermer, L. (2005), Increased risk of asthma attacks and emergency visits among asthma patients with allergic rhinitis: a subgroup analysis of the improving asthma control trial. Clinical & Experimental Allergy, 35: 723–727.doi:10.1111/j.1365-2222.2005.02251.x. http://onlinelibrary.wiley.com/doi/10.1111/j.1365-2222.2005.02251.x/full
  3. Pawankar R, Bunnag C, Chen Y, et al. Allergic rhinitis and its impact on asthma update (ARIA 2008)–western and Asian-Pacific perspective. Asian Pac J Allergy Immunol. 2009; 27: 237-243. Available from: http://www.ncbi.nlm.nih.gov/pubmed/20232579
  4. Price D, Zhang Q, Kocevar VS, et al. Effect of a concomitant diagnosis of allergic rhinitis on asthma-related health care use by adults. Clin Exp Allergy. 2005; 35: 282-7. Available from: http://www.ncbi.nlm.nih.gov/pubmed/15784104